– IM Nailing Technique – Open Femur Frx – Radiographs: – look for evidence of a pathologic lesion on x-ray, noting that it would be disasterous if a nail were driven through an occult osteosarcoma or chondroscaroma; – AP pelvis: (rule out concomitant injuries) – Hip Dislocation … Read more
– See: – Malgaigne Fracture – Sacral Fractures – Sacroiliac Fracture Dislocations – cresent fracture – Evaluation of Stability: – as noted by Kellam, et al. (1987), a stable injury is one that can withstand normal physiologic forces w/o excessive deformation; – it … Read more
Discussion trimalleolar fractures involve frx of the medial and lateral malleoli along w/ a frx of the posterior lip of tibial plafond; frx fragment results from avulsion by the posterior tibiofibular ligament at its site of attachment to the tibia; clinical results triamalleolar frxs are generally worse w/ larger fragments involving a larger portion of … Read more
– Discussion: – diagnosis: limb is shortened, internally rotated, and adducted; – Thompson and Epstein Classification: – Type I: w/ or w/o a minor fracture – Type II: w/ large single frx of post. acetabular rim; … Read more
– See: – Classification and Column Theory – Posterior Wall Fractures – AO Foundation Posterior Column Frx – Discussion: – posterior column extends from obturator foramen thru posterior aspect of the wt bearing dome of acetabulum & then obliquely through greater sciatic notch; – frx of … Read more
– See: Posterior Approach for Pelvic Frx – Indications for Use: – isolated posterior wall & posterior column frxs; – allows access to posterior column and posterior wall only, but exposure is limited proximally by superior gluteal vessels and greater trochanter; – isolated transverse frx (as well … Read more
– Discussion: – evaluation of the painful hip replacement and exam for THR loosening: – heterotopic ossification: – post op AP & lateral x-rays should include entire length of stem & cement mass; – femur and cement column are inspected carefully and compared w/ previous films for changes indicating component loosening, stem … Read more
– See: – Associated Transverse and Posterior Wall Frx – Classification and Column Theory – Discussion: – most common type of acetabular frx (up to 50% of acetabular fractures will contain a posterior wall fragment); – posterior wall frxs involve the posterior articular surfaces, often w/ retroacetabular … Read more
– Discussion: – refers to the portion of the posterior wall and column at the mid acetabulum lying above the ischial spine; – screws placed in this one are at risk for joint penentration; – anatomic safe zone: – entry point … Read more
– Assess ISS: – w/ multiple injuries (Pelvic Frx) consider supine position and use of universal femoral distractor; – Rotational Alignment – 45 deg Lateral on Flouro Table: – indications: – include ipsilateral femoral and acetabular frx or vertical unstable pelvic fracture; … Read more