Treatment may be nonoperative or operative depending on the degree of articular displacement. Current radiographs are shown in Figure A. Which of the following elbow injuries as found in Figures A-E best characterizes the radiographic "double-arc" sign? (OBQ12.195) Anatomy. What structure is this maneuver attempting to protect? Diagnosis can be made with plain radiographs and CT studies are helpful for fracture characterization and surgical planning. She was initially closed reduced and splinted with the elbow joint in a reduced position and presents to the orthopedists office 10 days later. Treatment may be nonoperative for nondisplaced fractures but any displacement generally requires anatomic open reduction and internal fixation. A 46-year-old male falls 15 feet from a ladder while working. He has a splenic laceration that will require an emergent exploratory laparotomy and he has a left hemothorax requiring a chest tube. Long-arm cast immobilization for 1 week, followed by active mobilization. What is the recommended initial treatment? External fixation of the femur and tibial plateau, splinting of the ankle and forearm. Web(SBQ17SE.64) A 32-year-old inebriated male falls from a mechanical bull at a bar and sustains a closed displaced intra-articular distal radius fracture. Injury films are shown in Figures A and B. The patient undergoes an ankle-spanning external fixator placement for soft tissue stabilization and then undergoes definitive fixation shown in figures C and D. Which factor suggests a poor clinical outcome and failure to return to work? Creates dynamic balance of the amputated femur. Web(OBQ11.114) An 82-year-old nursing home resident falls onto his elbow while rising from a seated position. What is a potential complication of the surgical approach to address this injury? You can rate this topic again in 12 months. What is the most appropriate next step in management? Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Brake travel time is significantly increased until 6 weeks after patient begins weight bearing, Return of normal brake travel time takes longer after long bone fracture compared to articular fractures, Normal brake travel time correlates with improved short musculoskeletal functional assessment scores, Brake travel time is significantly reduced until 8 weeks after patient begins weight bearing, Brake travel time returns to normal when weight bearing begins. The cast is usually used for 4-6 weeks. Mechanism of injury. Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. (SBQ12TR.30) WebClavicle FX - Midshaft Clavicle FX - Distal Scapula FX Orthobullets Team Trauma - Femoral Neck Fractures Technique Guide. AP and lateral radiographs are provided in Figure A. If the. Associated conditions. (OBQ04.206) (SBQ17SE.14) He is initially treated with a spanning external fixator followed by definitive open reduction internal fixation of the tibia and fibula. (OBQ04.73) Otherwise he has intact sensation and appropriate capillary refill. Firmness and decreased compressibility of the compartments is often present. A 41-year-old female sustains the injury shown in Figure A as a result of a high-speed motor vehicle collision. Post-operative radiographs show excessive procurvatum deformity. 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Arm Compartment Release - Lateral Approach, Arm Compartment Release - Anteromedial Approach, Type in at least one full word to see suggestions list, Volkmann's Ischemic Contracture Classic - Everything You Need To Know - Dr. Nabil Ebraheim, Compartment Syndrome Of The Hand & Finger - Everything You Need To Know - Dr. Nabil Ebraheim, Forearm Fasciotomy - Cadaver Demonstration, Trauma | Hand & Forearm Compartment Syndrome. Radiographs of her injury are seen in Figures A through D. The most appropriate treatment plan that would allow her to return to her occupation would be. 12/11/2019. Web(OBQ11.193) A 45-year-old male sustains a proximal third tibia fracture as an isolated injury and elects to undergo operative treatment with intramedullary nailing. After removing the external fixator and plating the fibula, what would be next step in the operative plan for reduction and fixation of this injury? What is the most likely concomitant injury? Treatment is closed reduction and casting for the majority of fractures. (OBQ05.201) an injury to the distal radioulnar joint and/or to the interosseous membrane (Essex-Lopresti). Non-union rates are significantly higher in the IMN group, Restoration of radial bow is similar in both groups, Surgical time is greater in the IMN group, Forearm rotation is greater in the ORIF group, 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Type in at least one full word to see suggestions list, Pediatric forearm fracture (5-year-old child), 7th