By Broughton, Nigel S. Broughton
A transparent, concise method of a small yet vital subspecialty that is an integral part of orthopaedic surgical education and ultimate examinations. Aimed additionally on the practising orthopaedic physician desiring entry to uncomplicated paediatric info, it really is as compatible for speedy referral because it is for revision reasons. positive factors: * A concise account of a vital subspecialty * the entire simple ideas of paediatric orthopaedics in a single simply obtainable booklet * basically illustrated * Covers all vital themes on the point of uncomplicated rules * Written by way of a unmarried extremely popular division, drawing at the joint services of its many participants and their adventure operating as a crew * Geared heavily to the necessities of surgical trainees all through Europe and Australia
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A transparent, concise method of a small yet vital subspecialty that is a vital part of orthopaedic surgical education and ultimate examinations. Aimed additionally on the working towards orthopaedic health practitioner wanting entry to easy paediatric info, it really is as appropriate for speedy referral because it is for revision reasons.
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Extra resources for A Textbook of Paediatric Orthopaedics
We use long screws, usually just shy of bicor tical purchase, although sometimes we do get bicortical purchase. The easiest way to size the screw length is to place a given length into the disk space before inserting the graft to see if the length is adequate (Fig. 6). We keep the plate as short as possible to prevent adja cent level ossification development (ALOD) (Fig. 4 To optimize plate symmetry and screw place ment, we pre-drill our holes in the proximal and distal vertebral bodies with the drill guide.
The paravertebral muscles are dissected laterally to expose the lateral margins of the articular masses completely for exact determination of the screw insertion point. Screw Placement The points of screw insertion at the lateral mass from C3 through C7 are slightly laterally to the center of the articular mass and close to the inferior margin of the inferior articular process of the cranially adjacent vertebra. Surgeons must carefully evaluate preoperative computed tomography (CT) images before screw insertion to check the shape and the size of the pedicle and lateral mass in each vertebra and in each individual.
Under these conditions, alternative fixation anchors, such as lateral mass screws or posterior wires, are recommended. 0-mm slice should be done for the accurate evaluation of pedicle dimensions and to measure the pedicle width, which helps surgeons choose the appropriate 31 32 Chapter 3 a b Fig. 7a,b Retrogression of the pedicle at the dominant side of the vertebral artery. (a) The left and right pedicles in the same vertebra differ significantly in diameter. The foramen transversarium enlarges on the side of the smaller pedicle.
A Textbook of Paediatric Orthopaedics by Broughton, Nigel S. Broughton