Operative Techniques for Hip Frx: Pins
– See: – Nail Placement and Depth – Cannulated Screws
Data Trace Editor
Operative Timing for Club Foot Deformity
– Discussion: – best time to do the operative procedure is debatable; – although some surgeons have recommended that the surgical release be done within the first few days or weeks of life, it is generally agreed that this is not advisable; … Read more
Open vs Closed Treatment of Tibial Frx
– 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
Open Excision of Distal Clavicle
– See: Distal Clavicle Excision – main discussion Discussion: – consider excising only 1 cm of the distal clavicle; – excision of the distal 1.5-2.0 cm of the clavicle ensures that impingement will not occur (excision of this fragment may cut trapezoid ligament); – the remaining conoid ligament is sufficient to anchor the distal clavicle to … Read more
Opening Wedge Proximal Metatarsal Osteotomy
– See: Hallux Valgus: – for mod hallux valgus in younger pts (HVA < 30 & IMA < 13-15 deg); – usually no pin or screw fixation is required; – no shortening of metatarsal will occur; – if a Silver Procedure is being performed, concomitantly, the excised medial eminence can be fashioned into a trapezoidal … Read more
Operative Checklist
Clickable Image Map: – Trauma Systems: Neuro (see Glasgow) Cranio-Maxillo-Facial Cardiac Respiratory Renal Vascular Compartments Hepatic Coag X-rays and Template Planned Incision Consent Bone Graft Open vs Closed Reduction Anesthesia & Cardiology Consults Prophylactic ATB DVT prophylaxis Posting Blood & Cell Saver Implant Selection Positioning Table type and Flouro – Initial Orders: – NPO … Read more
Operative Decompression of the PIN
– Technique: – there are two approaches that allow decompression of PIN: anterior and posterior (see Henry and Thompson); – Henry’s mobile wad (brachioradialis, ECRL , and ECRB) serves as the focal area for orientation; – anterior approach is more advantages since is allows decompression of all points of … Read more
Open Reduction of Femoral Neck Fracture
– 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
Open Reduction of Posterior Frx Dislocations of the Hip
See: Posterior Frx Dislocations of the Hip – Indications: – irreducible dislocation: – due to soft tissue interposition (ligamentum teres, capsule, labrum, piriformis, ect.); – incongruent joint: – due to intra-articular bone and cartilage fragments; … Read more
Open Reduction: Supracondylar Frxs
– See: – Percutaneous Pin Fixation – Type III Supracondylar Frx – Indications: – vascular injuries – inadequate reduction; – brachialis may become interposed at frx site or by proximal humeral frx fragment button-holed thru brachialis (see physical exam); … Read more