principles

Tendon Transfer

Epidemiology

 

Nearly 2/3 cervical level injury survivors have C6 root level function

- biceps and wrist extension function

 

Requirements

 

1. Transfer / Triceps

 

2. Object manipulation

- grip 

- key grip / self catheterisation 

 

Timing

 

Consider > 18/12

 

Allows

- serial evaluation

D Reimplantation Acetabulum

Principles of Acetabular reconstructionRevision Acetabulum Post Paprosky Type IIIC

 

Restore centre of rotation
Restore acetabular integrity
Component containment
Secure fixation


Preoperatively planning


Know components in situ (esp if leaving femur)
Quantify and grade bone defects
Beware intrapelvic cement / cup (angiogram)

Upper Limb Amputations

General Principles

 

All possible length should be preserved consistent with clinical judgement

- function of amputated stumps decrease progressively with each higher level of amputation 

- prosthetic rejection by patient increases with the more proximal amputations

- most ADL'S can be performed adequately with one limb, so don't use prosthesis

- all nerves are drawn distally into wound & sectioned so they retract well proximally to bone level of amputation

 

Ewing Sarcoma

Principles

 

Treatment algorithm similar to OS

 

Overall prognosis similar to OS

- 70% long term survival

 

Definition

 

A malignant neoplasm composed of small round cells of uncertain histogenesis

 

Genetics

 

Recent data suggests it is of neuroepithelial derivation

- ? neuroectodermal cells