Page 1 of 1: macewan's osteotomy

sgtkuks · Credits: 4061 My Scrapbook

i'm totally lost..can't find ans to this one and can't rely on salg..

macewan's osteotomy is done in cases of;
a. coxa vera
b. tibia vera
c. genu valgum
d. tom smith disease

can someone help me out in this.....

sgtkuks · Credits: 4061 My Scrapbook

isn't there anyone to help me out...bruno can u try pls

Bruno · Credits: 45660 My Scrapbook My Reading List 50 Books

Perkins Line
is a line vertically down from Anterior Superior Ilaic Spine
Nelatons Line
is a line from Ischial Tuberosity ----> Greater Trochanter ----> ASIS
Shoemakers Line
is a line from Ischial Tuberosity ----> Greater Trochanter ----> ASIS ----> Umbilicus
Shentons Line
is a curved line extending from the upper curved border of obturator foramen to the lower border of neck of Femur
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DUPUYTREN'S FRACTURE
is # of lower part of fibula, with dislocation of ankle
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delbet's classification is for fracture neck of femur in children
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perkins line - line along outer border of acetabulum- vertical
perkins line is important in congenital diclocation of hip
----
narath's sign is + ve in CDH
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nadu · Credits: 17728 My Scrapbook

its genu valgum !

salgu has given correct answer.

GENU VALGUM (Knock Knee)
Genu Valgum is an outward deviation of the legs at the knee. It is an acquired deformity. It can be unilateral or bilateral.

Injury or septic destruction of the lateral half of the lower femoral eqiphyseal plate, results in arrested growth of the lateral condyle of the femur. The continued growth of the medial condyle results in unilateral genu valgum. Bilateral genu valgum can result from continued growth of the medial con\dyle results in unilateral genu valgum. Bilateral genu valgum can result from conditions causing bone softening bone softening as in rickets, Osteomalacia and rheumatoid arthritis.

The degree of genu valgum is measured by the distance between the medial malleoli (Intermalleolar distance) at the ankle when the child stands or lies down with the knees touching each other. Genu valgum results in secondary flat foot. Excessive genu valgum often causes outward dislocation of the patella.

In mild cause of genu valgum in young children, where the intermalleolar distance is less than
5 cm, wearing of boots with the inner side of heel raised by 3/8 inch and elongated forward. (Robert Jones heel) corrects the deformity. When the deformity is moderate (the intermalleolar distance being 5 to 10 cm) correction is achieved by an orthosis consisting of boots with long outside bar up to the level of the greater trochanter and knee straps. Any active rickets should be controlled by vitamin D theraphy.

In case with severe deformity, a supracondylar osteotomy of the femur (Macewen's osteotomy) is done to correct the deformity.

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nadu · Credits: 17728 My Scrapbook

ALSO NOTE :

Kalamchi and MacEwen's classification of avascular necrosis in DDH :
(Developmental Dislocation of Hip )

Group I. Changes Affecting the Ossific Nucleus
Either delay in the appearance of the ossific nucleus or mottling of the ossific nucleus. With revascularization, there is flattening and fragmentation of the shadow of the ossific nucleus, but the head will usually regain its spherical shape. Some femoral heads will show the head-within-head appearance. This is the most common with the best prognosis.

Group II. Lateral Physeal Damage
The initial changes in the ossific center may follow exactly those seen in Group I, but in addition there is damage to the lateral part of the physis. The early roentgenographic signs indicating lateral physeal damage are: (1) lateral ossification, (2) lateral physeal irregularity and bridging, (3) lateral notching of the epiphysis, and (4) a lateral metaphyseal defect. The damage to the physis may remain dormant. By the age of ten years, however, valgus deformity of the head on the neck develops.( This type occurred in 35% of total AVN at AIDI.)

Group III. Central Physeal Damage
The early changes in the ossific nucleus are similar to those observed in Group I and II. The damage to the growth plate is more centrally located. Commonly, patients develop a short femoral neck without varus or valgus. Relative overgrowth of the greater trochanter and limb length discrepancy are the principal problems.

Group IV. Total Damage to the Head and the Physis
Damage of the entire femoral head and physis are characteristic of this group. Early irregular femoral head with varus, flattening, and coxa magna. Overgrowth of the greater trochanter, limb length discrepancy, and subsequent early arthritis are the principal complications.

nadu · Credits: 17728 My Scrapbook

something about Sir William Macewen :

Macewen studied in Glasgow and had Syme and Lister as teachers. The new era of antisepsis enabled him to make many contributions to Surgery. In terms of his Orthopaedic contributions, he performed many osteotomies and developed a one-piece osteotome. Macewen's main research interest was in bone growth and in 1879 he performed the first of his pioneering bone grafts. Many of his grafts were performed on people who had had portions of their bones excised, but who had otherwise normal function. Macewen was also a pioneering neurosurgeon and cardiothoracic surgeon. He worked on cerebral tumours and abscesses and also performed the first pneumonectomy.

nadu · Credits: 17728 My Scrapbook

again some related one.......

Macewen's operation:
an operation for the radical cure of hernia by closing the internal ring with a pad made of the hernial sac.

nadu · Credits: 17728 My Scrapbook

what is Mitell's osteotomy ?

a_medico · Credits: 5938 My Scrapbook

dunno mitell's ( ? misprinting?)

Mitchell's osteotomy- Distal osteotomy of the first metatarsal bone in the treatment of hallux valgus

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