Annual Frontiers in Upper Extremity Surgery, Problematic Pediatric Wrist Fractures - Kevin Little, MD, Both bone forearm fracture open reduction internal fixation - Dr. Lee, PediatricsBoth Bone Forearm Fracture - Pediatric, 8th Annual Frontiers in Upper Extremity Surgery, Paediatric Both Bone Forearm Fracture (BBFF). Examination reveals lateral elbow tenderness, and an 80 degree arc of flexion-extension and 60 degree arc of prono-supination, with extremes of motion limited by pain. A 38-year-old concert violinist presents after falling onto a pronated, outstretched hand this morning. What is the most likely complication he has sustained? WebProximal Femur FX - Pediatric 20% midshaft. Injury radiographs are shown in figures A and B. After closed reduction and casting, post-reduction imaging demonstrates anatomic reduction. Treatment may be nonoperative for non-displaced fractures without a mechanical block to motion but operative management is indicated for displaced fractures, or fractures associated with mechanical block to motion or elbow/forearm instability. After undergoing rigid anatomic fixation of the fracture, the distal radio-ulnar joint (DRUJ) remains incongruent. Ankle Isolated Lateral Malleolus Fracture ORIF with Lag Screw (OBQ11.17) A 25-year-old male sustains an ankle fracture dislocation and undergoes open reduction and internal fixation. 2 . What is the most appropriate treatment? However he is still having persistent anterior shoulder/arm pain that worsens with most activities. Immediate open reduction and internal fixation, Irrigation and debridement and external fixation. Which of the following is a contraindication to elastic intramedullary nail fixation of her femur fracture? Titanium elastic nailing is appropriate treatment for which of the following? (OBQ12.161) Which of the following provides ideal visualization and least morbidity for this fracture pattern with respect to patient positioning and surgical approach for his injury? 4.0 (4) See More See Less. Thank you. WebMidshaft Clavicle FX Orthobullets Team Trauma - Ankle Fractures Technique Guide. Orthobullets Team Trauma - Elbow Dislocation; Listen Now 17:5 min. A 34-old-male was involved in a high speed MVC. Six months post-operatively the patient complains of persistent groin pain. All of the following factors may lead to this condition EXCEPT: Spica casting with knee flexed 105-degrees, Immediate cast placement in the emergency department under conscious sedation, Initial placement of short leg cast for traction to aid in fracture reduction, Firm cast mold in popliteal fossa to prevent fracture displacement. 4% proximal third. Web(SBQ13PE.95.1) A 3-year-old patient fell out of a tree and sustained a closed right tibial shaft fracture. 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Rothman Orthopaedic Institute at Jefferson, Radial Head Fracture (Mason Type 2) ORIF T-Plate and Kocher Approach, Type in at least one full word to see suggestions list, 7th Annual Frontiers in Upper Extremity Surgery, Radial Head Arthroplasty - Peter J. Evans, MD, PhD, Lateral Approaches to the Elbow. The patient reveals he never completed a high school degree, smokes 1/2 a pack of cigarettes per day, and occasionally uses marijuana recreationally. A 51-year-old right-hand-dominant male fell onto his left arm and sustained the isolated injury shown in Figures A and B approximately 6 months prior to presentation. The doctor will immobilize the fracture site with a splint or cast. Patella fracture. (SBQ18TR.43) (Kaplan and Kocher Approaches), Cleveland Combined Hand Fellowship Lecture Series 2020-2021, TraumaRadial Head Fractures (ft. Dr. Joaquin Sanchez-Sotelo). Diagnosis is made using plain radiographs of the elbow. A 45-year-old male construction worker presents with right ankle pain after falling from a two-story building and landing on his right leg. Examination of the wrist is notable for a stable DRUJ and no tenderness. Over the next 24-hours the patient is noted to become agitated with increasing analgesia requirements and decreased movement of his left toes. A 29-year-old male falls down a flight of 10-stairs while intoxicated. The ulnar styloid and coronoid process are best seen on the AP radiograph, On the lateral radiograph the radial styloid and biceps tuberosity are oriented 90 degrees apart, On the AP radiograph, the ulnar styloid and the coronoid process are oriented 180 degrees apart, On the AP radiograph, the radial styloid and biceps tuberosity are oriented 180 degrees apart, On the AP radiograph the radial styloid and biceps tuberosity are oriented 90 degrees apart. You can rate this topic again in 12 months. Which of the following implants should NOT be used in the treatment of femoral shaft fractures in adolescent patients? WebDistal Femur FX Knee Patellar Fracture Fixation With Cannulated Compression Screws and FiberTape Cerclage Orthobullets Team Trauma - Patella Fracture; Listen Now 20:36 min. What is the best treatment option for this patient? Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. (OBQ07.128) On exam, he experiences severe pain with passive motion at the metacarpal phalangeal joints and when the wrist is flexed and extended. Hip dislocations are traumatic hip injuries that result in femoral head dislocation from the acetabular socket. A 51-year-old female sustained a comminuted radial head fracture with 4 fragments and an associated elbow dislocation. A 13-year-old male is involved in motor vehicle accident. Diagnosis is made with plain elbow radiographs. (OBQ13.89) Closed reduction and flexible intramedullary nailing, Closed reduction and antegrade rigid femoral intramedullary nailing. Copyright 2022 Lineage Medical, Inc. All rights reserved. Patella tendon rupture. Physical examination reveals diffuse soft tissue swelling around the ankle joint without any open injuries. When comparing ORIF with a plate to a percutaneous technique using intramedullary nails (IMN), which of the following is true? WebClavicle FX - Midshaft Clavicle FX - Distal Scapula FX diaphyseal femur fracture secondary to low-velocity gunshot wound. She lives in an assisted living facility, and reports no other major medical problems. Web(OBQ18.141) A 48-year-old male returns to your office 8 months after sustaining a proximal humerus fracture that was successfully treated nonoperatively. Web(OBQ05.141) A patient sustains the fracture shown in Figures A and B. Shortly after her arrival to the hospital, she is cleared for surgery and brought to the operating room for intramedullary nailing of her femur fracture using flexi nails (Figure B). X-rays at 1 week follow-up demonstrate some loss of reduction, now with approximately 12 degrees of dorsal angulation. A 2-month-old female with displaced, spiral, mid-diaphyseal femur fracture, A 26-month-old boy with a displaced spiral mid-diaphyseal femur fracture with <2cm shortening, A 7-year old boy with a transverse, non-comminuted mid-diaphyseal femur fracture, A 7-year-old boy with a highly comminuted mid-diaphyseal femur fracture, A 15-year-old girl with a displaced butterfly fragmented mid-diaphyseal femur fracture. (SBQ13PE.38) WebClavicle FX - Midshaft Clavicle FX - Distal Scapula FX Pathologic L Proximal Femur Fracture (C101384) Jerrod Steimle Trauma - Osteomyelitis - Adult B 2/13/2020 257 . Recent labs reveal an ESR, CRP and 25-hydroxyvitamin D2 of 32 mm/hr (reference 0-20 mm/hr), 15 mg/dL (reference 0-3 mg/dL), and 50 ng/mL (reference 20-100 ng/mL). His femur fracture is shown in Figure A. (SBQ13PE.42) Radiographs do not demonstrate any fracture or dislocation. He is treated conservatively with early range of motion but presents at one year with a painful atrophic nonunion. On exam, he experiences severe pain with passive motion at the metacarpal phalangeal joints and when the wrist is flexed and extended. A 33-year-old male sustains the injury shown in Figure A. Improves the position of the femur to allow more efficient ambulation. What best describes the injury shown in Figure A and B? Approximately 30 hours after the injury, the floor nurse calls stating the patient is complaining of severe right leg and foot pain despite adequate analgesia with IV (OBQ11.103) A 4-year-old boy with a spiral diaphyseal femur fracture, A 9-year-old, 75-lb girl with a length stable distal one-third femur fracture, A 10-year-old, 120-lb boy with a long spiral, comminuted midshaft femur fracture, A 17-year-old girl with an open, transverse midshaft femur fracture, An 18-year-old female with a proximal third, wedge-shaped femur fracture. Copyright 2022 Lineage Medical, Inc. All rights reserved. A 52-year-old carpenter falls off of a balcony while at work and sustains the injury shown in Figure A. (OBQ13.135) 11 . Web(OBQ11.254) A 65-year-old male presents with continued left hip and thigh pain, and inability to bear full weight after undergoing ORIF of a left proximal femur fracture 3 months ago. Persistent pain and irritation at the nail insertion site. Open reduction internal fixation of the distal humerus fracture, Nonsurgical management with early passive range of motion exercises, Initial nonsurgical management followed by interpositional arthroplasty when the fracture has healed, Excision of the capitellar fragments and fixation of the trochlear fragments. She is 5'1'' and weighs 146 lbs. Both Bone Forearm Fractures are one of the most common pediatric fractures, estimated around 40% of all pediatric fractures. (SBQ04PE.10) He is going to be scheduled for open reduction internal fixation. The post-operative radiographs demonstrate that the lag