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Minimal Invasive Management of the Necrotic Immature Root

Minimal Invasive Management of the Necrotic...

In this video dr Antonis Chaniotis presents a case of necrotic immature root (43 y.o patient). Minimal invasive management was implemented. The tooth was obturated with MTA. Video thanks to dr Antonis Chaniotis.

Ankle Fracture Surgery Video

Ankle Fracture Surgery Video

Ankle Fracture Surgery - Stryker 'VariAx Fibula' plating system The video shows how to fix a distal fibular fracture. Doctor describes the injury and shows the equipment used to perform the surgery. The ability to tell patients that they will not see or feel the plate on the outside of their ankle is important, especially smaller patients with thinner ankles. This patient had a very common ankle inversion injury that resulted in both an oblique fracture of the distal fibula and torn ankle ligaments. During the first ankle arthroscopic procedure, the anterior talofibular ligament was found to be completely torn, but still attached to the distal fibula. Debris and some osteochondral pathology was removed and then we performed the fibula fracture repair. The procedure went smoothly, the plate was conformed to the patients unique fibula shape, fracture position and then the anterior talofibular ligament was repaired with the final Modified Brostrom procedure. Post operatively, these ankle fracture patients will be non weight bearing for 4-6 weeks, then partial weight bearing in a walking boot.

How to Read Knee MRI of Medial Meniscus Tear

How to Read Knee MRI of Medial Meniscus Tear...

Colorado knee surgeon, Dr. Robert LaPrade details the specifics on how to read knee MRI of medial meniscus tear. There are different types of meniscus tears and a horizontal cleavage tear occurs within the fibers of the meniscus and splits the meniscus in the top and bottom pieces. To begin, we start with a sagittal view on the lateral side. As we start to go more towards the midline we start to see the lateral meniscus. There is a dark appearance to it, so there is no evidence of disruption. As we scan further we see the ACL and PCL, which both look normal. Moving more towards the medial side of the knee there is evidence of signal changes in the medial meniscus. In this case, we see a complete white pass of fluid in the meniscus, which indicates that there is a horizontal cleavage tear. The next view is a coronal scan. As we course more posteriorly we can see the meniscus is in relatively good position, but we are starting to see increase signal in the body of the meniscus, which is indicative of a tear. All the way to the posterior medial aspect we can see signal intensity, which is consistent with the horizontal cleavage tear. The last view we look at is an axial image. In some cases it is challenging to see the tear within the meniscus from this view, but it is important to assess.

Dermoid Limbus Ablation with Fugo Blade

Dermoid Limbus Ablation with Fugo Blade

A large limbal dermoid is wiped off with Fugo blade, without burning, without charring. Postoperative reaction is nil with Fugo blade surgery.

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.


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