orthopedic hardware complications

La chirurgie, quelle qu’elle soit, peut présenter des risques pendant l’intervention (risques anesthésiques, hémorragies, infections, etc) et des complications ensuite. Unicompartmental knee prostheses have been used in younger patients with isolated medial or lateral compartment arthritis (Figure 10-5). Note the medialized center of rotation, which allows the deltoid muscle to substitute for the deficient rotator cuff musculature to facilitate shoulder abduction. These surgeries are usually performed with minimal tissue exposure and may be performed in retrograde or anterograde fashion. Prior to the advent of joint replacement, surgical management of a painful or nonfunctional joint included joint arthrodesis (e.g., joint fusion), osteotomy, nerve division, and joint debridement. The patellar and tibial components may be cemented or cementless. The disease or damaged vertebral bone is first removed. Subsidence of the acetabular component will also result in protrusio acetabuli, or migration of the prosthesis into the pelvic cavity. Recommended … Lateral radiograph of the lumbar spine shows L3-S1 posterior fusion via rods and pedicle screws, with large anterior marginal osteophyte seen at L2-L3 (arrow) with marked endplate subchondral sclerosis indicative of vertebral body degenerative changes and discogenic sclerosis as a result of abnormal stress at the site of the fused and unfused segments. The outer portion of the acetabular cap articulates with the native acetabulum, while the inner portion articulates with the femoral head as one unit. They are combinations of different metals such as chromium–cobalt, chromium–cobalt–titanium, or chromium–cobalt–molybdenum.1 These different alloys have individual biomechanical properties based on their metal composition, and differ in terms of their resistance to stress, strain, and tension. The latter are arranged by anatomic location into joint replacement and spinal hardware. Tibial intramedullary nail with one proximal and one distal interlocking screw, transfixing a proximal transverse tibial fracture. A constrained prosthesis has two components that are directly linked together. Given the large surface area contact of such side plates with the cortex, cortical blood supply may be compromised, which may result in nonunion or delayed union. Three types of surgeries exist for shoulder replacement: hemiarthroplasty (Figure 10-6), total shoulder arthroplasty (Figure 10-7), and reverse shoulder arthroplasty (Figure 10-8). The cup of the humeral component is connected to the stem portion of the prosthesis. After about 2-3 weeks, you’ll meet again with your surgeon to ensure the foot is healing as expected now that the hardware has been removed. Figure 10-14. Figure 10-9. Though it is impossible for the radiologist to become familiar with all the different devices in the market, the structural material and complications are shared among the variety of different prostheses. Another complication seen in various joint replacements is heterotopic ossification seen around the periprosthetic region. Also note that the superior aspect of the prosthetic head lies above the greater tuberosity; this positioning helps prevent subacromial impingement. Additional signs of infection include soft tissue swelling, large joint effusion (Figure 10-12B), and abscess formation. Conversely, fractures of certain anatomical sites such as ribs, scapula, and clavicle need not be immobilized as they will heal well without immobilization.10. Posterior cervical fusion. One day in mid-December, orthopedic surgeon Dr. Bruno Gobbato walked into an operating room in Jaraguá do Sul, Brazil, put on a HoloLens 2 mixed-reality headset and prepared for surgery. Other radiologic examinations such as arthrography, ultrasonography, computed tomography (CT), magnetic resonance imaging, and nuclear scintigraphy also have specific roles in evaluating joint replacement. The other important concept to realize is that the spinal hardware is used to provide temporary fixation and stability by immobilizing the bone. Initially, there is formation of hematoma and a host inflammatory response surrounding the fracture site. The AP view best illustrates the angle of inclination (normal between 30 and 55°). Chapter; Chapter references; Aa; Aa; Get access. ICD-10-CM Code T84.8 Other specified complications of internal orthopedic prosthetic devices, implants and grafts. Various types of fracture hardware and fixation methods have been discussed. Intra-articular fractures require very precise anatomic reduction in near-perfect anatomic alignment to avoid development of callus formation, as this will increase the chance of developing early post-traumatic osteoarthritis.1,10. In this case, stability is provided by the adjacent muscles, and intact tendons and ligaments. Fractures of hardware components include broken screws ( Figure 10-20 ), broken wires, and fractures of the rods. Note one of the screws was erroneously placed in the fracture site. AP view of the right wrist, demonstrating K-wire fixation of distal radius fracture with spanning external fixator in place.

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