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Surgery of Severe Ptosis, Singh Technique

Surgery of Severe Ptosis, Singh Technique

A case of severe ptosis, operated by Singh orbital approach. The surgery is easy, no tissue is removed, only rearranged. There are minimal chances of lagophthalmos. Recovery is fast. The patient wants to go home after 3 hours, but I detain him for 24 hours at least. The current techniques anchors the Muller muscle and pulls forwards the floating LPS wrapped in tenon capsule. It is more comfortable to me with the recent modification of technique.

How to Read Knee MRI of ACL Tear | Anterior Cruciate Ligament Injury

How to Read Knee MRI of ACL Tear | Anterior...

In this video, Colorado knee surgeon Dr. LaPrade identifies how to read knee MRI of ACL tear. He looks at the normal anatomy of the knee and what a torn ACL looks like and the secondary signs of an anterior cruciate ligament injury. Starting with a sagittal view of the lateral aspect of the knee, we move more medial the first thing we see is bone bruising. Bone bruising is usually present with an ACL tear on the anterior aspect of the lateral femoral condyle and the posterior aspect of the lateral tibial plateau. About 70% of people with an ACL injury have a bone bruise. This bruising is usually due to the subluxation that happens with an ACL injury. Normally, the ACL is a dark structure in the center of the knee. In this case, the ACL is completely blown apart. There is some evidence of the ACL fibers, but we just do not see the normal ACL. As we move more medial we start to see fluid in the joint, which is consistent with bleeding from an ACL tear. It is also common for there to be a tear to the posterior horn of the medial meniscus with an ACL injury. We then move to the coronal images. As we start to move more posterior we look for bone bruising and we start to see a stump of a torn ACL. Instead of seeing normal contour of the dark ACL substance, we start to see more a balled-up appearance. In this view we can also see the injury to the posterior horn of the medial meniscus. Finally, we look at the axial views, although these are not as useful when looking at ACL tears. You can see the fluid present within the joint.

ACL Reconstruction and Knee Arthroscopy

ACL Reconstruction and Knee Arthroscopy

Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics explains and performs Anterior Cruciate Ligament (ACL) Surgery. Anterior Cruciate Ligament (ACL) tears are a common knee ligament injury often occurring as a result of an athletic injury. Anatomy of the ACL and Mechanism of Injury The ACL is one of the primary stabilizing ligaments of the knee. It originates from the back of the femur (thigh bone) and inserts on the front of the tibia (shin bone). It is about the size of your small finger but can withstand forces of up to 500 lbs. before it ruptures. The ACL minimizes excessive forward movement and rotation of the tibia in relationship to the femur. A tear of the anterior cruciate ligament (ACL) results from over stretching of the ligament. It is the most commonly injured ligament in the knee. How ACL Tears Occur An injury to the ACL can occur as the result of slow, twisting fall skiing or with a sudden deceleration in cutting and pivoting sports such as football, basketball or soccer. It is most often a non-contact injury. Women are 3–5 times more likely than male athletes to tear their ACL for a number of biomechanical reasons. The vast majority of ACL tears are complete tears, but one can occasionally suffer only a partial tear. Most people report feeling their knee give way, hearing a pop in the knee, and then having immediate pain and swelling. Pain is commonly located on the outside or lateral aspect of the knee. However, patients can also tear the medial collateral ligament (MCL) or medial meniscus, which can cause pain on the medial or inside of the knee. Immediate Aftermath of ACL Tear People can typically walk on the knee with pain after such an injury, but they may feel that their knee gives way or feels weak. Oftentimes, other structures, such as the meniscus cartilages, are also injured in the knee when the ACL tears. However, after 4–6 weeks, the knee can feel nearly normal and one can do non-athletic, everyday activities. However, if a person without a functioning ACL then suddenly twists or rotates on the knee, they may experience a giving way episode of the knee. Over time, these repeated giving way episodes damage other structures in the knee such as the meniscus and articular cartilage, leading to premature knee arthritis. ACL Tears Do Not Heal On Their Own Unfortunately, tears of the ACL do not heal. The ACL is bathed in synovial fluid. When it tears, the small blood vessels that once surrounded it also tear and there is bleeding within the knee. However, the surrounding synovial fluid quickly dilutes this blood and therefore the healing potential is greatly diminished. In contrast, when the MCL tears, the bleeding that occurs is not washed away from the site of the tear by synovial fluid. In turn, this bleeding helps mobilize healing cells to the site of the MCL tear. These cells form collagen fibers, which act to bridge the torn MCL back to its native attachment site from which it tore away. Most MCL tears can therefore fully heal as long as the knee is protected in a knee brace so that the MCL does not heal in an elongated and lax position.

Vascular Malformation Excision at the Kimbus

Vascular Malformation Excision at the Kimbus

The red nodule on the limbus has grown during the past 3 years. The lesion is excised and sent for histopathology. Fugo blade is helpful in excision the nodule with minimal trauma to the tissues.

Young Male With A Mysterious Bladder Stone - X-Ray And CT

Young Male With A Mysterious Bladder Stone...

Radiology Academy presents the video of a mysterious big bladder stone in young male on noncontrast CT study of the abdomen and pelvis and on traditional abdomen radiography.

Robotic Partial Nephrectomy - Step 9: Capsular Closure and Specimen Removal

Robotic Partial Nephrectomy - Step 9: Capsular...

This video demonstrates the final step (capsular closure and specimen removal) of robotic partial nephrectomy for kidney cancer. Author of video is Dr. Craig Rogers of the Vattiikuti Urology Institute.

Robotic Partial Nephrectomy - Step 8: Inner Layer Renal Reconstruction

Robotic Partial Nephrectomy - Step 8: Inner...

This video demonstrates the eighth step (inner layer renal reconstruction) of robotic partial nephrectomy for kidney cancer. Author of video is Dr. Craig Rogers from Vattiikuti Urology Institute.

Robotic Partial Nephrectomy - Step 7: Tumor Excision

Robotic Partial Nephrectomy - Step 7: Tumor...

This video demonstrates the seventh (tumor excision) step of robotic partial nephrectomy for kidney cancer. Author of video is Dr. Craig Rogers of the Vattiikuti Urology Institute.

Robotic Partial Nephrectomy - Step 6: Techniques for Hilar Clamping

Robotic Partial Nephrectomy - Step 6: Techniques...

This video demonstrates the sixth step (hilar clamping) of robotic partial nephrectomy for kidney cancer. Author of video is Dr. Craig Rogers from Vattiikuti Urology Institute.

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