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Doctor insights on: Artrial Fibulation

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Knee injury. MRI report "PCL Avulsion fracture of tibia (6-7mm displacement) with adjacent tibial bone edema. fibers are intact." is surgery needed?

Knee injury. MRI report  "PCL Avulsion fracture of tibia (6-7mm displacement) with adjacent tibial bone edema. fibers are intact." is surgery needed?

Yes, it should if-: -U expect 2 have a functioning knee 4 the rest of Ur life. It can only separate more, & a simple reduction & fixation will do what U want it 2 do, reunite the fragment 2 the tibia. The image is a tear & requires a major reconstruction if not fixed. U risk the fragment becoming a nonunion. ...Read more

Fibrillation (Definition)

Fibrillation is the rapid, irregular, and unsynchronized contraction of muscle fibers. An important occurrence is with ...Read more


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Advanced articular cartilage loss in medial compartment of tibio-femoral and patella-femoral joints. Would partial (unicondylar) knee replacement work?

Advanced articular cartilage loss in medial compartment of tibio-femoral and patella-femoral joints. Would partial (unicondylar) knee replacement work?

Maybe: This decision is best made by your own orthopedist who has direct access to your x rays. A second opinion never hurts. In someone so young, if you can get away with something short of a total joint replacement, it is always preferable to do so. ...Read more

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Surgery? Degeneration posterior horn of meniscus, tendinosis/partial thickness tearing of patellar tendon at interpolar patella, subcutaneous edema

Surgery? Degeneration posterior horn of meniscus, tendinosis/partial thickness tearing of patellar tendon at interpolar patella,  subcutaneous edema

When nonop tx fails: Surgery is not usually the first line of treatment for chronic injuries such as you described: degenerative (chronic) PHMMT, and patellar tendinosis (vs partial inferio pole tear). Nonoperative management: physical therapy, stretching program, NSAIDs, rest, ice, may all help considerably. Arthroscopy to debride a degenerative meniscal tear due to persistent mechanical symptoms may be needed later. ...Read more

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In derotational osteotomy tibia, which muscle compartments usually get fasciotomy? Have CS in anterior & deep compartments of leg and medal of foot.

In derotational osteotomy tibia, which muscle compartments usually get fasciotomy? Have CS in anterior & deep compartments of leg and medal of foot.

Derotational or high: 4 DJD?derotational R usually done in kids with severe deformity, & no compartments released. If it was high & derotational or 4 DJD, compartments R not routinely released. CS is a complication that must B watched 4 & addressed if develops post op. I have not had this as a complication but it's always in Ur mind post op, then all 4 should B released. Some use cont pressure monitoring & do the high ...Read more

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Right knee advanced loss of articular cartilage in medial compartment of tibio femoral and patella femoral joints. What are surgical options?

Right knee advanced loss of articular cartilage in medial compartment of tibio femoral and patella femoral joints. What are surgical options?

Best answered by Ur-: Treating ortho. There R a few options, but one needs 2 C Ur x-rays and do a hands on xam. The options R from a high tibial osteotomy, arthroscopic debredment,or TKA, tho Ur young 4 the TKA? There R also injections like synvisc (hylan g-f 20) or steroids. ...Read more

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Is a weber b distal fib fx a fx of the lateral malleolus?

Is a weber b distal fib fx a fx of the lateral malleolus?

Yes: The distal (lower end) fibula is also know as the lateral malleolus. The weber classification of ankle fractures classifies based on the location of the fracture (break) with respect to the syndesmosis (connection between tibia and fibula just above the ankle joint. A = below syndesmosis, b = at level, c = above. As you go from a to b to c, the risk of syndesmosis injury increases. ...Read more

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Treatment for radial & longitudinal tears of the posterior horn medial meniscus, severe knee osteoarthrits moderate joint effusion, diffuse synovitis?

Treatment for radial & longitudinal tears of the posterior horn medial meniscus, severe knee osteoarthrits moderate joint effusion, diffuse synovitis?

