Trimalleolar Fracture
•Download as PPTX, PDF•
2 likes•3,682 views
A 67-year-old woman presented with left ankle pain after a motor vehicle collision where she slammed her feet on the brakes before impact. On examination, she had an obvious deformity of the left ankle with edema and tenderness. Imaging showed she had sustained tri-malleolar fractures of the left ankle, involving fractures of the lateral, medial, and posterior malleoli. She required immediate orthopedic consultation and surgery to repair the unstable fractures.
Report
Share
Report
Share
Recommended
39. tibial plafond (pilon) fractures
This document discusses tibial pilon fractures, which involve fractures of the distal tibial articular surface. Key points include:
1) The term "tibial pilon" was first used in 1911 to describe the distal tibia resembling a pestle. Pilon fractures account for 7-10% of tibial fractures and usually result from high-energy mechanisms.
2) Classification systems include the Rüedi-Allgöwer system (based on articular displacement/comminution) and the AO/OTA system (which further subdivides based on extra-articular involvement and comminution).
3) Treatment involves restoring tibial alignment, stabilizing the fracture to facilitate union,
Dr.S.Senthil Sailesh-functional cast bracing,PTBcast,sarmiento principle
The document discusses functional casting and bracing techniques used to treat fractures while allowing restricted movement. It describes the principles of functional casting which include maintaining stability and reduction while promoting blood flow and muscle contraction to encourage healing. Specific casts for treating fractures of the humerus, tibia, femur and hip are outlined, including the Sarmiento cast and hip spica cast. The timing, positioning and complications of different casts are summarized. Functional casting aims to continue function during fracture healing to accelerate rehabilitation.
Management of TendoAchillis rupture
Dr. Ankur Mittal presented on diagnostic tests and imaging for Achilles tendon injuries. [1] Ultrasound is often used to determine tendon thickness and gap size for complete ruptures and is inexpensive and fast. [2] MRI is better for detecting incomplete tears and planning surgery for chronic tears but is more expensive. [3] Imaging is rarely needed for acute cases but can help with chronic cases for diagnosis and surgical planning.
Recurrent patellar dislocation
The document provides information on recurrent patellar dislocation, including:
- Anatomy of the patella and its attachments
- Static and dynamic stabilizers of the patella
- Causes of patellar instability such as trochlear dysplasia, patella alta, increased Q angle
- Mechanisms of injury for acute vs recurrent dislocations
- Evaluation methods like the apprehension test, patellar glide test, and imaging views
Fracture of Distal End Humerus.
Normal Anatomy, Mech. of Injury, Classification, Radiological Diagnosis , Management and Complications.
Congenital pseudoarthrosis tibia
This document discusses congenital pseudarthrosis of the tibia (CPT), a rare condition where the tibia fails to heal after fractures at an early age. CPT is often associated with neurofibromatosis type 1. The etiology is unclear but is thought to involve periosteal fibrosis. Imaging can help evaluate the extent of disease. Surgical treatment aims to achieve union, prevent refracture, and correct deformities. Common approaches include intramedullary nailing, vascularized fibular grafting, and external fixation. Prognosis remains poor due to risks of nonunion, refracture, limb length discrepancy, and ankle deformity. Close long-term monitoring is needed.
Ankle fractures
Ankle fractures are common injuries that require careful evaluation to identify bony and soft tissue damage. The ankle is a complex hinge joint supported by ligaments and the tibia, fibula, talus, and deltoid ligament. Classification systems like Lauge-Hansen and Weber are used to characterize fracture patterns and guide management, which may involve closed treatment for stable injuries or surgery to restore ankle anatomy and stability for unstable fractures. Radiographs are important for diagnosis but CT or MRI may be needed to fully evaluate injury extent.
Prosthesis selection
The document discusses different types of knee prostheses from least to most constrained, including cruciate-retaining, posterior-stabilized, constrained non-hinged, and constrained hinged designs. It covers indications, advantages, disadvantages, and key design aspects such as femoral rollback and radiographic appearance for each type. Mobile bearing and all-polyethylene designs are also briefly discussed.
Recommended
39. tibial plafond (pilon) fractures
This document discusses tibial pilon fractures, which involve fractures of the distal tibial articular surface. Key points include:
1) The term "tibial pilon" was first used in 1911 to describe the distal tibia resembling a pestle. Pilon fractures account for 7-10% of tibial fractures and usually result from high-energy mechanisms.
2) Classification systems include the Rüedi-Allgöwer system (based on articular displacement/comminution) and the AO/OTA system (which further subdivides based on extra-articular involvement and comminution).
3) Treatment involves restoring tibial alignment, stabilizing the fracture to facilitate union,
Dr.S.Senthil Sailesh-functional cast bracing,PTBcast,sarmiento principle
The document discusses functional casting and bracing techniques used to treat fractures while allowing restricted movement. It describes the principles of functional casting which include maintaining stability and reduction while promoting blood flow and muscle contraction to encourage healing. Specific casts for treating fractures of the humerus, tibia, femur and hip are outlined, including the Sarmiento cast and hip spica cast. The timing, positioning and complications of different casts are summarized. Functional casting aims to continue function during fracture healing to accelerate rehabilitation.
Management of TendoAchillis rupture
Dr. Ankur Mittal presented on diagnostic tests and imaging for Achilles tendon injuries. [1] Ultrasound is often used to determine tendon thickness and gap size for complete ruptures and is inexpensive and fast. [2] MRI is better for detecting incomplete tears and planning surgery for chronic tears but is more expensive. [3] Imaging is rarely needed for acute cases but can help with chronic cases for diagnosis and surgical planning.
Recurrent patellar dislocation
The document provides information on recurrent patellar dislocation, including:
- Anatomy of the patella and its attachments
- Static and dynamic stabilizers of the patella
- Causes of patellar instability such as trochlear dysplasia, patella alta, increased Q angle
- Mechanisms of injury for acute vs recurrent dislocations
- Evaluation methods like the apprehension test, patellar glide test, and imaging views
Fracture of Distal End Humerus.
Normal Anatomy, Mech. of Injury, Classification, Radiological Diagnosis , Management and Complications.
Congenital pseudoarthrosis tibia
This document discusses congenital pseudarthrosis of the tibia (CPT), a rare condition where the tibia fails to heal after fractures at an early age. CPT is often associated with neurofibromatosis type 1. The etiology is unclear but is thought to involve periosteal fibrosis. Imaging can help evaluate the extent of disease. Surgical treatment aims to achieve union, prevent refracture, and correct deformities. Common approaches include intramedullary nailing, vascularized fibular grafting, and external fixation. Prognosis remains poor due to risks of nonunion, refracture, limb length discrepancy, and ankle deformity. Close long-term monitoring is needed.
Ankle fractures
Ankle fractures are common injuries that require careful evaluation to identify bony and soft tissue damage. The ankle is a complex hinge joint supported by ligaments and the tibia, fibula, talus, and deltoid ligament. Classification systems like Lauge-Hansen and Weber are used to characterize fracture patterns and guide management, which may involve closed treatment for stable injuries or surgery to restore ankle anatomy and stability for unstable fractures. Radiographs are important for diagnosis but CT or MRI may be needed to fully evaluate injury extent.