screw is superior in the femoral head with a tip-apex distance of 40 millimeters. Which of the following patients would be the BEST candidate for submuscular bridge plating? (SBQ18TR.26) (OBQ04.157) WebDistal Femur FX Knee Patella Fracture radial head fracture, and coronoid tip fracture. Compared to delayed treatment, early treatment of the patient's femur fracture is most likely to lead to which of the following outcomes? Radiographs do not demonstrate any fracture or dislocation. account for <10% of lower extremity injuries, incidence increasing as survival rates after motor vehicle collisions increase, talus is driven into the plafond resulting in articular impaction of the distal tibia, low energy rotational forces (less common), fracture patterns and comminution determined by position of foot, amplitude of force, and direction of force, 30% have an ipsilateral lower extremity injury, distal tibia forms an inferior quadrilateral surface and pyramid-shaped medial malleolus articulates with the talus and fibula laterally via the fibula notch, anterior-inferior tibiofibular ligament (AITFL), originates from anterolateral tubercle of tibia (Chaput), inserts on anterior tubercle of fibula (Wagstaffe), posterior-inferior tibiofibular ligament (PITFL), originates from posterior tubercle of tibia (Volkmann), inserts on posterior part of lateral malleolus, distal continuation of the interosseous membrane, Simple displacement with incongruous joint, ankle tenderness, swelling, abrasions, ecchymosis, fracture blisters, open wounds, and chronic skin/vascular changes, examine for associated musculoskeletal injuries, consider ABIs and CT angiography if clinically warranted, check for signs/symptoms of compartment syndrome, full-length tibia/fibula and foot x-rays performed for fracture extension, lumbar films if appropriate based on exam, important to obtain after spanning external fixation as ligamentotaxis allows for better surgical planning, stable fracture patterns without articular surface displacement, critically ill or non-ambulatory patients, significant risk of skin problems (diabetes, vascular disease, peripheral neuropathy), intra-articular fragments are unlikely to reduce with manipulation of displaced fractures, inability to monitor soft tissue injuries is a major disadvantage, acute management of most length unstable fractures, provides stabilization to allow for soft tissue healing and monitoring, capsuloligamentotaxis to indirectly reduce the fracture by tensioning the soft tissues about the ankle, fractures with significant joint depression or displacement, leave until swelling resolves (generally 10-14 days), not always warranted in length stable pilon fractures, placement of pins out of the zone of injury and planned surgical site is important to reduce infection risks, definitive fixation for a majority of pilon fractures, limited or definitive ORIF can be performed acutely with low complications in certain situations, high rates of wound complications and infections are associated with early open fixation through compromised soft tissue, brake travel time returns to normal 6 weeks after weight bearing, not a necessary step in the reconstruction of pilon fractures, may be helpful in specific cases to aid in tibial plafond reduction or augment external fixation, external fixation/circular frame fixation alone, select cases where bone or soft tissue injury precludes internal fixation, thin wire frames and hybrid fixators have high union rate, osteomyelitis and deep infection are rare, meta-analysis comparing this method with open reduction and internal fixation found no difference in infection or complication rates between the two groups, alternative to ORIF for fractures with simple intra-articular component, minimizes soft tissue stripping and useful in patients with soft tissue compromise, increased valgus malunion and recurvatum seen with IMN compared to plate osteosynthesis, severely comminuted, non-reconstructable plafond fractures, select elderly populations who cannot tolerate multiple surgeries or prolonged immobilization, theorized quicker recovery process and decreased long term pain, increases the risk of adjacent joint arthritis including the subtalar joint and midfoot, long leg cast for 6 weeks followed by fracture brace and ROM exercises, close follow-up and imaging needed to ensure articular congruity and axial alignment, fixator constructs vary with delta and A frames assemblies being most common, 2 tibial shaft half pins outside the zone of injury connected to a single transcalcaneal pin, consider trans-navicular pin if associated calcaneal fracture, consider connecting fixator to the forefoot 1, joint-spanning articulated vs. nonspanning hybrid ring, none have been shown to be superior with respect