An 88-year-old female presents after a fall onto her left arm. Calcaneus fracture. She reports isolated left elbow pain, and radiographs are shown in Figure A. Anatomic location. WebGustilo Classification Tscherne Classification Calcaneus FX Other Trauma Topics important to distinguish from medial clavicle physeal fracture (physis doesn't fuse until age 20-25) mechanism. Capitellum fracture with extension into the trochlea. What is considered the earliest sign or symptom of a developing compartment syndrome of the leg? Diagnosis. He denies any fevers or chills. 45% (664/1485) 2. Orthobullets Team Type I. Coronal split fracture. 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. Radiographs and a CT scan are obtained, shown in Figures A-C. Sangeorzan Classification of Navicular Body Fractures any navicular stress fracture, regardless of type, can be initially treated with cast immobilization and nonweight bearing for 6-8 weeks with high rates of success. Classification of Low Ankle Sprains. (OBQ07.239) Initial radiographs are shown in Figures A and B, and intramedullary nailing of the fracture is planned. findings. His radiographs show a comminuted displaced olecranon fracture involving 25% of the articular surface with global osteopenia. Spiral (A1) Oblique (A2) Transverse (A3) Type B. Wedge fracture. He ambulates with crutches and refrains from putting weight on the extremity. lateral support. Physical examination is notable for laxity in his ankle and radiographs are unremarkable for fracture. Low velocity . Calcaneus FX Other Trauma Topics A Monteggia fracture is defined as a proximal 1/3 ulna fracture with an associated radial head dislocation. (OBQ06.70) A 33-year-old man sustains a femur fracture in a motorcycle accident. Radius/ulna, diaphyseal, simple fracture of radius with dislocation of DRUJ Orthobullets Team WebKennedy classification based on the direction of displacement of the tibia. A tibial plafond fracture (also known as a pilon fracture) is a fracture of the distal end of the tibia, most commonly associated with comminution, intra-articular extension, and significant soft tissue injury. He endorses significant low back pain and an inability to ambulate. AP and lateral radiographs are provided in Figure A. Treatment is often a combination of culture-directed antibiotics and surgical debridement of nonviable tissue. Distal to coronoid. His surgical wounds appear well-healed with a small sinus tract over the open fracture site. posterior dislocation (90%) occur with axial load on femur, typically with hip flexed and adducted scrutinize femoral neck to rule out fracture prior to attempting closed reduction. Calcaneus FX Other Trauma Topics A Monteggia fracture is defined as a proximal 1/3 ulna fracture with an associated radial head dislocation. must test each compartment separately. 91% What is considered the earliest sign or symptom of a developing compartment syndrome of the leg? Navicular fracture. Coronoid level. Classification. Kennedy classification based on the direction of displacement of the tibia. Nonoperative. Treatment. (OBQ11.114) An 82-year-old nursing home resident falls onto his elbow while rising from a seated position. posterior Preganglionic vs. postganglionic. He complains of right leg pain, and physical exam reveals no evidence of an open fracture. Web(OBQ11.253) A 17-year-old ballet dancer presents with 5 months of pain in the posterior aspect of the right lower extremity that is exacerbated with the ballet position shown in Figure A. usually high energy injury (MVA, contact sports) atraumatic subluxation. Galeazzi Fracture - Pediatric bifurcate ligament attaches the anterior process of the calcaneus to the navicular and cuboid bones. (OBQ18.141) A 48-year-old male returns to your office 8 months after sustaining a proximal humerus fracture that was successfully treated nonoperatively. calcaneus is osteotomized and rotated 50-90 degrees to keep posterior aspect of calcaneus distal. WebGaleazzi Fracture - Pediatric bifurcate ligament attaches the anterior process of the calcaneus to the navicular and cuboid bones. He complains of right leg pain, and physical exam reveals no evidence of an open fracture. Calcaneus FX Other Trauma Topics capitellar fracture can cause potential block to motion and instability due to loss of the radiocapitellar articulation. delineates fracture anatomy and classification. Sangeorzan Classification of Navicular Body Fractures any navicular stress fracture, regardless of type, can be initially treated with cast immobilization and nonweight bearing for 6-8 weeks with high rates of success. Debridement and lavage, exchange nailing using a larger diameter nail, intravenous antibiotics for 6 weeks. posterior talus. 8% (281/3364) 4. He recalls catching his foot on astroturf with a dorsiflexion and inversion moment about his ankle. Coronoid level. Web(OBQ12.6) A 75-year-old-male presents after being struck by a vehicle while crossing the street. Nonoperative. the location and size of the fracture fragment and degree of comminution depend on the position of the hip at the time of dislocation 5-15% of posterior hip dislocations are associated with a femoral head fracture because of contact between femoral head and posterior rim of acetabulum the location and size of the fracture fragment and degree of comminution depend on the position of the hip at the time of dislocation 5-15% of posterior hip dislocations are associated with a femoral head fracture because of contact between femoral head and posterior rim of acetabulum Orthobullets Team Ipsilateral calcaneus fracture. What best describes the injury shown in Figure A and B? His ESR and CRP are elevated. 