– Discussion: – x-rays are taken at 3-4 weeks to ensure that there is no loss of reduction; – intact fibula in bicondylar or medial plateau frxs causes many fractures to displace into varus; – local compession frx tend to loss reduction most frequently; – most common … Read more
– Post Op Care: – consider keeping the knee in 45-60 deg flexion; – for the first 5 postop days, the pts leg is maintained in a CPM machine, and the ROM is increased to a range of 15 to 70 deg; – POD #3: active assisted ROM exercises … Read more
– Discussion: – Lateral plateau: Incision: – Medial Plateau: Incision: – Tibial Osteotomy: – osteotominizing tibial tubercle to incr exposure can lead to difficulty in certain frx, because tubercle may be only component of a Bicondylar Fracture left intact; – Elevation of Fracture Frag: … Read more
– Discussion: – tibial component fixation requires a stem to prevent sinking of the implant due to compressive failure of prox tibial cancellous bone, & shear stresses are high enough in knee to require fixation of tibial tray with peripheral pegs; – tibial stem reduces shear forces at the prosthesis bone interface, as well as … Read more
– See: Innerv. Musc. Lower Limb: – Anatomy: – tibial nerve is derived from L4, L5, S1, S2, S3; – the anterior component, supplies muscles of posterior thigh (except short head of biceps whch is supplied by peroneal nerve); – in popliteal space it gives off branches that supply … Read more
– Discussion: (w/ assistance and narration by Dr Kyle Dickson MD) – term pilon (hammer) fracture was introduced to describe these compression injuries by Destot in 1911; – ref: High-energy tibial pilon fractures: an instructional review. – frx components: – combination of ankle frx & distal tibial metaphyseal frx, usually w/ intra articular comminution; – frx … Read more
– See Technique of IM Nailing – Indications: – tibial shaft fractures within 4 cm distal to the tibial tuberosity to 4 cm proximal to the ankle may be treated with interlocking techniques; – Soft Tissue Injury: – open tibial frx (Gustillo classification): – reconstruction for leg defects: – Frx … Read more
– Considerations: – pin care: – tissue motion impairs tissue resistance to infection; – excess motion at pin skin interface can be reduced by wrapping sterile gauze between the pin clamp and skin; – surgical sponges around pins … Read more
– See: Preparation for Proximal Tibial Cut: – Discussion: – intrameduallary & extrameduallary systems are available for aligning the proximal tibial cut; – IM system is less accurate, particularly when tibia has varus bow and may lead to excessive cement column; – ref: Extramedullary … Read more
Current Concepts Review. Treatment of Unstable Fractures of the Shaft of the Tibia. Current Concepts Review. Timing of Operative Treatment of Fractures in Patients Who Have Multiple Injuries. Pelvic and Lower Extremity Trauma–Symposium: Intramedullary Devices for Tibial Fracture Stabilization. The use of a tourniquet when plating tibial fractures. Conservative management or closed nailing for tibial shaft fractures. … Read more