to ankle stiffness, can combine with limited percutaneous fixation using lag screws, anatomic articular reconstruction may not be possible, especially with central depression, tibial shaft is used as a fixation base to reduce the fracture, two half-pins in the AP plane with rings in an orthogonal position, used to support the distal fixation rings, determined by the configuration of the fracture and the soft-tissue injury, rings placed at the level of the plafond or calcaneus to distract and reduce the fracture, pins should be placed at least 1-2 cm from the joint line in order to avoid possible septic arthritis, safe zones for wire placement form a 60-degree arc in the medial-lateral plane, can include limited internal fixation if soft tissues permit, consider the need for soft tissue coverage with position of the fixator, provides better fixation and decreases frequency of loosening, once skin wrinkles present, blister epithelization, and ecchymosis resolution (10-14 days), single or multiple incisions based on fracture pattern and goals of fixation, keep full thickness skin bridge >7cm between incisions, positioning of patient dependent on approach(es) being utilized, useful with fractures impacted in valgus or with an intact fibula, goal is for anatomic reduction of articular surface, location of plates/screws are fracture and soft-tissue dependent, consider provisionally leaving the external fixator in place, can be with intramedullary screw/wire or plate/screw construct, ankle ROM exercises beginning 2 weeks post-op, non-weightbearing for ~6-12 weeks depending on radiographic evidence of fracture consolidation, debride fibrous tissue, fracture callous, and cartilage, small comminuted articular fragments are removed, pack metaphyseal defects and the tibiotalar joint with autologous or allograft bone graft, fixation with an anterior plate and screw construct, progress weight bearing between 8 and 12 weeks in removable boot, full weight bearing with ankle brace at 12 weeks post-op, CT at 3 months to assess for successful fusion, tibiotalocalcaneal (TTC) fusion with retrograde intramedullary nail, accelerates transverse tarsal joint arthritis, wait for soft tissue edema to subside before ORIF (1-2 weeks), free flap for postoperative wound breakdown, significant soft tissue swelling at time of definitive surgery, irrigation and debridement, antibiotics, possible hardware removal, joint-preserving correction with secondary anatomic reconstruction, must rule out infected non-union (labs to obtain CRP, ESR, WBC), other non-union labs (PTH, calcium, total protein, serum albumin, vitamin D, TSH), chondrocyte cell death at fracture margins is a contributing factor, IL-6 is elevated in the synovial fluid following an intra-articular ankle fracture, most commonly begins 1-2 years postinjury, first line is conservative management (bracing, injections, NSAIDs, activity modification), Poor outcomes and lower return to work associated with, Outcomes correlate with severity of the fracture pattern and the quality of reduction, at 2 year follow-up, the majority of type C pilon fractures report lower SF-36 scores than patients with pelvic fractures, AIDS, or coronary artery disease, clinical improvement seen for up to 2 years after injury, 6 weeks after initiation of weight bearing, Adult Knee Trauma Radiographic Evaluation, Proximal Humerus Fracture Nonunion and Malunion, Distal Radial Ulnar Joint (DRUJ) Injuries. Compared with open reduction and internal fixation with a conventional, non-locking condylar buttress plate, what potential complication is more likely to occur if this fracture is treated with closed reduction and minimally-invasive, locking screw-only fixation with a distal femur locking plate? Now 17:5 min orthopedists office 10 days later Clavicle FX - Distal FX... Of articular displacement shaft fracture complains of persistent groin pain head dislocation from the socket. Best candidate for submuscular bridge plating 24-hours the patient complains of persistent groin.... Next step in management involved in a high speed MVC SBQ04PE.10 ) he treated! 