– Discussion: – retrograde IM nailing – Workup for Femoral Shaft Frx – PreOp Planning: – rule out femoral neck fracture: – Is Reconstruction Nailing of All Femoral Shaft Fractures Cost Effective? A Decision Analysis. – Diagnosis of femoral neck fracture associated with femoral shaft fracture: blinded comparison of computed tomography and plain radiography. – IM nailing of … Read more
– See: – Anterior Approach to the Shoulder – Discussion: – with plate fixation of the humerus, the anterior approach is preferred for proximal and mid-diaphyseal frx w/ application of plate to anterolateral aspect of the humerus (see humeral shaft fractures); – interval lies … Read more
– See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more
PreOp Planning consider NG tube and foley catheter; have proper sized C-collar available for post operative care; position: supine w/ halter cervical traction (3-5 lbs) w/ head turned slightly to the right; consider placing a rolled towel between the shoulder blades; prep for iliac crest bone graft; hall burr is helpful for shaping bone graft; … Read more
Discussion varus deformity of the ankle may follow distal tibial fracture or distal tibial epiphyseal frx; deformities due to distal tibial epiphyeal injuries are often progressive; deformities due to tibial plafond injuries are usually static (from malreduction at the time of the original procedure); left untreated, the varus deformity may lead to DJD of the … Read more
– See: Refereneces for Ankle Fractures: The Segmental Rectus Abdominis Free Flap for Ankle and Foot Reconstruction. The deltoid ligament. An evaluation of need for surgical repair. Salvage procedures for complications of total ankle arthroplasty. Diagnostic and operative arthroscopy of the ankle. An experimental approach. Acute rupture of the peroneal retinaculum. Guidelines for selective radiological … Read more
– Discussion: – w/ an “isolated fibular frx,” the paramount indication of an unstable frx is lateral talar shift (which indicates deltoid ligament injury); – this is manifested radiographically as an increase in the medial clear space; – normally the medial clear space (between talus & medial … Read more
(See also: Antiglide Plate) Discussion position of plate is dependent on level of frx, condition of overlying soft tissues, and the extent of comminution; Posteriorly Positioned Plate see antiglide plate: allows use of a thicker, stronger plate; less risk of wound slough; irritate peroneal tendons; distal screws obtain better purchase, since they engage a thicker part … Read more
– Discussion: – select appropriately sized 6.5 mm or 7.0 mm canulated screw (threads must cross the frx site); – consider direction of maximal deformity and displacment; – guide wire insertion (for cannulated screw insertion); – K wire is inserted from deep w/ in sinus … Read more
– See: Equinovarus: – Discussion: – most common problem; – in those w/ diplegia, it is bilateral & almost always flexible in child under three years; – diff dx: toe walking – Exam: – it is essential that the ankle and hindfoot be held in varus while … Read more