Prosthesis selection
The document discusses different types of knee prostheses from least to most constrained, including cruciate-retaining, posterior-stabilized, constrained non-hinged, and constrained hinged designs. It covers indications, advantages, disadvantages, and key design aspects such as femoral rollback and radiographic appearance for each type. Mobile bearing and all-polyethylene designs are also briefly discussed.
Inra medullary nailing - basic concepts
This document provides an overview of intramedullary nailing, including:
- Evolution from 1st to 3rd generation nails with improved stability and anatomical fit
- Classification by entry point and direction of insertion
- Biomechanical principles of load transfer and stability depending on nail design, number/location of locking screws, and reaming
- Applications for treating fractures of long bones and considerations for special circumstances
Telescopic nails in Osteogenesis Imperfecta
Osteogenesis imperfecta is a hereditary bone disease caused by mutations in type 1 collagen genes. It causes bone fragility and fractures. Telescopic intramedullary rods are the preferred treatment for long bone fractures and deformities in patients with osteogenesis imperfecta. There are several types of telescopic rods including Bailey-Dubow, Sheffield, Fassier-Duval, and interlocking rods. Studies have shown telescopic rods have lower revision rates compared to solid rods and allow for continued bone growth. Complications are also less common with telescopic rods. Fassier-Duval rods in particular have advantages of single entry point fixation and low risk of migration.
Soft Tissue Balancing in Primary Total Knee Arthroplasty
The document discusses principles of soft tissue balancing during primary total knee replacement, including defining soft tissue stabilizers of the knee, techniques for soft tissue balancing like measured resection and gap balancing, and how to manage coronal plane deformities like varus and valgus knees through staged releases of tight soft tissues and bone cuts that create symmetrical flexion and extension gaps.
Ankle injuries & Trimallelor fracture classification
Trimalleolar fractures involve fractures of the medial malleolus, lateral malleolus, and posterior malleolus. They are typically caused by high-energy injuries like falls or motor vehicle accidents. Open reduction and internal fixation is usually required due to the instability caused by the involvement of all three fracture sites. The size and displacement of the posterior malleolar fragment determines if open reduction is needed, with a fragment over 25-30% of the joint surface or over 2-3mm of displacement requiring open reduction. Proper anatomic reduction and fixation of all fracture fragments is important to achieve stability and prevent post-traumatic arthritis.
Triple arthrodesis seminar by Dr Chirag Patel
This seminar mainly useful for all post graduates of orthopeadics and helpful for theory and practical examination.
Calcaneal fractures
Here are the key steps in the ORIF procedure:
1. Patient is placed in lateral decubitus position and a right-angled lateral incision is made to minimize soft tissue damage.
2. The fracture line at the angle of Gissane is identified.
3. Fragments are temporarily held in place with K-wires under fluoroscopy while the reconstruction restores the 3D shape of the calcaneus.
4. The "constant" sustentacular fragment is used to begin the reconstruction, working anteriorly and medially.
5. Traction may be needed to restore the posterior facet.
6. The lateral wall fragment is closed like a door last to complete the
Hemiarthroplasty of Hip joint
Hemiarthroplasty involves replacing the femoral head while retaining the natural acetabulum. It is commonly used to treat fractures of the femoral neck in elderly patients. There are two main types - unipolar, which replaces just the head, and bipolar, which adds an inner bearing. Selection depends on factors like bone quality and joint stability. Cemented stems are generally preferred in patients with poor bone stock, while uncemented can be used if bone is adequate. Positioning and fixation are important to optimize function and stability.
Tuberculosis of the hip
This document discusses tuberculosis of the hip joint. It begins by describing the causative organism, Mycobacterium tuberculosis, which is an acid-fast bacillus. It then covers the pathophysiology of tuberculosis infection in the hip, including the formation of tubercles and caseation necrosis. The document outlines the clinical presentation of TB of the hip and its radiographic appearance. It discusses the different stages of TB arthritis in the hip and associated radiographic findings. The document concludes by covering treatment approaches for TB of the hip including chemotherapy, traction, arthroplasty, arthrodesis and osteotomy.
Pilon fractures
1) Pilon fractures involve injuries to the distal tibial articular surface and were first described in 1911.
2) They account for 5-7% of tibial fractures and result from high-energy impacts.
3) Treatment is challenging due to articular comminution, bone loss, and soft tissue injury. Surgical management aims to reconstruct the articular surface and metaphysis while treating soft tissues.
supracondylar fracture humerus in children
Supracondylar fractures of the humerus are the most common elbow injuries in children, making up approximately 60% of cases. They typically occur as a result of a fall onto an outstretched hand in children aged 5-7 years old. Radiographs are used to classify fractures as non-displaced (Type I), displaced with an intact posterior cortex (Type II), or completely displaced (Type III). Posteromedial displacement is more common than posterolateral. Physical examination focuses on evaluating neurovascular status and detecting any S-shaped deformity, with nerve injuries occurring in up to 16% of cases.
Damage control orthopaedic surgery
Damage control orthopaedics (DCO) is an approach that temporarily stabilizes orthopaedic injuries in severely injured trauma patients to avoid worsening their condition. It focuses on controlling hemorrhage, managing soft tissue injury, and achieving provisional fracture stability through temporary stabilization methods like external fixation. This allows time for the patient's physiology to stabilize before definitive repair and reduces the risks of complications from a major orthopaedic procedure when the patient is still unstable. DCO has evolved from traditional approaches as an understanding has grown of the body's inflammatory response to trauma and risks of multiple hits.
Aseptic loosening total hip arthroplasty
This document discusses aseptic loosening of total hip arthroplasty (THA) components. It notes that while success rates for THA are high, osteolysis and loosening continue to plague surgeons, with failure rates as high as 20% due to these complications. The document then discusses the biological process of osteolysis, sources and rates of particulate debris from different bearing surfaces, modes of wear, and radiographic signs of loosening for cemented and cementless femoral and acetabular components. Treatment options including revision surgery and indications for surgery are also summarized.
Locking plates
This document discusses locking plate technology for fracture fixation. Some key points include:
- Locking plates provide fixed-angle stability between screws and plate through threaded screw holes.
- They allow for angular stability, increased pullout strength, and preservation of blood supply compared to conventional plates.
- Indications include osteoporotic, periarticular, and comminuted fractures. Plates can be used in compression, neutralization, bridging, or combination modes.
- Proper surgical planning, screw placement, and technique are important to avoid complications like loss of reduction, screw protrusion, or plate/screw failure.
Ankle fractures final
The document discusses the anatomy and biomechanics of the ankle joint. It describes the ankle joint as a three bone joint composed of the tibia, fibula, and talus. It notes that the talus articulates superiorly with the tibial plafond and posteriorly with the posterior malleolus of the tibia. The lateral articulation is with the malleolus of the fibula. The joint is saddle-shaped and wider anteriorly to accommodate dorsiflexion. Disruption of the ankle mortise can decrease contact area by 42%.