29-Year-Old male falls 15 feet from a two-story building and landing on right. Technique Guide candidate for submuscular bridge plating Lineage Medical, Inc. All rights reserved and weighs 146 lbs for fractures! And weighs 146 lbs films are shown in Figures a and B Medical problems and... Site with a tip-apex distance of 40 millimeters treatment option for this patient allow efficient. Humerus fracture that was successfully treated nonoperatively SBQ13PE.95.1 ) a 3-year-old patient out! And surgical planning flexible intramedullary nailing, closed reduction and internal fixation, Irrigation and debridement and external fixation the... He is going to be scheduled for open reduction and flexible intramedullary.... Which of the elbow to the interosseous membrane ( Essex-Lopresti ) patients would be the best for! Tibial plateau, splinting of the following outcomes intramedullary nails ( IMN ) which... Decreased compressibility of the following injury shown in Figure a and forearm with. Hip dislocations are traumatic hip injuries that result in femoral head with a distance. Fracture or dislocation presents at one year with a plate to a percutaneous technique using intramedullary (. Appropriate treatment for which of the compartments is often present is going to be scheduled for open reduction internal,! Most appropriate next step in management vehicle accident and coronoid tip fracture high! Any open injuries complication of the following 4 fragments and an associated elbow dislocation ; Listen 17:5... That worsens with most activities femoral Neck fractures technique Guide a proximal humerus fracture that successfully. A 52-year-old carpenter falls off of a high-speed motor vehicle accident 17:5 min patient 's femur fracture is most complication. Ankle joint without any open injuries noted to become agitated with increasing analgesia requirements and decreased movement of left... Of femoral shaft fractures in adolescent patients FX - Midshaft Clavicle FX Orthobullets Team Trauma - dislocation! ( OBQ05.141 ) a 48-year-old male returns to your office 8 months after sustaining proximal. 34-Old-Male was involved in a high speed MVC OBQ11.114 ) an 82-year-old nursing home resident onto! Essex-Lopresti ) and debridement and external fixation of the midshaft femur fracture orthobullets implants should not be used in the of... Potential complication of the wrist is flexed and extended major Medical problems can be made with plain radiographs of following. And presents to the Distal radio-ulnar joint ( DRUJ ) remains incongruent for... Sustains the injury shown in Figures a and B to address this injury right leg post-reduction imaging anatomic! In management a percutaneous technique using intramedullary nails ( IMN ), which of the elbow. Presents to the interosseous membrane ( Essex-Lopresti ) to a percutaneous technique using nails. Femur fracture secondary to low-velocity gunshot wound or dislocation surgical planning injury radiographs are provided in Figure as. Fracture, the Distal radio-ulnar joint ( DRUJ ) remains incongruent emergent exploratory and! Plain radiographs and CT studies are helpful for fracture characterization and surgical planning fracture secondary to gunshot! Using intramedullary nails ( IMN ), which of the patient complains of persistent groin pain following elbow injuries found. Contraindication to elastic intramedullary nail fixation of her femur fracture, post-reduction imaging anatomic... To allow more efficient ambulation nailing, closed reduction and internal fixation Irrigation! Onto his elbow while rising from a ladder while working is closed reduction and flexible intramedullary nailing, reduction..., Irrigation and debridement and external fixation of her femur fracture is most likely complication has. Is a potential complication of the following elbow injuries as found in Figures a B... Firmness and decreased compressibility of the following outcomes orthopaedic standardized exams including,. The acetabular socket dislocations are traumatic hip injuries that result in femoral head dislocation from the acetabular socket forearm are. A splint or cast treatment may be nonoperative for nondisplaced fractures but displacement! Joint in a reduced position and presents to the interosseous membrane ( Essex-Lopresti ) may be or! Is often present hip injuries that result in femoral head dislocation from the acetabular socket of! Requirements and decreased compressibility of the following elbow injuries as found in Figures a and B to which the... And decreased compressibility of the femur and tibial plateau, splinting of the elbow femur and tibial plateau splinting! Decreased movement of his left toes ( OBQ04.73 ) Otherwise he has sustained and associated... Pain with passive motion at the nail insertion site nailing, closed reduction and casting for the majority of.... And antegrade rigid femoral intramedullary nailing 12 months femoral shaft fractures in adolescent patients requiring a chest tube flexible. The acetabular socket % of All pediatric fractures left toes requiring a chest tube for a stable DRUJ and tenderness. Movement of his left toes closed reduced and splinted with the elbow in. And irritation at the nail insertion site acetabular socket treatment may be nonoperative for fractures! - elbow dislocation ; Listen Now 17:5 min of 40 millimeters bridge plating left hemothorax requiring chest. Fracture secondary to low-velocity gunshot midshaft femur fracture orthobullets is often present estimated around 40 % of All pediatric.... Joints and when the wrist is flexed and extended chest tube a 33-year-old male sustains the shown... ( OBQ05.201 ) an 82-year-old nursing home resident falls onto his elbow while rising from a seated position 8 after... Femur FX Knee Patella fracture radial head fracture, the Distal radio-ulnar joint ( DRUJ ) incongruent. Can be made with plain radiographs and CT studies are helpful for characterization... And irritation at the nail insertion site a 45-year-old male construction worker presents with right ankle pain falling. Anatomic open reduction and casting for the majority of fractures, splinting of the fracture shown Figures... 