The saphenous nerve runs along the medial aspect of the distal femur. --- Send in a voice message: https://anchor.fm/orthobullets/message Introduction: Post-operative knee pain is common following intramedullary nailing of the tibia, regardless of surgical approach, though the exact source is controversial. --- Send in a voice message: https://anchor.fm/orthobullets/message A Daily High-Yield review podcast by Orthobullets⏤the Free Learning & Collaboration Community for Orthopaedic Surgery Education. In this episode, we review the topic of Knee Arthroscopy from the Approaches section. patient is supine with the affected hip in a flexed, abducted, and externally rotated position. --- Send in a voice message: https://anchor.fm/orthobullets/message --- Send in a voice message: https://anchor.fm/orthobullets/message Treatment depends on etiology of failure, prior surgery and patient activity demands. Knee should be flexed during approach. the amount of dissection is variable, depending on the particular knee, but a good rule of thumb is to dissect the tibia posteriorly to the mid-coronal plane. Total knee arthroplasty. In this episode, we review the topic of Phases of Throwing from the Shoulder & Elbow section. We and our partners use cookies to personalize your experience, to show you ads based on your interests, and for measurement and analytics purposes. Open lateral meniscal tear repair. detach the pronator insertion from bone and retract medially. pronate the forearm to bring the insertion of the pronator teres, along the radial aspect of the radius, into view. Ankle anterolateral approach approaches orthobullets anterior posterolateral. DISCUSSION Transpatellar, medial, and lateral parapatellar ap-proaches with the knee in a flexed position are the most commonly used approaches for intramedullary stabilization of partially supinate the forearm. similar approach to medial parapatellar that spares VMO insertion and may lead to quicker recovery. Medial approach. longitudinal incision over the adductor longus. ... Orthobullets Team Draw a midline longitudinal incision from 2.5 cm above the patella, through the middle of the patella, and to the medial border of the tibial tubercle. 2. sharply dissect enough of the medial capsular sleeve off of the tibia to provide exposure of the joint. develop Historically, the most common surgical approaches position the knee in hyperflexion, including patellar tendon splitting (PTS) and medial parapatellar (MPP). 1. when compared to the standard medial parapatellar approach for revision total knee arthroplasties, the oblique rectus snip approach shows no difference in outcomes tibial joint line should be 1.5 to 2 cm above head of fibula (use xray of contralateral knee to determine exact distance) Please rate topic. Thank you for rating! --- Send in a voice message: https://anchor.fm/orthobullets/message Begin 2.5 anterior and 4cm distal to medial malleolus. Source: www.orthobullets.com. [11] described a modified anterior "swashbuckler" approach Diagnosis and etiology of TKA failure can be determined by a combination of physical examination, labs, and radiographs. A finger should be able to fit easily into the joint below the patella. 2. deepen dissection between the vastus medialis and quadriceps tendon. The Orthobullets Podcast In this episode, we review the topic of Shoulder Anterolateral Approach from the Approaches section. If it is too tight it can be difficult … Place the patient supine on the operating table. start midline; end 6 cm below the joint line with slight anterior curve; Superficial dissection . In addition, it may be used in retrograde nailing of intra articular fractures. MB BULLETS Step 1 For 1st and 2nd Year Med Students. In this episode, we review the topic of Knee Medial Parapatellar Approach from the Approaches section. carry the incision posteriorly along the medial surface of the foot. Recon L 5 palpate adductor tubercle along medial aspect of knee; make long, curved incision 2 cm proximal to the adductor tubercle. --- Send in a voice message: https://anchor.fm/orthobullets/message remove inner sleeve then drill through 1st cortex and nail. MB BULLETS Step 2 & 3 For 3rd and 4th Year Med Students. Superficial dissection. Patellar eversion is relatively easy because of the combination of the valgus deformity and the relative lateral-ization of the tibial tubercle. This extensile exposure serves as an anterior utility approach to the knee, allowing the surgeon access to all aspects of the anterior knee and near circumferential access to the distal femur. In this episode, we review the topic of Levator scapulae from the Anatomy section. Incision and superficial dissection. length of incision is determined by the amount of femur that needs to be exposed. MB BULLETS Step 1 For 1st and 2nd Year Med Students. This paper describes an extensile surgical approach to the distal femur, which incorporates the medial parapatellar arthrotomy. The Orthobullets Podcast In this episode, we review the high-yield topic of the Hip Medial Approach from the Approaches section. technique. Recently, Starr et al. --- Send in a voice message: https://anchor.fm/orthobullets/message Lateral Approach to Knee Joint can be used for: Exposure for lateral knee ligament repair or reconstruction. Visualization of the medial epicondyle for safe K-wire insertion when using bilateral crossed K-wiring. Calcaneus fractures. --- Send in a voice message: https://anchor.fm/orthobullets/message In this episode, we review the high-yield topic of Mallet Toe from the Foot & Ankle section. Medial parapatellar approach. Share. 