Tendon repair
This document discusses tendon anatomy, injury, and repair. It describes the composition and vascular supply of tendons. Common tendon injuries include open wounds requiring surgical repair and closed injuries causing deformities. The goals of repair are to reestablish tendon continuity and gliding function. Various suture techniques are discussed for end-to-end, end-to-side, and tendon-to-bone repairs. Post-operative rehabilitation aims to promote intrinsic healing while minimizing scarring through early controlled motion to optimize tendon gliding and range of motion recovery.
Floating Knee
This document discusses floating knee injuries, which involve ipsilateral fractures of the femur and tibia. It describes the classification system for floating knee injuries, which includes true floating knee injuries (extra-articular fractures of both bones) and various types involving articular fractures. These injuries often result from high-energy trauma and are associated with injuries to other body parts. Treatment involves stabilizing the patient, addressing any life-threatening injuries, and providing initial stabilization of the fractures often using external fixation before definitive surgical fixation of the fractures.
Masquelet Technique
The document discusses the Masquelet technique, a two-stage procedure for treating bone defects and non-unions. In the first stage, radical debridement is performed followed by placement of an antibiotic-loaded cement spacer to form an induced membrane. In the second stage 6-8 weeks later, the membrane is preserved while removing the spacer and filling the defect with bone graft for reconstruction. Studies reported successful outcomes using this technique for various bone defects up to 25cm in length. Key factors for success include thorough debridement, maintaining the induced membrane, adequate stabilization and soft tissue management.
Total knee approaches
This document describes various approaches for total knee arthroplasty, including the medial and lateral parapatellar approaches, midvastus approach, subvastus approach, and extensile exposures like the quadriceps snip, V-Y turndown, and tibial tubercle osteotomy. Each approach has advantages and disadvantages in terms of exposure, impact on soft tissues, technical difficulty, and postoperative recovery considerations. The medial parapatellar approach is the most familiar but can impact patellar tracking and the medial capsular repair, while the lateral parapatellar approach is useful for valgus deformities but more technically demanding.
Radial head fracture
This document summarizes the epidemiology, anatomy, mechanisms of injury, classification, treatment approaches, and complications for radial head fractures. Some key points:
- Radial head fractures account for 4% of all fractures and 30% of elbow fractures. They are rare in children.
- The radial head provides stability to the elbow joint and transmits 50-60% of the load across the elbow.
- Fractures are typically classified using the Mason classification system based on displacement.
- Treatment depends on fracture type but may include non-operative management, open reduction and internal fixation, radial head replacement, or radial head excision.
- Complications can include nerve injuries, stiffness, hardware issues, and recurrent
High Tibial Osteotomy_UTSAV
This document discusses high tibial osteotomy (HTO), a procedure that corrects knee alignment to relieve pressure from arthritic areas. It was first described in 1961 and involves cutting and reshaping the tibia to transfer weight from an arthritic to a healthier area of cartilage. The document outlines indications, contraindications, techniques like closing wedge and opening wedge osteotomy, management of the fibula, fixation methods, advantages and disadvantages of different techniques, expected results, and potential complications. HTO is a well-established procedure for unicompartmental knee arthritis with typical satisfactory results in 80% of cases.
Tillaux Fracture
A 13-year-old male presented with ankle pain after twisting his foot while hiking. On examination, he had limited range of motion in his right ankle with marked swelling and tenderness. Radiographs revealed a Salter Harris III fracture involving avulsion of the anterolateral tibial epiphysis. He was treated with pain control, orthopedic consultation for possible open reduction and internal fixation, and stabilization in a long leg cast or splint with orthopedic follow-up.
Triplane Fracture
A 15-year-old male presents to the emergency department after jumping off a merry-go-round and landing on his right foot, experiencing achy pain and swelling. On examination, he has dorsal swelling and tenderness over the foot and malleolus, and pain with ankle movement. This suggests a triplane fracture, which involves the tibial growth plate and metaphysis, occurring through multiple planes. Treatment involves splinting nondisplaced fractures and closed or open reduction for displaced fractures.
More Related Content
What's hot
Inra medullary nailing - basic concepts
This document provides an overview of intramedullary nailing, including:
- Evolution from 1st to 3rd generation nails with improved stability and anatomical fit
- Classification by entry point and direction of insertion
- Biomechanical principles of load transfer and stability depending on nail design, number/location of locking screws, and reaming
- Applications for treating fractures of long bones and considerations for special circumstances
Telescopic nails in Osteogenesis Imperfecta
Osteogenesis imperfecta is a hereditary bone disease caused by mutations in type 1 collagen genes. It causes bone fragility and fractures. Telescopic intramedullary rods are the preferred treatment for long bone fractures and deformities in patients with osteogenesis imperfecta. There are several types of telescopic rods including Bailey-Dubow, Sheffield, Fassier-Duval, and interlocking rods. Studies have shown telescopic rods have lower revision rates compared to solid rods and allow for continued bone growth. Complications are also less common with telescopic rods. Fassier-Duval rods in particular have advantages of single entry point fixation and low risk of migration.
Soft Tissue Balancing in Primary Total Knee Arthroplasty
The document discusses principles of soft tissue balancing during primary total knee replacement, including defining soft tissue stabilizers of the knee, techniques for soft tissue balancing like measured resection and gap balancing, and how to manage coronal plane deformities like varus and valgus knees through staged releases of tight soft tissues and bone cuts that create symmetrical flexion and extension gaps.
Ankle injuries & Trimallelor fracture classification
Trimalleolar fractures involve fractures of the medial malleolus, lateral malleolus, and posterior malleolus. They are typically caused by high-energy injuries like falls or motor vehicle accidents. Open reduction and internal fixation is usually required due to the instability caused by the involvement of all three fracture sites. The size and displacement of the posterior malleolar fragment determines if open reduction is needed, with a fragment over 25-30% of the joint surface or over 2-3mm of displacement requiring open reduction. Proper anatomic reduction and fixation of all fracture fragments is important to achieve stability and prevent post-traumatic arthritis.
Triple arthrodesis seminar by Dr Chirag Patel
This seminar mainly useful for all post graduates of orthopeadics and helpful for theory and practical examination.
Calcaneal fractures
Here are the key steps in the ORIF procedure:
1. Patient is placed in lateral decubitus position and a right-angled lateral incision is made to minimize soft tissue damage.
2. The fracture line at the angle of Gissane is identified.
3. Fragments are temporarily held in place with K-wires under fluoroscopy while the reconstruction restores the 3D shape of the calcaneus.
4. The "constant" sustentacular fragment is used to begin the reconstruction, working anteriorly and medially.
5. Traction may be needed to restore the posterior facet.
6. The lateral wall fragment is closed like a door last to complete the
Hemiarthroplasty of Hip joint
Hemiarthroplasty involves replacing the femoral head while retaining the natural acetabulum. It is commonly used to treat fractures of the femoral neck in elderly patients. There are two main types - unipolar, which replaces just the head, and bipolar, which adds an inner bearing. Selection depends on factors like bone quality and joint stability. Cemented stems are generally preferred in patients with poor bone stock, while uncemented can be used if bone is adequate. Positioning and fixation are important to optimize function and stability.
