Bones of the Lower Limb
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Skeletal Foot Structure
Foot Skeletal Structure The disarticulated bones of the left foot, from above (The talus and calcaneus remain articulated) 1 Calcaneus 2 Talus 3 Navicular 4 Medial cuneiform 5 Intermediate cuneiform 6 Lateral cuneiform 7 Cuboid 8 First metatarsal 9 Second metatarsal 10 Third metatarsal 11 Fourth metatarsal 12 Fifth metatarsal 13 Proximal phalanx of great toe 14 Distal phalanx of great toe 15 Proximal phalanx of second toe 16 Middle phalanx of second toe 17 Distal phalanx of second toe Bones of the tarsus, the back part of the foot Talus Calcaneus Navicular bone Cuboid bone Medial, intermediate and lateral cuneiform bones Bones of the metatarsus, the forepart of the foot First to fifth metatarsal bones (numbered from the medial side) Bones of the toes or digits Phalanges -- a proximal and a distal phalanx for the great toe; proximal, middle and distal phalanges for the second to fifth toes Sesamoid bones Two always present in the tendons of flexor hallucis brevis Origin and meaning of some terms associated with the foot Tibia: Latin for a flute or pipe; the shin bone has a fanciful resemblance to this wind instrument. Fibula: Latin for a pin or skewer; the long thin bone of the leg. Adjective fibular or peroneal, which is from the Greek for pin. Tarsus: Greek for a wicker frame; the basic framework for the back of the foot. Metatarsus: Greek for beyond the tarsus; the forepart of the foot. Talus (astragalus): Latin (Greek) for one of a set of dice; viewed from above the main part of the talus has a rather square appearance. -
Medial Lateral Malleolus
Acutrak 2® Headless Compression Screw System 4.7 mm and 5.5 mm Screws Supplemental Use Guide—Medial & Lateral Malleolus Acumed® is a global leader of innovative orthopaedic and medical solutions. We are dedicated to developing products, service methods, and approaches that improve patient care. Acumed® Acutrak 2® Headless Compression Screw System—4.7 mm and 5.5 mm This guide is intended for supplemental use only and is not intended to be used as a stand-alone surgical technique. Reference the Acumed Acutrak 2 Headless Compression Screw System Surgical Technique (SPF00-02) for more information. Definition Indicates critical information about a potential serious outcome to the Warning patient or the user. Indicates instructions that must be followed in order to ensure the proper Caution use of the device. Note Indicates information requiring special attention. Acumed® Acutrak 2® Headless Compression System—Supplemental Use Guide—Medial & Lateral Malleolus Table of Contents System Features ...........................................2 Surgical Techniques ........................................ 4 Fibula Fracture (Weber A and B Fractures) Surgical Technique: Acutrak 2®—5.5 .......................4 Medial Malleolus Surgical Technique: Acutrak 2®—4.7 ......................10 Ordering Information ......................................16 Acumed® Acutrak 2® Headless Compression System—Supplemental Use Guide—Medial & Lateral Malleolus System Features Headless screw design is intended to minimize soft tissue irritation D Acutrak 2 Screws Diameter -
Assessment, Management and Decision Making in the Treatment Of
Pediatric Ankle Fractures Anthony I. Riccio, MD Texas Scottish Rite Hospital for Children Update 07/2016 Pediatric Ankle Fractures The Ankle is the 2nd most Common Site of Physeal Injury in Children 10-25% of all Physeal Injuries Occur About the Ankle Pediatric Ankle Fractures Primary Concerns Are: • Anatomic Restoration of Articular Surface • Restoration of Symmetric Ankle Mortise • Preservation of Physeal Growth • Minimize Iatrogenic Physeal Injury • Avoid Fixation Across Physis in Younger Children Salter Harris Classification Prognosis and Treatment of Pediatric Ankle Fractures is Often Dictated by the Salter Harris Classification of Physeal Fractures Type I and II Fractures: Often Amenable to Closed Tx / Lower Risk of Physeal Arrest Type III and IV: More Likely to Require Operative Tx / Higher Risk of Physeal Arrest Herring JA, ed. Tachdjian’s Pediatric Orthopaedics, 5th Ed. 2014. Elsevier. Philadelphia, PA. ISOLATED DISTAL FIBULA FRACTURES Distal Fibula Fractures • The Physis is Weaker than the Lateral Ankle Ligaments – Children Often Fracture the Distal Fibula but…. – …ligamentous Injuries are Not Uncommon • Mechanism of Injury = Inversion of a Supinated Foot • SH I and II Fractures are Most Common – SH I Fractures: Average Age = 10 Years – SH II Fractures: Average Age = 12 Years Distal Fibula Fractures Lateral Ankle Tenderness SH I Distal Fibula Fracture vs. Lateral Ligamentous Injury (Sprain) Distal Fibula Fractures • Sankar et al (JPO 2008) – 37 Children – All with Open Physes, Lateral Ankle Tenderness + Normal Films – 18%: Periosteal -
Free Vascularized Fibula Graft with Femoral Allograft Sleeve for Lumbar Spine Defects After Spondylectomy of Malignant Tumors Acasereport