91% Jupiter Classification of Type II Monteggia Fracture-Dislocations. findings. (OBQ08.95) A 51-year-old female sustained a comminuted radial head fracture with 4 fragments and an associated elbow dislocation. posterior dislocation (90%) occur with axial load on femur, typically with hip flexed and adducted scrutinize femoral neck to rule out fracture prior to attempting closed reduction. The best functional outcome can be expected with which of the following definitive treatment options? A 34-year-old man sustained a gunshot wound to the knee 18 months ago and was treated with bullet removal and a 10 day course of oral antibiotics. Web(OBQ06.70) A 33-year-old man sustains a femur fracture in a motorcycle accident. 91% Classification. obtain post reduction CT for characterization of fracture. OTA classification of radius/ulna. Treatment may be nonoperative for nondisplaced fractures but any displacement generally requires anatomic open reduction and internal fixation. Treatment. Treatment is usually emergent fasciotomies of all 3 compartments. She was initially closed reduced and splinted with the elbow joint in a reduced position and presents to the orthopedists office 10 days later. Needle compartment pressures are diagnostic in cases ofinconclusive physical exam findings and in sedated patients. His radiographs show a comminuted displaced olecranon fracture involving 25% of the articular surface with global osteopenia. (SBQ18TR.42) Web(OBQ05.191) An 11-year-old child has a tibia-fibula fracture following a fall from a swing. He is afebrile. His surgical wounds appear well-healed with a small sinus tract over the open fracture site. What is the most appropriate Gustilo-Anderson classification of preganglionic . Debridement and lavage, excision of sinus tract, exchange nailing using antibiotic impregnated-cement nail, intravenous antibiotics for 6 weeks. He has not done any physical therapy nor received a corticosteroid injection. rings placed at the level of the plafond or calcaneus to distract and reduce the fracture. He underwent operative fixation of his fracture. WebClassification. Calcaneus FX Other Trauma Topics capitellar fracture can cause potential block to motion and instability due to loss of the radiocapitellar articulation. (OBQ05.178) A 42-year-old male sustains a closed, isolated ulna shaft fracture with 2mm displacement and 3 degrees valgus angulation. Distal to coronoid. Simple fracture. Biomechanics. Team Orthobullets (D) Trauma (OBQ10.19) A 47-year-old male sustained a comminuted calcaneus fracture in a motorcyle accident. A biopsy of the mass is shown in Figures B, and C. What is the most likely pathologic process? He underwent operative fixation of his fracture. He presents at 2 months after surgery. Anatomic (based on dislocation direction of midfoot/forefoot) anterior process of calcaneus acts as fulcrum for the anterolateral corner of the talus to pivot around. Prior to surgery, a CT scan of the knee is ordered for preoperative planning. findings. Galeazzi Fracture - Pediatric bifurcate ligament attaches the anterior process of the calcaneus to the navicular and cuboid bones. Orthobullets Team WebClassification. Orthobullets Team Diagnosis is made using plain radiographs of the elbow. WebHohl and Moore Classification of proximal tibia fracture-dislocations. Classification. Biomechanics. 5.0 (2) See More See Less. Over the last year, he has noticed "tissue growing out of the wound" and a malodorous smell. History of COPD. Anatomic. Type II. Anatomic classification. History of COPD. On exam, his wounds are well healed with no erythema. Classification of Low Ankle Sprains. History of COPD. Type IIC. Lateral decubitus with olecranon osteotomy. Type I. Coronal split fracture. obtain AP, inlet/outlet, judet views after reduction. (OBQ11.114) An 82-year-old nursing home resident falls onto his elbow while rising from a seated position. (SBQ12FA.67) A 35-year-old male fell and sustained an open talar neck fracture. Firmness and decreased compressibility of the compartments is often present. (OBQ18.241) A 28-year-old male that sustained a closed left femoral shaft fracture 12 months ago and underwent intramedullary nailing presents with persistent pain in the right thigh. He has pain and swelling at the elbow without evidence of instability. must test each compartment separately. Webthe location and size of the fracture fragment and degree of comminution depend on the position of the hip at the time of dislocation 5-15% of posterior hip dislocations are associated with a femoral head fracture because of contact between femoral head and posterior rim of acetabulum He is fracture identified on post reduction plain films. His surgical sites are well healed and there are no signs of drainage. 1% (25/2927) 4. A 41-year-old male sustained the open injury shown in Figures A and B after a motor vehicle accident. (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. Type IIB. Calcaneus FX Other Trauma Topics OTA classification. Ecchymosis and swelling. Figures A and B are the current radiographs. (OBQ13.14) A 30-year-old man is brought to your level 1 trauma center with a closed left diaphyseal humerus fracture, a closed left midshaft femur fracture, right sided rib fractures, and multiple facial fractures following a motorcycle accident. (SBQ12FA.67) A 35-year-old male fell and sustained an open talar neck fracture. (OBQ09.222) A patient with an intertrochanteric hip fracture undergoes reduction and dynamic hip screw application. WebDiagnosis is made radiographically with foot radiographs but CT scan is often needed for full characterization of the fracture. delineates fracture anatomy and classification. Orthobullets Team Ligament disruption. He denies any constitutional