Tuberculosis of the hip
This document discusses tuberculosis of the hip joint. It begins by describing the causative organism, Mycobacterium tuberculosis, which is an acid-fast bacillus. It then covers the pathophysiology of tuberculosis infection in the hip, including the formation of tubercles and caseation necrosis. The document outlines the clinical presentation of TB of the hip and its radiographic appearance. It discusses the different stages of TB arthritis in the hip and associated radiographic findings. The document concludes by covering treatment approaches for TB of the hip including chemotherapy, traction, arthroplasty, arthrodesis and osteotomy.
Pilon fractures
1) Pilon fractures involve injuries to the distal tibial articular surface and were first described in 1911.
2) They account for 5-7% of tibial fractures and result from high-energy impacts.
3) Treatment is challenging due to articular comminution, bone loss, and soft tissue injury. Surgical management aims to reconstruct the articular surface and metaphysis while treating soft tissues.
supracondylar fracture humerus in children
Supracondylar fractures of the humerus are the most common elbow injuries in children, making up approximately 60% of cases. They typically occur as a result of a fall onto an outstretched hand in children aged 5-7 years old. Radiographs are used to classify fractures as non-displaced (Type I), displaced with an intact posterior cortex (Type II), or completely displaced (Type III). Posteromedial displacement is more common than posterolateral. Physical examination focuses on evaluating neurovascular status and detecting any S-shaped deformity, with nerve injuries occurring in up to 16% of cases.
Damage control orthopaedic surgery
Damage control orthopaedics (DCO) is an approach that temporarily stabilizes orthopaedic injuries in severely injured trauma patients to avoid worsening their condition. It focuses on controlling hemorrhage, managing soft tissue injury, and achieving provisional fracture stability through temporary stabilization methods like external fixation. This allows time for the patient's physiology to stabilize before definitive repair and reduces the risks of complications from a major orthopaedic procedure when the patient is still unstable. DCO has evolved from traditional approaches as an understanding has grown of the body's inflammatory response to trauma and risks of multiple hits.
Aseptic loosening total hip arthroplasty
This document discusses aseptic loosening of total hip arthroplasty (THA) components. It notes that while success rates for THA are high, osteolysis and loosening continue to plague surgeons, with failure rates as high as 20% due to these complications. The document then discusses the biological process of osteolysis, sources and rates of particulate debris from different bearing surfaces, modes of wear, and radiographic signs of loosening for cemented and cementless femoral and acetabular components. Treatment options including revision surgery and indications for surgery are also summarized.
Locking plates
This document discusses locking plate technology for fracture fixation. Some key points include:
- Locking plates provide fixed-angle stability between screws and plate through threaded screw holes.
- They allow for angular stability, increased pullout strength, and preservation of blood supply compared to conventional plates.
- Indications include osteoporotic, periarticular, and comminuted fractures. Plates can be used in compression, neutralization, bridging, or combination modes.
- Proper surgical planning, screw placement, and technique are important to avoid complications like loss of reduction, screw protrusion, or plate/screw failure.
Ankle fractures final
The document discusses the anatomy and biomechanics of the ankle joint. It describes the ankle joint as a three bone joint composed of the tibia, fibula, and talus. It notes that the talus articulates superiorly with the tibial plafond and posteriorly with the posterior malleolus of the tibia. The lateral articulation is with the malleolus of the fibula. The joint is saddle-shaped and wider anteriorly to accommodate dorsiflexion. Disruption of the ankle mortise can decrease contact area by 42%.
Tendon repair
This document discusses tendon anatomy, injury, and repair. It describes the composition and vascular supply of tendons. Common tendon injuries include open wounds requiring surgical repair and closed injuries causing deformities. The goals of repair are to reestablish tendon continuity and gliding function. Various suture techniques are discussed for end-to-end, end-to-side, and tendon-to-bone repairs. Post-operative rehabilitation aims to promote intrinsic healing while minimizing scarring through early controlled motion to optimize tendon gliding and range of motion recovery.
Floating Knee
This document discusses floating knee injuries, which involve ipsilateral fractures of the femur and tibia. It describes the classification system for floating knee injuries, which includes true floating knee injuries (extra-articular fractures of both bones) and various types involving articular fractures. These injuries often result from high-energy trauma and are associated with injuries to other body parts. Treatment involves stabilizing the patient, addressing any life-threatening injuries, and providing initial stabilization of the fractures often using external fixation before definitive surgical fixation of the fractures.
Masquelet Technique
The document discusses the Masquelet technique, a two-stage procedure for treating bone defects and non-unions. In the first stage, radical debridement is performed followed by placement of an antibiotic-loaded cement spacer to form an induced membrane. In the second stage 6-8 weeks later, the membrane is preserved while removing the spacer and filling the defect with bone graft for reconstruction. Studies reported successful outcomes using this technique for various bone defects up to 25cm in length. Key factors for success include thorough debridement, maintaining the induced membrane, adequate stabilization and soft tissue management.
Total knee approaches
This document describes various approaches for total knee arthroplasty, including the medial and lateral parapatellar approaches, midvastus approach, subvastus approach, and extensile exposures like the quadriceps snip, V-Y turndown, and tibial tubercle osteotomy. Each approach has advantages and disadvantages in terms of exposure, impact on soft tissues, technical difficulty, and postoperative recovery considerations. The medial parapatellar approach is the most familiar but can impact patellar tracking and the medial capsular repair, while the lateral parapatellar approach is useful for valgus deformities but more technically demanding.
Radial head fracture
This document summarizes the epidemiology, anatomy, mechanisms of injury, classification, treatment approaches, and complications for radial head fractures. Some key points:
- Radial head fractures account for 4% of all fractures and 30% of elbow fractures. They are rare in children.
- The radial head provides stability to the elbow joint and transmits 50-60% of the load across the elbow.
- Fractures are typically classified using the Mason classification system based on displacement.
- Treatment depends on fracture type but may include non-operative management, open reduction and internal fixation, radial head replacement, or radial head excision.
- Complications can include nerve injuries, stiffness, hardware issues, and recurrent
High Tibial Osteotomy_UTSAV
This document discusses high tibial osteotomy (HTO), a procedure that corrects knee alignment to relieve pressure from arthritic areas. It was first described in 1961 and involves cutting and reshaping the tibia to transfer weight from an arthritic to a healthier area of cartilage. The document outlines indications, contraindications, techniques like closing wedge and opening wedge osteotomy, management of the fibula, fixation methods, advantages and disadvantages of different techniques, expected results, and potential complications. HTO is a well-established procedure for unicompartmental knee arthritis with typical satisfactory results in 80% of cases.