Numerous : The most definitive option is a knee replacement. Knee arthroscopy is not likely to be helpful at this point. Various injections such as cortisone, hyaluronic acid/joint fluid or platelet-rich plasma are reasonable options. Meds, braces and PT are considerations. If I can help, then join my care team and virtual practice at www.healthtap.com/dr-clarkeholmes ...Read more

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Is lumbar medial branch radiofrequency ablation safe in patients with multiple sclerosis?

Is lumbar medial branch radiofrequency ablation safe in patients with multiple sclerosis?

Yes: There is absolutely NO clinical evidence that any type of surgery, anesthesia, or standard clinical injections can affect the trajectory of MS, and radio frequency ablation should be relatively safe. ...Read more

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Artrial septial defect with pulmonary hypertension in children?

Artrial septial defect with pulmonary hypertension in children?

Talk to MD: As long as there is no reversal of flow which can happen soon due to pulmonary hypertension, a surgical repair may be beneficial. The answer should be given by a cardiologist. Talk to the cardiologist please for your child's sake. Good luck. ...Read more

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3 fx of med and post malleolus w oblique fx of fib, disruption of syndesmosis, several ligaments torn via eversion injury. Classification?(weber, etc)

3 fx of med and post malleolus w oblique fx of fib, disruption of syndesmosis, several ligaments torn via eversion injury. Classification?(weber, etc)

Depends: Depending on the level of the fibular fracture, this is either a weber b or c. The c category shows a fracture above the syndesmosis and is much more unstable. ...Read more

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Calf tightness w/ swelling Achilles (and paratendon) + distended unilateral tributary over achilles. Compartment syndrome? Venous? No known injury.

Calf tightness w/ swelling Achilles (and paratendon) + distended unilateral tributary over achilles. Compartment syndrome?  Venous? No known injury.

DVT: Could be many things, but you need to have an ultrasound of your leg to rule out deep vein thrombosis. These can break off and go to the lungs and be life threatening. ...Read more

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Is the Ankle Brachial Index effective in detecting peroneal artery problems?

Is the Ankle Brachial Index effective in detecting peroneal artery problems?

PAD: Yes, the peroneal artery is also known as the posterior tibial. The ankle brachial index is used to diagnose and follow the progression of peripheral arterial disease. The arteries' pressure measured are the posterior tibial and the dorsailis pedis. If you have an abnormal abi, there is a problem with the blood flow in your lower legs. I hope this helps. ...Read more

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MRI showed in left ankle chronic full-thickness tear of the anterior talofibular ligament superior bundle. Is surgery required?

MRI showed in left ankle chronic full-thickness tear of the anterior talofibular ligament superior bundle. Is surgery required?

Usually not.: For most lateral ankle ligament injuries, including tears, surgery is not required. Of course, different circumstances call for different treatments. Most respond to immobilization, physical therapy and eventual rehab with some injuries. Consult your physician you considerations about your specific circumstances. ...Read more

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Left knee medial compartment joint replacement hardware with abnormal uptake of tracer in the medial left femoral condyle proximal to the prosthesis.

Left knee medial compartment joint replacement hardware with abnormal 
uptake of tracer in the medial left femoral condyle proximal to the prosthesis.

Varies : It varies in part on the type of scan you underwent and the timing of when your knee replace my was done as well. A standard bone scan will light up with increased bone activity and would be concerning for loosening, infection, or fracture. A white blood labeled scan that lights up whilst be concerning for infection. I would discuss with your surgeon. ...Read more

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Peroneal tendons subluxing. Extensor retinaculum repair just failed. Cavus foot from CS. Can both retinacula (2) & cavus be fixed at once? Techniques?

Peroneal tendons subluxing. Extensor retinaculum repair just failed. Cavus foot from CS. Can both retinacula (2) & cavus be fixed at once? Techniques?

Yes: the cavus is the bone position typically as in your condition at the heel. A bone cut can be made to align the heel. The retinacular repair can be done at the same time. ...Read more

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Is surgery necessary for longitudinal peroneal tendon split?

Is surgery necessary for longitudinal peroneal tendon split?

Function : Studies show surgery if indicated for ruptures or when injuries diminish function. See ortho surgeon for expert consultation. http://emedicine.medscape.com/article/91344-treatment#d10 ...Read more