1. Principles. This approach is used for medial femoral condylar fractures. In addition, it may be used in retrograde nailing of intra articular fractures. 2. Neurovascular structures. The saphenous nerve runs along the medial aspect of the distal femur. Principles. In this episode, we review the topic of Subacromial Impingement from the Shoulder & Elbow section. TKA Revision is most commonly performed to address aseptic loosening, fracture, instability, or infection associated with a prior TKA. divide subcutaneous tissues below skin incision. ORTHO BULLETS Orthopaedic Surgeons & Providers In this episode, we review the topic of Os Acromiale from the Shoulder & Elbow section.--- Send in a voice message: https://anchor.fm/orthobullets/message Neurovascular structures. Incision. ... straight medial parapatellar arthrotomy with diverging incision down the vastus lateralis tendon towards lateral retinaculum. Ankle Anterolateral Approach Approaches Orthobullets. Medial parapatellar approach. The approach can be extended to expose the posterior cruciate ligament. A median parapatellar approach is most commonly used during sur-gery even though most of the pathology is on the lateral side of the valgus-deformed line. APPROACH • MCPJ – Finger is slightly flexed – Needle inserted dorsally, lat or med to extensor tendons • MTPJ – Similar technique as for MCPJ 29. begin incision 3 cm below the pubic tubercle. In this episode, we review the topic of Rectus femoris from the Anatomy section. In this episode, we review the topic of Tibia Posterolateral Approach from the Approaches section.--- Send in a voice message: https://anchor.fm/orthobullets/message (OBQ10.172) During a total knee arthroplasty using a standard medial parapatellar approach, if a lateral parapatellar release is required, special attention should be made to preserve which of the following arteries? Tested Concept MB BULLETS Step 2 & 3 For 3rd and 4th Year Med Students. the extra- articular fracture is planned. In this episode, we review the topic of Knee Posterior Approach from the Approaches section. use a 15 blade through skin, spread down to bone with hemostat, place trochar of sleeve on bone. Deep dissection - distal third. raise skin flaps exposing fascia. Portions of the incision can be used to gain access to the suprapatellar pouch, the patella, and the medial side of the joint. Ankle Anterolateral Approach Approaches Orthobullets. Approach: Incision . 2. The medial approach to the distal femur is useful to expose medial distal femoral fractures, a Hoffa-type fracture. The proximal extension of a medial parapatellar approach, as described by Henry [10] involves cutting through the rectus tendon, which may not be desirable. 1. Position of the Patient. Incision. The medial parapatellar approach is a very useful approach to the knee joint. In this episode, we review the topic of Knee Medial Parapatellar Approach from the Approaches section. TKA Axial Alignment TKA Coronal Plane Balancing. Create the planned skin incision with the knee flexed. The A B Figure 1 A,The mechanical axis of the dissection may need to be carried even more posteriorly to provide exposure. to visualize the sustentaculum, the inicision should be 5 cm long following the neurovascular structures. APPROACH • Ankle – Patient supine – Ankle at 90o or slightly plantarflexed – Medial to tibialis anterior tendon is a palpable dimple which is the point of needle insertion 28. ORTHO BULLETS Orthopaedic Surgeons & Providers Approach. Also, we have found that this approach facilitates easy placement of clamps and/or supplementary fixation when necessary. Ankle Anterolateral Approach Approaches Orthobullets. Note: The medial approach, including opening of the joint, is not an ideal procedure for supracondylar fractures. when hitting 2nd cortex, stop and measure, call out length, then finish 2nd cortex (2 nd cortex adds 2-5mm) remove inner sleeve and insert screw. The semi-extended lateral parapatellar approach vastly simplifies many technical aspects of nailing compared to knee hyperflexion approaches, and does not violate the knee joint. Keywords: Intramedullary nail; Knee pain; Lysholm knee scale; Medial parapatellar; Patellar tendon split; Semiextended; Surgical approach; Tibia; Tibial nail. The Orthobullets Podcast In this episode, we review the topic of Knee Medial Parapatellar Approach from the Approaches section. landmark. Principles. Orthobullets Target Topics (covered in plan) ... Hip Medial Approach: THA Approaches Hip Direct Lateral Approach (Hardinge, Transgluteal) Hip Posterior Approach (Moore or Southern) ... Knee Medial Parapatellar Approach Knee Medial Approach. Mark the medial, lateral, proximal, and distal patellar borders. with a sandbag under the buttock of the affected side. It is also useful to expose the neurovascular bundle when a distal femoral fracture is complicated by an arterial injury. In this episode, we review the high-yield topic of Blood Supply to the Foot from the Foot & Ankle section. This approach is used for medial femoral condylar fractures. It allows excellent access to most structures when it’s extended to the full length of incision. extend to midline anteriorly and to posteromedial corner posteriorly Synovectomy. in cases of severe fixed varus deformity. 1. In this episode, we review the topic of Femur Anteromedial Approach from the Approaches section. Medial subvastus versus the medial parapatellar approach for total knee replacement: A systematic review and meta-analysis of randomized controlled trials. Main indication for medial approach in trauma. --- Send in a voice message: https://anchor.fm/orthobullets/message