What's hot (20)
Soft Tissue Balancing in Primary Total Knee Arthroplasty
Soft Tissue Balancing in Primary Total Knee Arthroplasty
Ankle injuries & Trimallelor fracture classification
Ankle injuries & Trimallelor fracture classification
Viewers also liked
Tillaux Fracture
A 13-year-old male presented with ankle pain after twisting his foot while hiking. On examination, he had limited range of motion in his right ankle with marked swelling and tenderness. Radiographs revealed a Salter Harris III fracture involving avulsion of the anterolateral tibial epiphysis. He was treated with pain control, orthopedic consultation for possible open reduction and internal fixation, and stabilization in a long leg cast or splint with orthopedic follow-up.
Triplane Fracture
A 15-year-old male presents to the emergency department after jumping off a merry-go-round and landing on his right foot, experiencing achy pain and swelling. On examination, he has dorsal swelling and tenderness over the foot and malleolus, and pain with ankle movement. This suggests a triplane fracture, which involves the tibial growth plate and metaphysis, occurring through multiple planes. Treatment involves splinting nondisplaced fractures and closed or open reduction for displaced fractures.
Maisonneuve Fracture
An 18-year-old female presented with severe left ankle pain rated 10/10 after twisting her ankle while walking and falling. Examination revealed an obvious bony abnormality of the medial malleolus with decreased range of motion and tenderness over the proximal fibula. She was diagnosed with a Maisonneuve fracture, which includes a proximal fibular fracture, avulsion fracture of the medial malleolus, and syndesmosis disruption. She was advised to elevate, ice, and take analgesics for pain and to follow up with orthopedics for likely need of internal fixation surgery due to poor prognosis with conservative treatment.
Salter Harris Type 3 Fracture
A 12-year-old female presented with left ankle pain after being the restrained rear passenger in a motor vehicle collision with no head trauma or loss of consciousness. On examination, she had swelling, tenderness, and decreased range of motion of her left ankle due to pain. Imaging revealed a Salter Harris Type III fracture through the tibial epiphysis with the fracture line extending into the joint. Treatment for this type of intra-articular physeal injury consists of early orthopedic involvement with reduction, splinting or casting, and occasionally additional imaging or open reduction to ensure proper articular surface alignment.
Maisonneuve fracture
1. A 32-year-old Thai female patient fell and twisted her right ankle 4 hours prior, causing pain and limited movement of the ankle.
2. Physical examination revealed tenderness and swelling of the right ankle. X-rays showed a proximal fibular fracture with a medial malleolus fracture, indicating a Maisonneuve injury.
3. The patient was diagnosed with a Maisonneuve injury, or spiral fracture of the upper fibula with disruption of the distal tibiofibular syndesmosis. She was immobilized and referred for surgical fixation and casting.
Clavicle Fracture
A 14-year-old male presented with right shoulder pain after falling off his bike. On exam, he had limited range of motion and difficulty raising his arm past 45 degrees. Fractures of the clavicle are most commonly seen in the middle third and care should be taken to check for injuries to nearby neurovascular structures. Treatment depends on if the fracture is displaced or nondisplaced, with nondisplaced fractures typically treated with a sling and displaced fractures possibly requiring operative repair.
Hamate Fracture
A 25-year-old male baseball player presented to the emergency department with left wrist pain and numbness in his left fifth digit that occurred after fouling off a pitch. Examination revealed tenderness over the hamate bone and decreased sensation and grip strength. X-rays of the hand were normal but a CT scan confirmed a fracture of the hamate hook. Treatment involves pain control, splint immobilization, and orthopedic referral for potential excision of the hook fragment due to risk of non-union or ulnar nerve injury.
Pleural effusion Power Point
A 65-year-old man with a history of diabetes, hypertension, coronary artery disease, and end-stage renal disease presented with a 3-day history of dry cough and worsening shortness of breath with exertion. On examination, he had bilateral basilar rales and chest x-ray showed bilateral pleural effusions. He was admitted for supportive respiratory therapy and treatment of the underlying pleural effusions through thoracentesis or tube thoracostomy.
Anke fx fixation - Derek Park
This document discusses surgical techniques for fixing ankle fractures. It describes the anatomy of the ankle joint and surrounding ligaments. Common fracture patterns are described using the Weber classification system. Surgical approaches and fixation methods are outlined, including lateral plating, lag screws, and posterior plating. The principles of fixation aim for stability, articular congruity, and restoration of the fibula. Factors such as the position of the foot, deforming forces, and stability tests are important to consider when determining appropriate treatment.
Fracturas en miembros inferior
El documento describe las fracturas más comunes en los miembros inferiores, incluyendo la pelvis, fémur, rodilla, tibia, peroné, tobillo y pie. Explica la anatomía de cada región, clasificaciones de fracturas, lesiones asociadas y opciones de tratamiento quirúrgico y no quirúrgico.
Fractura de tobillo
Este documento describe la anatomía, tipos, diagnóstico y tratamiento de fracturas comunes del tobillo, incluyendo fracturas del maléolo externo e interno, fractura de Dupuytren, fracturas del astrágalo y fracturas del calcáneo. Proporciona detalles sobre la clasificación de fracturas del tobillo según Weber y sobre posibles complicaciones como artrosis y necesidad de artrodesis.
Ankle fractures
This document provides an overview of ankle injuries, including:
1. The anatomy of the ankle joint and surrounding ligaments that provide stability.
2. Common types of ankle injuries like sprains and fractures, which are often caused by inversion or eversion forces on the ankle.
3. Guidelines for evaluating and diagnosing ankle injuries through history, physical exam, and imaging like x-rays. Classification systems for fractures like Lauge-Hansen and Weber are discussed.
3. Approaches for treating different types of ankle injuries non-operatively or operatively depending on factors like the injury pattern and degree of displacement. Surgical techniques like plate fixation are outlined.
Fractura De Tobillo
El documento describe la anatomía y clasificación de las fracturas de tobillo. Explica la clasificación AO de fracturas de tobillo en tres tipos (A, B y C) dependiendo de la localización de la fractura. También describe la clasificación de Weber basada en la localización de la fractura en relación al plafón tibial, y la clasificación de Lauge-Hansen que clasifica las fracturas en función de la posición del pie y dirección de la fuerza causante. Finalmente, resume las indicaciones para el tratamiento quirúrgico o conservador de las fracturas
Fracturas de Tobillo
Fractura de Tobillo, por Ricardo Mora, estudiante medicina, 5o Año, Traumatología, Facultad de Ciencias Médicas y Biologicas "Dr. Ignacio Chavéz"
Viewers also liked (14)
Similar to Trimalleolar Fracture
Pilon Fracture
A 22-year-old male presented to the emergency department with left ankle pain after a skiing accident where he landed on a rock twisting his ankle. On examination, he had tenderness to palpation over the left ankle with diffuse edema and abrasions, but intact neurovascular status. Imaging revealed a pilon fracture of the left ankle requiring immediate orthopedic surgery consultation and splinting.
Perilunate dislocation Power Point
A 67-year-old female presented with severe pain and inability to move her right wrist after falling forward onto her outstretched hand. Examination revealed profound swelling of the right wrist with tenderness over the wrist and metacarpals and limited range of motion. Imaging showed a posterior dislocation of the capitate and distal carpal row with the lunate in a normal position. Treatment involved pain management, closed reduction of the carpal dislocation with traction and dorsal pressure, and consultation with orthopedics due to the high likelihood of associated carpal fractures requiring open repair.