1 COPYRIGHT Ó 2020 BY THE JOURNAL OF BONE AND JOINT SURGERY,INCORPORATED Free Vascularized Fibula Graft with Femoral Allograft Sleeve for Lumbar Spine Defects After Spondylectomy of Malignant Tumors ACaseReport Michiel E.R. Bongers, MD, John H. Shin, MD, Sunita D. Srivastava, MD, Christopher R. Morse, MD, Sang-Gil Lee, MD, and Joseph H. Schwab, MD, MS Investigation performed at Massachusetts General Hospital, Boston, Massachusetts Abstract Case: We present a 65-year-old man with an L4 conventional chordoma. Total en bloc spondylectomy (TES) of the involved vertebral bodies and surrounding soft tissues with reconstruction of the spine using a free vascularized fibula autograft (FVFG) is a proven technique, limiting complications and recurrence. However, graft fracture has occurred only in the lumbar spine in our institutional cases. We used a technique in our patient to ensure extra stability and support, with the addition of a femoral allograft sleeve encasing the FVFG. Conclusions: Our technique for the reconstruction of the lumbar spine after TES of primary malignant spinal disease using a femoral allograft sleeve encasing the FVFG is viable to consider. he treatment of primary malignant neoplasms of the spine mended a magnetic resonance imaging (MRI), but the request currently mainly relies on surgery, often in conjunction with was denied by the insurance company, and the patient T 1-3 radiotherapy .Totalen bloc spondylectomy (TES) is a widely underwent a course of physical therapy with no benefitand accepted surgical technique and has lower reported recurrence rates progression of back pain and radiculopathy. Four months compared with patients who undergo intralesional surgery3,4. -
Carpals and Tarsals of Mule Deer, Black Bear and Human: an Osteology Guide for the Archaeologist
Western Washington University Western CEDAR WWU Graduate School Collection WWU Graduate and Undergraduate Scholarship 2009 Carpals and tarsals of mule deer, black bear and human: an osteology guide for the archaeologist Tamela S. Smart Western Washington University Follow this and additional works at: https://cedar.wwu.edu/wwuet Part of the Anthropology Commons Recommended Citation Smart, Tamela S., "Carpals and tarsals of mule deer, black bear and human: an osteology guide for the archaeologist" (2009). WWU Graduate School Collection. 19. https://cedar.wwu.edu/wwuet/19 This Masters Thesis is brought to you for free and open access by the WWU Graduate and Undergraduate Scholarship at Western CEDAR. It has been accepted for inclusion in WWU Graduate School Collection by an authorized administrator of Western CEDAR. For more information, please contact [email protected]. MASTER'S THESIS In presenting this thesis in partial fulfillment of the requirements for a master's degree at Western Washington University, I grant to Western Washington University the non-exclusive royalty-free right to archive, reproduce, distribute, and display the thesis in any and all forms, including electronic format, via any digital library mechanisms maintained by WWu. I represent and warrant this is my original work, and does not infringe or violate any rights of others. I warrant that I have obtained written permissions from the owner of any third party copyrighted material included in these files. I acknowledge that I retain ownership rights to the copyright of this work, including but not limited to the right to use all or part of this work in future works, such as articles or books. -
Common Stress Fractures BRENT W
COVER ARTICLE PRACTICAL THERAPEUTICS Common Stress Fractures BRENT W. SANDERLIN, LCDR, MC, USNR, Naval Branch Medical Clinic, Fort Worth, Texas ROBERT F. RASPA, CAPT, MC, USN, Naval Hospital Jacksonville, Jacksonville, Florida Lower extremity stress fractures are common injuries most often associated with partic- ipation in sports involving running, jumping, or repetitive stress. The initial diagnosis can be made by identifying localized bone pain that increases with weight bearing or repet- itive use. Plain film radiographs are frequently unrevealing. Confirmation of a stress frac- ture is best made using triple phase nuclear medicine bone scan or magnetic resonance imaging. Prevention of stress fractures is most effectively accomplished by increasing the level of exercise slowly, adequately warming up and stretching before exercise, and using cushioned insoles and appropriate footwear. Treatment involves rest of the injured bone, followed by a gradual return to the sport once free of pain. Recent evidence sup- ports the use of air splinting to reduce pain and decrease the time until return to full par- ticipation or intensity of exercise. (Am Fam Physician 2003;68:1527-32. Copyright© 2003 American Academy of Family Physicians) tress fractures are among the involving repetitive use of the arms, such most common sports injuries as baseball or tennis. Stress fractures of and are frequently managed the ribs occur in sports such as rowing. by family physicians. A stress Upper extremity and rib stress fractures fracture should be suspected in are far less common than lower extremity Sany patient presenting with localized stress fractures.1 bone or periosteal pain, especially if he or she recently started an exercise program Etiology and Pathophysiology or increased the intensity of exercise. -
