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Flashcards in Nelson Case III Deck (28)
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1

What do we want the A1C to be around for diabetics to do elective surgery?

Less than 8

2

Can you still use betadine if patient has shellfish allergy?

Yes

3

Average thigh tourniquet?

300 - 350mmhg

4

Complication with Type I

More prone to hyper and hypoglycemia

5

Elevatus is more common in which osteotomies

Closing base wedge

6

What are other techniques for joint resection?

Osteotome
Saggital Saw/oscillating saw
Curettage

7

Treatments for stage I hallux limitus

Reverse Mortons Extension

8

Treatment for Stage III and IV

Mortons Extension

9

Oloff and Jacobs- Grade I Hallux Limitus

Minimal Adaptive changes
- Pain on end ROM
- Rearfoot pronation
-Metatasus primus elevatus

10

Oloff and Jacobs- Grade II Hallux Limitus

- flattening of 1st metatarsal head with possible osteochondral defect
- Small dorsal exostosis
- Pain on end ROM

11

Oloff and Jacobs - Grade III Hallux Limitus

- More severe flattening of 1st metatarsal head
- osteophytes
- Asymmetrical joint narrowing
- Eburnation
- Crepitus

12

Oloff and Jacobs - Grade IV Hallux Limitus

- Total obliteration of joint space
- Loose bodies
- < 10 degrees of motion
-

13

What is the difference of structural and functional hallux limitus?

Structural- limits dorsiflexion of first ray when loaded and unloaded

14

Non-joint destructive Osteotomy

Exostectomy
Proximal Phalanx Osteotomy
1st metatarsal Osteotomy

15

NJD procedures - Exostectomy - Stage 2 procedure

Cheilectomy

16

NJD procedures - Proximal phalanx - Kessel Bonney

Dorsal base wedge removal of proximal phalanx

17

NJD procedures - Proximal phalanx - Regnauld

Mexican hat - peg and hole - shortens the proximal phalanx

18

NJD procedures - Proximal phalanx - Watermann

Dorsal wedge osteotomy out o the first metatarsal head

19

NJD procedures - Proximal phalanx - Watermann- Green

Preserves the sesamoid articulation by providing angulated cut with removal of the dorsal half of the metatarsal head

20

NJD procedures - Proximal phalanx - Youngswick

Austin with two parrallel cuts dorsally to allow for plantarflexion

21

NJD procedures - Proximal phalanx - Dorsal V

Chevorn cut made dorsal to plantar through metatarsal neck

22

NJD procedures - Proximal phalanx - Saggital Z

Saggital Z through metatarsal shaft with proximal arm exiting medially and distal arm laterally

23

NJD procedures - Proximal phalanx - Lambrinudi

Closing plantarflexory base wedge

24

What is the distraction rate for a arthrodiastasis?

.5mm/day for 1 week ( max 14 days )

25

What is a keller?

Removal of the base of the proximal phlalanx with a possible chielectomy

- may insert implant if failed

26

Causes of Hallux Limitus

- OCD
Long First Met
- Elevatus
- Hypermobility of 1st ray

27

Arthrodesis fixation

- 10-15 abduction fixation
- 10 - 20 degrees of dorsiflexion for fixation

28

With implants, why do you use grommets ?

Helps to decrease shearing forces on the silicon implant