– See: – Maisonneuve Fracture – Surgical Approaches for Lateral Malleolar Fracture: – Anterolateral Approach – Posterolateral Approach – Weber A Lateral Malleolar Frx – Weber B Lateral Malleolar Frx – Weber C: Lateral Malleolus – Discussion: – malposition of lateral malleolus w/ tilting or shortening, will lead to distorted talotibial wt bearing and lead … Read more
– See: – Nail Placement and Depth – Cannulated Screws
– 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
– 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
– 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: 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
– 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
– Discussion: – see open frx menu, tibia fracture menu and infections of the tibia – Initial Treatment and Timing of Surgery: – preoperative antibiotics; – therapeutic doses of ancef and tobramycin for 3 days are appropriate; – w/ contamination consider … Read more
– See: Gun Shot Wounds Plumbism Open Fractures Septic Joint – Classifaction of Open Joint Injuries: (from Collins and Temple (1992)) – type 2: – single capsular perforation or laceration w/o extensive soft tissue injury – A: w/ minimal step … Read more
– Discussion: – fracture types: open tibia fractures, open fractures of femur – treat all open fractures as an emergency; – perform thorough initial eval to dx other life-threatening injuries: (see trauma management); – open joint injuries – gun shot wounds – controversies: non operative treatment: – Nonoperative … Read more