By Robert E. Hunter

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Extra info for AANA Advanced Arthroscopy. The Knee

Sample text

The fracture bed. A longitudinal incision is centered over the tibial tubercle. The medial pin enters the tibia just medial to the tubercle, and the lateral pin just lateral. The guide places two 3-mm cannulated retropins at the medial and lateral edges of the fracture bed in the midcoronal plane under direct arthroscopic visualization. A Nitinol wire loop is passed up through the cannulated retro pins, medially and laterally, respectively. Routine suture passage brings the suture ends out through the medial and lateral drill holes.

This has not been found to be a problem FIGURE 2-2 A probe is used to hold the fracture site open to débride the clot, intermeniscal ligament, or other debris. FIGURE 2-3 A probe and Steinmann pin are used to reduce the fracture anatomically. nor have elevated compartment pressures. An anterolateral portal is established for the arthroscope. The hematoma is evacuated until reasonable visualization is possible. Once pathology can be visualized, an anteromedial portal is established after localization with a spinal needle.

Although less common, ACL avulsion also occurs in adults. On physical examination, patients present with painful swollen knees and generally are unable to bear weight. Careful history differentiates high- or low-energy injuries and a careful examination notes any evidence of a fracture blister, compartment syndrome, meniscal or ligamentous disruption, or neurovascular injury. To re-emphasize this key point, attention must be paid to peripheral pulses, neurologic function, and the status of the compartments of the injured extremity.

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