Data Trace Editor – Discussion: – general discussion of non union / infected femoral nails – femoral shaft that has not healed in 26 wks signals a delayed union; – may be more common in segmental fractures and in winquest type IV fractures; – most common iatrogenic risk factor is failure to … Read more
– Discussion: – advantages of femoral shaft reaming: – avoids potential mis-sizing of nail diameter (which can occur when non-reamed nails are inserted); – reaming may carry bone graft particulate into the fracture site; – faster union may be achieved in … Read more
– Measurement of Length: – its essential to plan ahead to achieve proper leg length; – w/ comminuted frx, use opposite leg to determine leg length; – one method is to obtain long cassette radiograph of opposite side w/ radiographic ruler included on the film; … Read more
– Discussion: – child abuse: child abuse occurs in 50-80% of children < 2 yrs w/ femoral frx; – limb length inequality are seldom a problem since frx does not shorten excessively; – acceptable reduction: – in children younger than 2 yrs, shortening of … Read more
– Discussion: – child abuse: 30% of femoral frx in children < 4 yrs are 2nd to child abuse; – Over-riding of Fracture Fragments: – in children between the ages of 2-10 yrs, overgrowth averages 0.9 cm; – in kids between 2 & 10 yrs, side to side apposition … Read more
– Discussion: – External Fixation – ref: External fixation of pediatric femoral fractures. – IM Nailing: (flexible vs rigid) – avascular necrosis is a reported complication in young adolescents; – consider IM entry point anterior to piriformis fossa; – children w/ coxa … Read more
(see: Synthes Femoral Products) Workup for Femoral Shaft Frx (trauma workup) assessment of perfusion: damage control orthopaedics timing of surgery in orthopaedic patients with brain injury surgical timing and prevention of ARDS in patients with femur frx IM Nailing Technique Anatomy of Femur Arterial supply Canal Entry Point Comminuted Femoral Shaft Fractures Distal Femoral Physeal … Read more
– Discussion: – goal: ream close to endosteal cortex, which has strongest cancellous bone; – enter medullary canal w/ curet, & ensure that there are no perforations; – this is esp important w/ osteoporotic bone; – to enlarge medullary canal of diaphysis, use … Read more
– Discussion: – physeal bone bridges – methods to estimate growth potential – anatomy of distal femoral physis – distal femoral physis grows roughly at a rate of 9 mm/year (girls finish growing at age 14) – growth arrest, partial or complete, w/ progressive angulation &/or shortening ranges from 30% & 80% of pts; … Read more
– Discussion: – performed to correct either anteversion / valgus deformity of femoral neck in patients w/ dysplasia that reduces w/ abduction and medial rotation; – if hip is not reducible, then open reduction is performed prior to osteotomy; – the procedure is most useful when the acetabular dyspasia … Read more