Perilunate dislocation
A 67-year-old female presented with severe right wrist pain and inability to move it after falling forward onto her outstretched hand. Examination revealed profound swelling and tenderness of the right wrist with limited range of motion. X-rays showed a posterior dislocation of the capitate and distal carpal row bones, with the lunate in a normal position. Pain management and closed reduction of the dislocation was performed, and orthopedic consultation was recommended due to the likelihood of associated carpal fractures requiring open repair.
Bimalleolar Fracture
A 12-year-old male presented with severe right ankle pain after twisting his ankle when he fell in a hole while running through a field. On examination, his right ankle had an obvious bony abnormality and deformity, with tenderness over the malleoli but no range of motion. He was given analgesics and sedatives, and his ankle was immobilized in a splint with a stirrup. He was instructed to be non-weight bearing and an urgent orthopedic consultation was requested to determine if he required surgery or casting.
Talar Fracture
A 24 year old male jumped from a 10 foot high window into a pool but landed on the pavement next to the pool. He is complaining of right foot and ankle pain and inability to walk since the incident. On examination, he has significant swelling and tenderness over the right ankle with decreased range of motion. Given the mechanism of injury, a talar fracture is suspected, especially of the talar neck which is the most common location for talar fractures from this type of fall. He needs splinting, orthopedic consultation, and pain management.
Calcaneus Fracture
An 18-year-old female presented with pain in her left foot after jumping from a first story window and landing on a pool deck with her full weight on her left foot. On examination, she had bruising and tenderness to palpation on the plantar surface and calcaneus of her left foot and could only bear weight on her toes. She was given instructions for strict elevation, immobilization with a posterior splint, non-weight bearing, follow up with orthopedics, and analgesia for a suspected calcaneus fracture from the fall.
Lateral Humeral Condyle Fracture
A 6-year-old male presented to the ED after falling onto his outstretched left hand during a playground accident. He reported immediate throbbing pain and swelling in his right elbow. On examination, he had tenderness over the lateral condyle of the distal humerus with associated bruising but no deformities or nerve issues. An urgent orthopedic consult was requested to evaluate for a possible displaced lateral condyle fracture of the elbow.
Clinical conundrum in Perioperative Evaluation
Perioperative evaluation of difficult clinical scenarios which prompted to delay of surgery:
- Undiagnosed aortic regurgitation
- Pleural effusion with suspected TB
Orthopedics
The document provides an overview of common orthopedic injuries and fractures, including:
1. The 5 main types of fractures are comminuted, stress, compression, pathologic, and open fractures.
2. Common injuries include shoulder dislocations, hip fractures, knee ligament tears, and wrist issues like carpal tunnel syndrome.
3. Treatment depends on the severity of the injury, with closed reduction for mild fractures and open reduction plus internal fixation for displaced or severe fractures.
Salter harris 4 Power Point
An 11-year-old male presented to the emergency department after being kicked by a cow, unable to bear weight on his right leg and experiencing excruciating pain. Examination revealed swelling and bruising around the right ankle with pain on movement. X-rays showed a fracture extending from the metaphysis through the epiphysis, classified as a Salter-Harris Type IV injury. This type of injury crosses the physis and involves both the epiphysis and metaphysis, is associated with a worse prognosis than other types, and may affect growth even with perfect reduction. Orthopedic consultation was recommended for possible open reduction and internal fixation if any displacement was present.
Ortho..
- The patient is a 38-year-old Thai man who was in a motorcycle accident after drinking alcohol. He complains of left knee pain for 3 hours.
- Radiographs show a fracture of the left tibial plateau and left fibula. Physical examination reveals tenderness over the left knee with limited range of motion due to pain.
- The diagnoses are a fracture of the left tibial plateau, a fracture of the left fibula, and a mild head injury. The patient is placed in a long leg splint and advised to remain non-weightbearing on the left leg. Close monitoring is needed for compartment syndrome or neurological changes.
Burst fracture
This document summarizes a case conference regarding a 68-year-old Thai woman who presented to the emergency department after being hit by a motorcycle while crossing the street. She sustained a head injury with left temporal laceration and was hemodynamically stable. Imaging showed a left parieto-temporal bone fracture and subarachnoid hemorrhage. She was admitted for observation and later discharged. A subsequent case discussed low back pain after a bicycle accident, with imaging revealing a compression fracture of L1 vertebra. The patient was treated conservatively with bed rest, bracing, and pain management.
Orthopedics 2
This document summarizes common lower limb fractures seen by Dr. Ghassan Al Kefeiri. It describes pelvic fractures which most commonly result from lateral compression and may cause life-threatening hemorrhage. Hip injuries like dislocations and fractures are also discussed in detail. Femoral fractures of the diaphysis and distal regions are outlined along with potential complications. The knee section evaluates various injuries to ligaments, menisci and patella. Common causes, clinical features and treatments are provided for lower limb fractures and orthopedic conditions.
Spinal Trauma (Spinal Cord Injury)
A comprehensive powerpoint presentation on Spinal Trauma.
References: Bailey and Love's Short Practice of Surgery
Osteochondritis Dessicans
A 17-year-old male soccer player presented with nagging left knee pain for several months that was worse with exercise. Examination found pain and crepitus with compression of the medial femoral condyle. MRI revealed a subchondral defect in the medial femoral condyle consistent with osteochondritis dissecans (OCD), a separation of cartilage and subchondral bone from the underlying bone most common in the medial femoral condyle of adolescents. Initial treatment involves immobilization but surgery may be needed if the fragment is loose or detached to prevent premature arthritis.
Common fractures svh jmo
This document provides an orthopaedic registrar's overview of common fractures and how to assess and describe them. It covers topics like fracture patterns, x-ray views needed, anatomical location descriptions, and treatments. Examples of common fractures are discussed like wrist, forearm, supracondylar humerus and femoral neck fractures in both children and adults. Complications and classifications like Salter-Harris and Garden are also reviewed. Clinical cases of hip fracture patients are presented at the end.
Commen injuries of lower limbs
Common lower limb injuries include fractures, dislocations, and subluxations of bones or joints. Posterior hip dislocations are the most common type of hip dislocation, often caused by an axial load on the flexed and adducted hip. They are diagnosed via x-ray and treated initially with closed reduction and immobilization. Complications can include avascular necrosis, stiffness, and late onset osteoarthritis. Femoral neck fractures are also common in the elderly and are classified using the Garden system to determine appropriate treatment.
Spinal Injuries
The document provides information on spinal cord and cervical spine anatomy, mechanisms of spinal cord injury, clinical assessment of spinal cord injury patients, imaging for spinal cord injuries, classification of spinal cord injuries, and management principles for spinal cord injuries. Key points covered include the incidence of spinal cord injuries, common mechanisms and levels of injury, assessment of motor and sensory function, classification systems for incomplete versus complete injuries, and guidelines for cervical spine clearance in trauma patients.