Foot and Ankle Systems Coding Reference Guide
Foot and Ankle Systems Coding Reference Guide Physician CPT® Code Description Arthrodesis 27870 Arthrodesis, ankle, open 27871 Arthrodesis, tibiofibular joint, proximal or distal 28705 Arthrodesis; pantalar 28715 Arthrodesis; triple 28725 Arthrodesis; subtalar 28730 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse 28735 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction) 28737 Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure) 28740 Arthrodesis, midtarsal or tarsometatarsal, single joint 28750 Arthrodesis, great toe; metatarsophalangeal joint 28755 Arthrodesis, great toe; interphalangeal joint 28760 Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure) Bunionectomy 28292 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with resection of proximal phalanx base, when performed, any method 28295 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method 28296 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with distal metatarsal osteotomy, any method 28297 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method 28298 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with -
Bones of the Upper and Lower Limb Musculoskeletal Block - Lecture 1
Bones of the Upper and Lower limb Musculoskeletal Block - Lecture 1 Objective: Classify the bones of the three regions of the lower limb (Thigh, leg and foot). Memorize the main features of the – Bones of the thigh (femur & patella) – Bones of the leg (tibia & Fibula) – Bones of the foot (tarsals, metatarsals and phalanges) Recognize the side of the bone. Color index: Important In male’s slides only In female’s slides only Extra information, explanation Editing file Click here for Contact us: useful videos [email protected] Please make sure that you’re familiar with these terms Terms Meaning Example Ridge The long and narrow upper edge, angle, or crest of something The supracondylar ridges (in the distal part of the humerus) Notch An indentation, (incision) on an edge or surface The trochlear notch (in the proximal part of the ulna) Tubercles A nodule or a small rounded projection on the bone (Dorsal tubercle in the distal part of the radius) Fossa A hollow place (The Notch is not complete but the fossa is Subscapular fossa (in the concave part of complete and both of them act as the lock of the joint the scapula) Tuberosity A large prominence on a bone usually serving for Deltoid tuberosity (in the humorous) and it the attachment of muscles or ligaments ( is a bigger projection connects the deltoid muscle than the Tubercle ) Processes A V-shaped indentation (act as the key of the joint) Coracoid process ( in the scapula ) Groove A channel, a long narrow depression sure Spiral (Radial) groove (in the posterior aspect of (the humerus -
The Appendicular Skeleton the Appendicular Skeleton
The Appendicular Skeleton Figure 8–1 The Appendicular Skeleton • Allows us to move and manipulate objects • Includes all bones besides axial skeleton: – the limbs – the supportive girdles 1 The Pectoral Girdle Figure 8–2a The Pectoral Girdle • Also called the shoulder girdle • Connects the arms to the body • Positions the shoulders • Provides a base for arm movement 2 The Clavicles Figure 8–2b, c The Clavicles • Also called collarbones • Long, S-shaped bones • Originate at the manubrium (sternal end) • Articulate with the scapulae (acromial end) The Scapulae Also called shoulder blades Broad, flat triangles Articulate with arm and collarbone 3 The Scapula • Anterior surface: the subscapular fossa Body has 3 sides: – superior border – medial border (vertebral border) – lateral border (axillary border) Figure 8–3a Structures of the Scapula Figure 8–3b 4 Processes of the Glenoid Cavity • Coracoid process: – anterior, smaller •Acromion: – posterior, larger – articulates with clavicle – at the acromioclavicular joint Structures of the Scapula • Posterior surface Figure 8–3c 5 Posterior Features of the Scapula • Scapular spine: – ridge across posterior surface of body • Separates 2 regions: – supraspinous fossa – infraspinous fossa The Humerus Figure 8–4 6 Humerus • Separated by the intertubercular groove: – greater tubercle: • lateral • forms tip of shoulder – lesser tubercle: • anterior, medial •Head: – rounded, articulating surface – contained within joint capsule • Anatomical neck: – margin of joint capsule • Surgical neck: – the narrow -
Stress Fractures in the Foot and Ankle of Athletes Fratura Por Estresse No Pé E Tornozelo De Atletas Authors: Asano LYJ, Duarte Jr