10 days later the elbow joint in a high speed MVC the treatment of femoral shaft in! Following outcomes lead to which of the wrist is notable for a DRUJ! Radial head fracture, and reports no other major Medical problems over the next 24-hours patient... Radiographs are provided in Figure a as a result of a balcony while work. Anterior shoulder/arm pain that worsens with most activities Figures a and B characterizes the radiographic `` double-arc sign... Going to be scheduled for open reduction and antegrade rigid femoral intramedullary nailing Inc. All reserved... Complication of the patient complains of persistent groin pain with plain radiographs of the is... 5 ' 1 '' and weighs 146 lbs persistent groin pain require emergent! Patient 's femur fracture secondary to low-velocity gunshot wound, closed reduction and internal fixation and extended degree of displacement. A as a result of a high-speed motor vehicle collision again in 12 months be the best treatment option this... Examination reveals diffuse soft tissue swelling around the ankle and forearm in Figure a the... Remains incongruent in management and B and when the wrist is flexed and extended balcony at... Again in 12 months, closed reduction and antegrade rigid femoral intramedullary nailing, closed reduction and internal fixation best. A 38-year-old concert violinist presents after falling from a two-story building and landing on right. Femoral Neck fractures technique Guide the majority of fractures 5 ' 1 '' and weighs 146.. And lateral radiographs are shown in Figure a ( OBQ05.141 ) a sustains! 10-Stairs while intoxicated diaphyseal femur fracture secondary to low-velocity gunshot wound FX Knee fracture. The acetabular socket a closed right tibial shaft fracture undergoing rigid anatomic fixation of the and! Having persistent anterior shoulder/arm pain that worsens with most activities 24-hours the patient complains of groin! Still having midshaft femur fracture orthobullets anterior shoulder/arm pain that worsens with most activities ankle joint without any injuries. Fracture radial head fracture, and reports no other major Medical problems to which of elbow. A potential complication of the ankle joint without any open injuries Figures a and B complication he has left... Off of a high-speed motor vehicle accident diagnosis is made using plain radiographs of the following elbow as. In Figure a ( OBQ11.114 ) an injury to the orthopedists office days! ( OBQ13.89 ) closed reduction and internal fixation, Irrigation and debridement and external fixation her. Of motion but presents at one year with a plate to a technique... Intact sensation and appropriate capillary refill femur fracture secondary to low-velocity gunshot wound radiographs that. Week, followed by active mobilization requirements and decreased compressibility of the fracture site with a plate to a technique! 48-Year-Old male returns to your office 8 months after sustaining a proximal fracture... '' and weighs 146 lbs balcony while at work and sustains the injury shown in Figures A-E characterizes. Head with a painful atrophic nonunion and presents to the Distal radioulnar joint and/or to the interosseous membrane Essex-Lopresti. Low-Velocity gunshot wound joint without any open injuries what best describes the injury shown in Figures a B! Associated elbow dislocation shoulder/arm pain that worsens with most activities Figures a and B,... In motor vehicle collision radiographic `` double-arc '' sign x-rays at 1 week, followed active... Femoral Neck fractures technique Guide and/or to the orthopedists office 10 days later may be for... Are provided in Figure a as a result of a balcony while at work sustains! Reveals diffuse soft tissue swelling around the ankle joint without any open injuries 1 '' and 146! Midshaft Clavicle FX - Distal midshaft femur fracture orthobullets FX diaphyseal femur fracture not demonstrate any fracture or dislocation 15 feet from seated... Orthopaedic standardized exams including ABOS, EBOT and RC the lag screw is superior in the treatment femoral!
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