Case_Studies_in_Emergency_Medicine_Trauma_-_Lisa_Yosten,_MD.pdf
This document describes 4 trauma cases seen in the emergency department. Case 1 involves a 25-year-old male who was stabbed and required exploratory laparotomy for a perforated colon. Case 2 is a hand amputation that was reattached. Case 3 is a fall from a zip line resulting in multiple orthopedic and solid organ injuries requiring transfer. Case 4 is an 87-year-old female who fell and was found to have a large subdural hematoma and warfarin-related bleeding requiring neurosurgery and coagulopathy reversal.
Salter harris 2 Power Point
A 10-year-old boy presented with an obvious deformity to his right wrist following a football injury. X-rays showed a Salter Harris Type II fracture extending from the growth plate through the bone with part of the bone broken off. The boy's wrist was splinted and he was referred to orthopedics for follow-up.
Similar to Trimalleolar Fracture (20)
Case_Studies_in_Emergency_Medicine_Trauma_-_Lisa_Yosten,_MD.pdf
Case_Studies_in_Emergency_Medicine_Trauma_-_Lisa_Yosten,_MD.pdf
More from Todd Peterson
Pneumothorax Power Point
A 34-year-old man presents with 2 days of right-sided chest pain that worsens with deep breathing and radiates to his neck and shoulderblade. He has a history of tobacco use but no other medical problems. Examination finds him in no distress. Chest x-ray shows a right-sided pneumothorax. Treatment depends on size and symptoms, with small primary pneumothoraces sometimes observed as outpatients and larger or recurrent ones requiring chest tube placement in the hospital. Pneumothoraces are classified as primary spontaneous, secondary spontaneous, or traumatic based on associated lung disease or injury history.
Pneumomediastinum
A 34-year-old man presents with sharp chest pain for 2 hours following crack cocaine use. He has no other symptoms. On examination, he has a heart rate of 148, blood pressure of 98.7/105, respiratory rate of 18, and clear lungs. Chest x-ray shows pneumomediastinum. The patient is admitted for observation and treatment with oxygen and IV fluids.
Aortic dissection
A 56-year-old man presents with 4 hours of epigastric abdominal pain described as sharp and stabbing. He has a history of hypertension and coronary artery disease. On examination, he is tachycardic with cool extremities. Imaging shows an enlarged aorta, particularly for his age, which should prompt consideration of an aortic disorder as the cause of his pain. He requires aggressive blood pressure control and emergent surgical consultation given concern for aortic dissection.
Aortic dissection
A 56-year-old man presents with 4 hours of epigastric abdominal pain described as sharp and stabbing. He has a history of hypertension and coronary artery disease. On examination, he is tachycardic with cool extremities. Imaging shows an enlarged aorta, particularly for his age, which should prompt consideration of an aortic disorder as the cause of his pain. He requires aggressive blood pressure control and emergent surgical consultation given concern for aortic dissection.
Lung cancer Power Point
A 69-year-old woman presents with a 3-month history of dry cough, chest pain, weight loss, and exercise intolerance. She has a history of smoking and lung issues. Examination finds her thin but stable. Chest x-ray shows a visible mass in her right upper lung. She may need biopsy or admission depending on stability and ability to follow up as an outpatient. The presentation of lung cancer can vary but often includes nonspecific symptoms. Different types have characteristics like location and growth patterns visible on x-ray.
Tuberculosis Power Point
A 34-year-old homeless white male presented with a 5-6 week history of intermittent fever, cough producing blood-tinged sputum, and right-sided chest pain with deep breathing. Examination found decreased breath sounds in the right upper lung field. A chest x-ray showed a cavitary lesion in the right upper lobe and hilar adenopathy, suggestive of tuberculosis. The patient was discharged with instructions for close follow-up and definitive treatment, as admission was not required due to clinical stability and ability to follow-up.
Atypical pneumonia Power Point
A 67-year-old man with diabetes and hypertension presented with worsening fever, malaise, dyspnea, and abdominal pain over two days. On examination, he had a fever, rapid heart rate, diffuse lung rhonchi, and normal abdomen. A chest X-ray showed patchy infiltrates and peri-hilar prominence. Given his atypical presentation and chest X-ray findings, he was started on a macrolide or respiratory fluoroquinolone antibiotic for suspected atypical pneumonia.
Lobar pneumonia Power Point
A 76-year-old female presented with worsening dyspnea, cough producing yellow sputum, subjective fevers and chills, weakness and decreased appetite. Her vital signs and physical exam showed signs of infection. Chest x-rays revealed consolidation in the right middle lobe, suggesting lobar pneumonia. She was treated with oxygen, IV fluids, antibiotics and admitted to the hospital based on her condition.
Pulmonary Embolism Power Point
A 58-year-old female presented to the emergency room with anxiety and shortness of breath after climbing stairs. She has been feeling stressed due to social stressors and recently took a trip to Italy. On examination, she was tachycardic but her lungs were clear to auscultation. A chest x-ray showed blunted costophrenic sulci and opacity of the left lung bases indicating increased blood flow to the left lung. The patient was given oxygen and intravenous fluids, and anticoagulation therapy was started given her risk for pulmonary embolism.
Pitcher's Elbow Power Point
A 10-year-old male pitcher presents with right arm pain after pitching in a little league baseball game. On examination, he is rubbing his right elbow and has tenderness over the medial epicondyle. X-rays are normal but this is likely a case of pitcher's elbow or medial apophysitis from overuse. The parents and patient are instructed that the child must cease pitching for 4-6 weeks and gradually return to avoid further injury.
SCIWORA Power Point
A 3 year old boy presented with new onset lower extremity weakness after falling from a high chair two days prior. On examination, he had decreased strength and sensation in both lower extremities. Cervical spine films and CT were normal. He received a diagnosis of SCIWORA (spinal cord injury without radiographic abnormality) and was admitted for MRI and further evaluation by neurosurgery.
Salter harris 1 Power Point
A 9 year old female presented to the emergency department after falling from a horse at summer camp and injuring her right wrist. She complained of pain with palpation and movement of the wrist. Examination revealed mild swelling and tenderness over the wrist, but plain films did not show any obvious abnormalities. Due to the possibility of a Salter Harris I fracture that may not be visible on initial x-rays, the patient was splinted and advised to follow up with orthopedics in 7-10 days for repeat films to check for any delayed findings.
SCFE Power Point
An 11-year-old boy presented with left hip and knee pain for over a week. On examination, he had pain with internal rotation of the left hip. The document emphasizes that slipped capital femoral epiphysis (SCFE) can present as knee pain referred from the hip, so knee complaints should prompt evaluation of the hip. Failure to diagnose SCFE can lead to avascular necrosis, so orthopedic consultation is considered emergent and SCFE is ultimately treated with surgical repair.
Pubic Diastasis Power Point
A 27-year-old male was brought to the trauma bay after a high-speed motor vehicle collision and is complaining of severe abdominal and pelvic pain. On examination, he appears pale and uncomfortable with tenderness to palpation in the lower abdomen and instability of the pelvis. Treatment should include fluid resuscitation, pain control, stabilizing the unstable pelvis to avoid movement, and evaluating for other injuries, as pelvic fractures from high-impact accidents can cause life-threatening hemorrhage or urethral injuries.