GUIDELINES IN FOCUS ASANO LYJ ET al. Stress fractures in the foot and ankle of athletes FRATURA POR ESTRESSE NO PÉ E TORNOZELO DE ATLETAS Authors: Asano LYJ, Duarte Jr. A, Silva APS http://dx.doi.org/10.1590/1806-9282.60.06.006 The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standar- dize procedures to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, de- pending on the conditions and the clinical status of each patient. DESCRIPTION OF THE EVIDENCE COLLECTION INTRODUCTION METHOD Stress fractures were described for the first time in 1855 To develop this guideline, the Medline electronic databa- by Breihaupt among soldiers reporting plantar pain and se (1966 to 2012) was consulted via PubMed, as a primary edema following long marches.1 For athletes, the first cli- base. The search for evidence came from actual clinical nical description was given by Devas in 1958, based so- scenarios and used keywords (MeSH terms) grouped in lely on the results of simple X-rays.2 Stress injuries are the following syntax: “Stress fractures”, “Foot”, “Ankle”, common among athletes and military recruits, accoun- “Athletes”, “Professional”, “Military recruit”, “Immobili- ting for approximately 10% of all orthopedic injuries.3 zation”, “Physiotherapy”, “Rest”, “Rehabilitation”, “Con- It is defined as a solution for partial or complete con- ventional treatment”, “Surgery treatment”. The articles tinuity of a bone as a result of excessive or repeated loads, were selected by orthopedic specialists after critical eva- at submaximal intensity, resulting in greater reabsorp- luation of the strength of scientific evidence, and publi- tion faced with an insufficient formation of bone tissue.1 cations of greatest strength were used for recommenda- Although stress fractures may affect all types of bone tion. -
Bones of Upper Limb
BONES OF UPPER & LOWER LIMBS Khaleel Alyahya, PhD, MEd King Saud University College of Medicine @khaleelya OBJECTIVES At the end of the lecture, students should be able to: o List the different bones of the the upper and lower limbs. o List the characteristic features of each bone in both. o Differentiate between bones of right and left sides. o List the articulations between the different bones. o Learn some clinical significances associated with the upper and lower limbs. UPPER LIMBS BONES OF UPPER LIMB It consists of the following: o Pectoral Girdle • Clavicle • Scapula o Arm • Humerus o Forearm • Radius & Ulna o Wrist • Carpal bones o Hand • Metacarpals & Phalanges PECTORAL GIRDLE It composed of Two bones: o Clavicle o Scapula It is very light and it allows the upper limb to have exceptionally free movement. CLAVICLE It is considered as a long bone but it has no medullary (bone marrow) cavity. Its medial (Sternal) end is enlarged & triangular. Its lateral (Acromial) end is flattened. The medial 2/3 of the body (shaft) is convex forward. The lateral 1/3 is concave forward. These curves give the clavicle its appearance of an elongated capital (S) It has two surfaces: • Superior: smooth as it lies just deep to the skin. • Inferior: rough because strong ligaments bind it to the 1st rib. Functions: • It serves as a rigid support to keep upper limb suspended away from the trunk. • Transmits forces from the upper limb to the axial skeleton. • Provides attachment for muscles. • Forms a boundary of the cervicoaxillary canal for protection of the neurovascular bundle of the UL. -
Bones of the Lower Limb Doctors Notes Notes/Extra Explanation Editing File Objectives
Color Code Important Bones of the Lower Limb Doctors Notes Notes/Extra explanation Editing File Objectives Classify the bones of the three regions of the lower limb (thigh, leg and foot). Memorize the main features of the – Bones of the thigh (femur & patella) – Bones of the leg (tibia & Fibula) – Bones of the foot (tarsals, metatarsals and phalanges) Recognize the side of the bone. ﻻ تنصدمون من عدد ال رشائح نصها رشح زائد وملخصات واسئلة Some pictures in the original slides have been replaced with other pictures which are more clear BUT they have the same information and labels. Terminology (Team 434) شيء مرتفع /Eminence a small projection or bump Terminology (Team 434) Bones of thigh (Femur and Patella) Femur o Articulates (joins): (1) above with Acetabulum of hip bone to form the hip joint, (2) below with tibia and patella to form the knee joint. Body of femur (shaft) o Femur consists of: I. Upper end. II. Shaft. III. Lower end. Note: All long bones consist of three things: 1- upper/proximal end posterior 2- shaft anterior 3- lower/distal end I. Upper End of Femur The upper end contains: A. Head B. Neck C. Greater trochanter & D. Lesser trochanter A. Head: o Articulates (joins) with acetabulum of hip bone to form the hip joint. o Has a depression in the center called Fovea Capitis. o The fovea capitis is for the attachment of ligament of the head of Femur. o An artery called Obturator Artery passes along this ligament to supply head of Femur. B. Neck: o Connects head to the shaft.