Ortho Oracle - orthopaedic operative atlas

Adult Distal Radius Frx: Non Operative Treatment

– Discussion: (distal radius fracture menu)       – technique of closed reduction       – position of immobilization:              – generally need to avoid positions of marked palmar flexion & ulnar deviation (Cotton-Loder position);              – a truly stable fracture will probably be stable in any position once it is reduced;         … Read more

Distal Radius Frx: Use of Ligamentotaxis

– Discussion:     – longitudinal traction restores skeletal length and improves fracture alignment,     – radial styloid frx and scaphoid facet are usually amenable to reduction through ligamentotaxis or by manipulation and reduction with a large, pointed bone clamp;     – residual incongruity usually involves the lunate facet of the distal end of … Read more

Distal Interlocking

– Discussion:     – generally distal interlocks should be inserted prior to the proximal interlocks;           – this allows the leg to be rotated in the most advantageous position for interlock insertion and allows more effecient compression across the frx site (by gently tapping the proximal nail assembly proximally);     – … Read more

Distal Olecranon Fracture

– Discussion:     – if frx extends distally past midpoint of trochlear notch, it no longer represents only a disruption of the triceps mechanism;     – it comprimises stability of elbow in withstanding varus & valgus forces; – Reduction:     – reduction of olecranon frx is easiest w/ elbow in extension which relaxes the … Read more

Distal Phalangeal Fractures

– See: – Phalangeal Menu: – Nail Bed Injuries: – Finger Tip Injuries: – Mallet Frx – Discussion: – fractures of the distal phalanx usually result from crushing injuries that produce significant soft tissue injury; – in such injuries the primary concern is soft tissue repair; – when the fractures are comminuted, the fragments are … Read more

Distal Radial Frx: Radial Length

        – Distal Radial Length:     – shortening results from extensive comminution and impaction of frx fragments into the metaphysis;     – shortening of radius is more disabling than an angulatory deformity of the distal radius (ie, dorsal tilt or loss or radial inclination);     – radial shortening following … Read more

Distal Radius Fracture

– Discussion:     – fracture types: – barton’s fracture – dorsal – barton’s fracture – volar – chauffeur’s fracture – colles fracture – intra-articular fractures of distal radius – pediatric distal radius fracture – smith’s fracture – classification: – frykman classification – melone classification – universal classification – radiographs: – radial inclination – radial length … Read more