case discussion 1t day课件.ppt

Location Humerus No. 1 Radius and ulna No. 2 Femur No. 3 Tibia and fibula No. 4 Morphology Simple Type A Full contact Multifragmentary Wedge Type B Some contact Complex Type C No contact Case 55 yo female falls while biking Healthy woman with no active medical issues Closed and isolated injury Distal NV status is normal Case Treatment options ? Plate vs Nail? Relative or absolute stability? Direct or indirect reduction? Weight-bearing status post-op ? Case 4 Discuss tips and tricks How to obtain a good reduction? Normal operating table or fracture table? Bone grafting? Immediate postop xray Operation done with minimal soft tissue stripping Weightbearing at 3 months What are the pros and cons of this choice of fixation? 6 month follow-up Return to work – desk job How to tell if it is healed? What if there is still a bit of pain? What if no pain? What about a cephalomedullary device in this instance ? What about an LCPwith MIPO Case 7 50-year-old man Fell from back of truck Closed injury Soft tissues are good Neurovascular is normal What went wrong?What priniciple was broken? What went wrong?What priniciple was broken? What went wrong?What priniciple was broken? What went wrong?What priniciple was broken? What went wrong?What priniciple was broken? Case 7 Articular fracturesCase 3 Classification ? Articular fracturesCase 3 Investigations? Articular fracturesCase 3 Treatment ? Articular fracturesCase 3 Pre operative planning? Timing for surgery? What kind of stability ? Articular fracturesCase 3 Position ? Approach ? Reduction technique ? Bone graft ? Type of implant ? Articular fracturesCase 3 3 months post operative * Case discussion I Case 1 Case 1 Classify fracture according to AO classification Which bone ? Which segment ? Proximal segment No. 1 Diaphyseal segment No. 2 Distal segment No. 3 Malleolar segment No. 4 3 2 - . 3 2 A 3 Case 2