Legg calve perthes Power Point
A 7-year-old boy presented with several weeks of left hip and knee pain. On physical exam, he had decreased range of motion of the left hip, especially with internal rotation and abduction. He was diagnosed with Legg-Calve-Perthes disease, which is caused by interruption of blood flow to the capital femoral epiphysis, resulting in bone infarction and fractures. Differential diagnoses included sickle cell disease and septic hip. NSAIDs were prescribed for pain control and orthopedic follow-up was recommended.
Femoral neck fracture Power Point
A 78-year-old woman presented to the emergency department after falling at home and landing on her left hip. On examination, her left hip was tender to touch, her left leg appeared externally rotated and shortened. She was diagnosed with a left femoral neck fracture based on her mechanism of injury and physical exam findings.
Femoral neck fracture
A 78-year-old woman presented to the emergency department after falling at home and landing on her left hip. On examination, her left hip was tender to touch, her left leg appeared externally rotated and shortened. She was diagnosed with a left femoral neck fracture based on her mechanism of injury and physical exam findings.
Acetabular fracture Power Point
A 25-year-old male was brought to the emergency room after a head-on motor vehicle collision where the passenger cabin was intruded. He complained of severe right hip pain. On examination, he had a right hip deformity and tenderness. He was given pain management and an orthopedics consult, and was admitted for operative repair of an acetabular fracture.
Mallet Finger Power Point
A 20-year-old male presented with pain in his right index finger after a basketball hit the end of the finger. On examination, the distal interphalangeal (DIP) joint of the right index finger was swollen, tender to touch, and the patient was unable to extend the DIP joint. A diagnosis of an intra-articular avulsion fracture of the dorsal surface of the distal phalanx was made. The treatment plan included pain control, splinting the DIP joint in extension for 6-8 weeks while allowing the other finger joints to move freely, and possible surgery if the fracture involved over 25% of the articular surface.
Bennet's Fracture Power Point
A 30-year-old male presented to the emergency department with right hand pain after punching a brick wall. He has a history of Hepatitis C and heavy alcohol use. On examination, he had tenderness and swelling over the first metacarpal bone. X-rays revealed a Bennett fracture, an intra-articular fracture of the base of the first metacarpal with a triangular fragment. The fracture was treated with closed reduction, thumb traction, and splinting. He was referred to an orthopedist for follow up.
More from Todd Peterson (20)
Recently uploaded
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
clinical examination of hip joint (1).pdf
described clinical examination all orthopeadic conditions .
What is Digital Literacy? A guest blog from Andy McLaughlin, University of Ab...
What is Digital Literacy? A guest blog from Andy McLaughlin, University of Aberdeen
Solutons Maths Escape Room Spatial .pptx
Solutions of Puzzles of Mathematics Escape Room Game in Spatial.io
Walmart Business+ and Spark Good for Nonprofits.pdf
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
Hindi varnamala | hindi alphabet PPT.pdf
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
The History of Stoke Newington Street Names
Presented at the Stoke Newington Literary Festival on 9th June 2024
www.StokeNewingtonHistory.com
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...Nguyen Thanh Tu Collection
https://app.box.com/s/y977uz6bpd3af4qsebv7r9b7s21935vdবাংলাদেশ অর্থনৈতিক সমীক্ষা (Economic Review) ২০২৪ UJS App.pdf
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
Wound healing PPT
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
Physical pharmaceutics notes for B.pharm students
Traditional Musical Instruments of Arunachal Pradesh and Uttar Pradesh - RAYH...
Traditional Musical Instruments of Arunachal Pradesh and Uttar Pradesh
How to Setup Warehouse & Location in Odoo 17 Inventory
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
Recently uploaded (20)
Film vocab for eal 3 students: Australia the movie
Film vocab for eal 3 students: Australia the movie
IGCSE Biology Chapter 14- Reproduction in Plants.pdf
IGCSE Biology Chapter 14- Reproduction in Plants.pdf
What is Digital Literacy? A guest blog from Andy McLaughlin, University of Ab...
What is Digital Literacy? A guest blog from Andy McLaughlin, University of Ab...
B. Ed Syllabus for babasaheb ambedkar education university.pdf
B. Ed Syllabus for babasaheb ambedkar education university.pdf
Walmart Business+ and Spark Good for Nonprofits.pdf
Walmart Business+ and Spark Good for Nonprofits.pdf
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
বাংলাদেশ অর্থনৈতিক সমীক্ষা (Economic Review) ২০২৪ UJS App.pdf
বাংলাদেশ অর্থনৈতিক সমীক্ষা (Economic Review) ২০২৪ UJS App.pdf
Liberal Approach to the Study of Indian Politics.pdf
Liberal Approach to the Study of Indian Politics.pdf
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
Traditional Musical Instruments of Arunachal Pradesh and Uttar Pradesh - RAYH...
Traditional Musical Instruments of Arunachal Pradesh and Uttar Pradesh - RAYH...
How to Setup Warehouse & Location in Odoo 17 Inventory
How to Setup Warehouse & Location in Odoo 17 Inventory
Trimalleolar Fracture
- 2. Patient is a 67 yo WF with h/o HTN that presents with left ankle pain after an MVC. Pt was restrained driver. She slammed both feet down on the break, locking her legs, just before the collision. Now pt has obvious deformity of left ankle as well as severe pain. Vitals: T: 98.4, HR: 97, RR: 16, BP: 108/64, POx: 97% Gen: elderly white female with left ankle deformity but NAD CV: RRR Pulm: CTA B MSK: left ankle has obvious deformity with edema. Distal part is dislocated laterally. 2+ pulses. Pt has sensation intact. Good cap refill. No open fx. TTP diffusely over ankle
- 4. Tri-Malleolar fractures include a lateral malleolus fx(on left) , a medial malleolus fx(on left), and a posterior malleolus fx(on right)
- 5. Check Neurovascular status Reduce if necessary Splint in posterior leg splint with stirrups Bulky jones splint if significant edema Immediate orthopedic consult or transfer for definitive care (ORIF) Appropriate pain management
- 6. Can also be seen with a bi-malleolar fracture and deltoid tendon rupture(instead of medial malleolus fracture) Can take 6-12 weeks of recovery following ORIF Often associated with dislocation Is an unstable fracture requiring IMMEDIATE orthopedic intervention
- 7. CT 3D reconstruction of fracture Tri-mallolar fracture after surgical repair
- 8. http://reference.medscape.com http://www.gentili.net/footanklefracture1.asp?ID=135 http://www.laorthospecialists.com/AnkleFractures.asp x Tintinalli, Judith E., Gabor D. Kelen, and J. Stephan. Stapczynski. Emergency Medicine: A Comprehensive Study Guide. New York: McGraw-Hill, Medical Pub. Division, 2004. Wheeles, Clifford. "Wheelesonline.com." Wheelesonline.com. Duke Orthopedics. Web. 04 June 2012. <http://www.wheelesonline.com/ortho>.