Trochella dysplasia, Arthroscopic release .pptx

Trochella dysplasia

1. Ortho 4 surgical review April 1s t week

2. Nithuna 18/F C/0 giving away of knee joint for 8yrs No comorbidity H/o rt MPFL reconstruction at 2022 L/e No valgus deformity J sign posi tive Apprehension test negative Patella glide >2quadrants

3. Pre op xray

4. CT - TYPE C TROCHLEA DYSPLASIA

5. FEMORAL ANTEVERSION - 14* TT-TG DISTANCE - 22 MM

6. TROCHLEA DYSPLASIA

7. GRADE 2 CHONDRAL CHANGES OVER PATELLA

8. LATERAL RETINACULUM RELEASE

9. Post op xray

10. Ot notes UNDER SPINAL ANESTHESIA, PATIENT IN SUPINE POSITION , RIGHT LOWER LIMB IN LITHOTOMY UNDER TOURNIQUET CONTRO, UNDER C ARM GUIDANCE, PARTS PAINTED AND DRAPED.THROUGH ANTEROLATERAL PORTAL PATELLA MALTRACKING VISUALISED WITH TROCHLEAR DYSPLASIA, GRADE II CHONDRAL CHANGES NOTED OVER MEDIAL PATELLA FACET.GRACILIS GRAFT HARVESTED THROUGH 3CM VERTICAL INCISION OVER THE MEDIAL BORDER OF PATELLA, SKIN , SUBCUTANEOUS TISSUE INCISED.MEDIAL RETINACULUM ENGAGED AT THE MEDIAL BORDER AND 2 DRILL HOLE USING 2.5MM DRILL BITS MADE FROM MEDIAL TO LATERAL.2 FIBRE WIRES PASSED ACROSS AND GRAFT FIXED. UNDER C ARM GUIDANCE, SIHOTTLE POINT IDENTIFIED AND DRILLED USING 4.5MM REAMER.GRAFT TUNNELED SUBMUSCULARLY AND RETRIEVED AT THE FEMORAL TUNNEL.ISOMETRY CHECKED AND FIXED WITH 6MM/25MM PEEK SCREW.ARTHROSCOPICALLY LATERAL RETINACULUM RELEASE DONE USING RF PROBE.WOUND CLOSED IN LAYERS, STERILE DRESSING DONE .

11. Arumugam 24/M A/h/o RTA No comorbidity L/e Swelling and t enderness present over mid shaft of radius Deformity present Rom restricted No DNVD

12. Pre op xray

13. Intraop images

14. Post op xray

15. Ot notes UNDER SUPRACLAVICULAR BLOCK, PATIENT IN SUPINE POSITION WITH RIGHT ARM OVER ARM BOARD, PARTS PAINTED AND DRAPED. UNDER TOURNIQUET CONTROL, THROUGH VOLAR HENRY APPROACH, SKIN INCISION MADE OVER THE MIDDLE THIRD OF FOREARM, THROUGH PLANE BETWEEN FLEXOR CARPI RADIALIS AND BRACHIORADIALIS. RADIAL ARTERY AND SUPERFICIAL RADIAL NERVE VISUALISED AND RETRACTED. SOFT TISSUES DISSECTED AND FRACTURE SITE EXPOSED. FRACTURE REDUCED AND STABILIZED WITH 7 HOLES 3.5MM LCP WITH 3 SCREWS PROXIMALLY ( 3 LOCKING) AND 3 SCREWS DISTALLY (1 CORTICAL, 2 LOCKING). WOUND CLOSED IN LAYERS OVER SUCTION DRAIN. STERILE DRESSING APPLIED.