– Technique: – stratedgy involves, performing articular surface reduction, and then to secure proximal portion to tibial metaphysis w/ use of lateral butress plate along w/ possible use of medially applied external fixation; – application of lateral plate takes advantage of the better soft tissue envelop on the lateral side of … Read more
– Discussion: – main indication for operative Rx is failure of closed Rx: – when closed reduction requires forced, abnormal positioning of foot (forced plantar flexion and inversion); – when displaced or unstable fractures of either or both malleoli result in displacement of talus or widening of mortise greater than 1 to 2 mm; – Indications for Treatment: … Read more
– Surgical Approaches: – if operative treatment has been selected, it is essential that a near anatomic reduction be obtained; – malunion may lead to reduction is subtalar motion and eventual arthrosis; – its essential to avoid varus and dorsal angulation; – the area of … Read more
– See: – Maisonneuve Fracture – Surgical Approaches for Lateral Malleolar Fracture: – Anterolateral Approach – Posterolateral Approach – Weber A Lateral Malleolar Frx – Weber … Read more
– Discussion: – closed weight bearing treatment should be used for the majority of low energy tibial fractures; – advantages of open treatment: – allows early weight bearing; – minimizes hospitalization; – infection; – disadvantages … Read more
– See: – Closed Reduction – X-rays for Femoral Neck Fractures – Indications: – w/ failure to obtain a closed reduction persists, esp in younger pt or older child, then open reduction is considered; – Posterior Approach: – in young pt requiring ORIF of a displaced femoral neck frx, consider … Read more
– See: Open Frx Menu: – Discussion: – traumatic wound is nearly always anterior in location, and may have a variable degree of damage to the extensor mechanism; – in pts w/ grades I, II, or IIIa open supracondylar frx consider ORIF – for IIIb and IIIc fractures consider external … Read more
– See: – External fixators for tibia frx – IM nails for tibial frx – Indications for Fixator Exchange (for IM nail): (factors for successful exchange:) – absence of pin tract infections; – short duration of external fixator; – it is unclear whether the … Read more
– Discussion of Open Femur Frx: (see open frx menu) – see: gun shot wounds – rates of wound infection should be < 4 % w/ meticulous debridement of wound; – rates of union and the functional results have been comparable with those obtained after nailing of closed fractures; – compartment … Read more