Orthopedic Care and Consultation
Lamina means a very thin layer. [Plural - laminae]
In medicine, lamina mostly refers to lamina of vertebral arch.
The laminæ are two broad plates, extending dorsally and medially from the pedicles. [See image below]
The both laminae fuse posteriorly and along with pedicles they constitute vertebral arch.
Literary meaning of isthmus a narrow strip of land connecting two larger land areas, In anatomy isthmus indicates a narrow anatomical part or passage connecting two larger structures or cavities.
In bone, isthmus refers to the narrowest part of the bony canal.
The location of isthmus varies with the bone.
In femur, for example, it is located approximately at upper third and middle third junction.
Palmar Tilt represents the angle between a line joining the dorsal and volar margins of the articular surface and the long axis of the radius on a lateral xray.
Palmar TIlt of Distal Radius
It is also called Volar Angle or Radial Tilt.
The normal palmar tilt averages 11° and has a range of 2°-20°.
It is an important parameter in treatment of distal radius fractures.
Image Credit http://www.radiologyassistant.nl/en/476a23436683b
Other terms – Multiple organ failure, Multisystem organ failure
Multiple Organ Dysfunction Syndrome is altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis.
It usually involves two or more organ systems.
The condition can result following infection, injury, hypoperfusion and hypermetabolism.
The syndrome occurs when the primary cause triggers an uncontrolled inflammatory response. In one-third of the patients no primary focus can be found.
Pathophysiology
A definite explanation has not been found. Local and systemic responses are initiated by tissue damage. Respiratory failure is common in the first 72 hours after the original insult. Following this one might see hepatic failure, gastrointestinal bleeding, and renal failure.
Treatment and Prognosis
At present there is no agent that can reverse the established organ failure. Therapy therefore is limited to supportive care. Maintaining adequate tissue oxygenation is a principal target. Starting enteral nutrition within 36 hours of admission to an Intensive care unit has reduced infectious complications.
Human recombinant activated protein C has been recently found to reduce the immediate mortality.
Mortality has been reported in 30% to 100% of the cases.
The hip bone, innominate bone [ Also called hip bone or coxal bone] is a large, flattened, irregularly shaped bone, constricted in the center and expanded above and below.
With opposite innominate bone and sacrum, the hip bone comprises the skeletal component of the pelvis.
It consists of three parts, the ilium, ischium, and pubis.
Each of these part is separate in childhood but fuse in adulthood by 25 years of age.
The ilium is the superior broad and expanded portion which extends upward from the acetabulum.
The ischium is the lowest and strongest portion of the bone; it proceeds downward from the acetabulum, expands into a large tuberosity, and then, curving forward, forms, with the pubis, a large aperture, the obturator foramen.
The pubis extends medially and inferiorly from the acetabulum and articulates in the midsagittal plane at the pubic symphysis, with the bone of the opposite side: it forms the front of the pelvis and supports the external organs of reproduction.
Kyphosis is a curving of the spine that causes a bowing of the back, such that the apex of the angle points backwards.
An adult with Scheuermann's disease resulting in kyphosis
Kyphosis leads to a hunchback or slouching posture.
Image Credit: Wikipedia
Interfragmentary screw or lag screw is used in fixation of spiral or oblique fractures of the shaft of a bone. Interfragmentary screw or lag screw is used as an adjunct to plating and often as initial fixation holder so as to safe and secure application of plate in neutral mode in reduced fracture.
The procedure involves placement of one or more screws across a fracture site so that fractured fragments are apposed and compressed to each other, called interfragmentary compression ( See image below). The interfragmentary screw can also be used for fixation after osteotomies. [Read more...]
Ligamntotaxis is a technique where ligaments are placed insustained longitudinal traction so as to cause the relalignment of the fractured fragments.
This method is used in reduction of fractures near the joints.The sustained traction is held most commonly by external instrumentation.
This is called indirect reduction of the fracture [When compared with direct technique of holding and reducing the fractured fragments]
Principle
When you apply traction to the ligament it causes the attached bone fragments to reduce. [Read more...]
Image Credit: mattle.ch/upload/Minerva.jpg
The Minerva brace is a cervical and upper thoracic orthosis. It provides good orthotic control of the neck. There are many instances where Minerva brce can be used. For example severe whiplash injury or fracture of the vertebra or lower cervical fusion.
The Minerva orthosis has a rigid plastic posterior section that goes from the base of the skull down to the midtrunk. There is a solid chest piece in the front that is attached to the back along the sides with Velcro straps that can be adjusted.
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