symptoms and his pain is well controlled. (OBQ12.6) A 75-year-old-male presents after being struck by a vehicle while crossing the street. No vascular injury is identified. The patient presents to your clinic 12 months from his surgery with persistent pain at the fracture site. A 29-year-old male falls down a flight of 10-stairs while intoxicated. Imaging is shown in Figure A. talar body fractures . A CT is obtained for preoperative planning and there are no signs of trochlear involvement or posterior comminution. Radiographs of the right elbow are demonstrated in Figure A. Anatomic classification. The fracture is reduced and placed in a long leg splint in the emergency room. He endorses significant low back pain and an inability to ambulate. He was treated with a tibial intramedullary nail (IMN). On exam, his wounds are well healed with no erythema. LUCL), Bryan and Morrey Classification (with McKee modification), Large osseous piece of the capitellum involved, Articular cartilage separation with very little subchondral bone attached, Coronal shear fracture that includes the capitellum and trochlea, typically, elbow is in semi-flexed elbow position, mechanical block to flexion/extension and/or rotation, "double arc" sign created from subchondral bone of capitellum and lateral part of trochlea, delineates fracture anatomy and classification, type IV fractures that can have trochlear involvement, ORIF with posterior approach with or without olecranon osteotomy, capitellar fractures with associated fractures/injuries to distal humuers/olecranon and/or medial side of the elbow, displaced Type II fractures (>2 mm displacement), displaced Type III fractures (>2 mm displacement), unreconstructable capitellar fractures in, elderly patients with associated medial column instability, lateral approach recommended for isolated Type I and Type IV fx, lateral skin incision centered over the lateral epicondyle, minifragment screw using posterior to anterior fixation, counter sink screw using anterior to posterior fixation, mini-fragment or capitellar plates can be used to capture fractures with proximal extension, concomitant medial sided injuries and/or distal humeral fractures, long-posterior based incision along the elbow, independent headless compression/cannulated screws for capitellar component, supplemental fixation for concomitant pathology, parallel or orthoogonal distal humerus plates, LUCL/UCL repair via bone tunnels or suture anchors, indicated for isolated capitellar fractures, supine or lateral positioning (dependent on desire for anterior or posterior access), can be combined with limited open technique for fracture manipulation, standard portals (anteromedial, anterolateral, posterolateral), proximal anterolateral portal established under fluoroscopic guidance to place trocar to allow for reduction of fracture fragment, extend elbow and push fragment with trocar for reduction, flex radial head past 90 to lock reduction, anteromedial and posterolateral portals allow for fracture debridement, freer elevator can help maintain reduction while cannulated/headless compression screws are placed under fluoroscopic guidance (typically posterior to anterior in direction), Elbow contracture/stiffness (most common), Most patients will gain functional range of motion but have, Surgical treatment results are generally favorable, reoperation rates as high as 48% (mostly due to stiffness), Adult Knee Trauma Radiographic Evaluation, Proximal Humerus Fracture Nonunion and Malunion, Distal Radial Ulnar Joint (DRUJ) Injuries. Initial radiographs are shown in Figures A and B, and intramedullary nailing of the fracture is planned. Webcalcaneus is osteotomized and rotated 50-90 degrees to keep posterior aspect of calcaneus distal. Sangeorzan Classification of Navicular Body Fractures any navicular stress fracture, regardless of type, can be initially treated with cast immobilization and nonweight bearing Ligament disruption. from a handgun with a muzzle-velocity of 1000 feet/second if he is neurovascularly intact and radiographs reveal no fracture? What is a potential complication of the surgical approach to address this injury? Prior to surgery, a CT scan of the knee is ordered for preoperative planning. (OBQ09.222) A patient with an intertrochanteric hip fracture undergoes reduction and dynamic hip screw application. Classification. Diagnosis is made radiographically with foot radiographs but CT scan is often needed for full characterization of the fracture. Orthobullets Team 12/11/2019. Orthobullets Engineer (admin) Trauma - Gun Shot Wounds; Listen Now 20:10 min. Orthobullets Engineer (admin) Trauma - Gun Shot Wounds; Listen Now 20:10 min. His surgical sites are well healed and there are no signs of drainage. Core needle bone culture followed by intravenous antibiotics, Surgical debridement, culture, and intravenous antibiotics, Core needle biopsy, chest CT scan, and bone scan, Neoadjuvant chemotherapy and wide resection followed by adjuvant chemotherapy. Navicular fracture. preganglionic . Figures A and B are the current radiographs. calcaneus. What is considered the earliest sign or symptom of a developing compartment syndrome of the leg? Copyright 2022 Lineage Medical, Inc. All rights reserved. Imaging is shown in Figure A. Figures C-E are the most recent imaging findings. from a handgun with a muzzle-velocity of 1000 feet/second if he is neurovascularly intact and radiographs reveal no fracture? OTA classification of radius/ulna. Diagnosis is made radiographically with foot radiographs but CT scan is often needed for full characterization of the fracture. May occur anywhere that skeletal muscle is surrounded by fascia, but most commonly, tight casts, dressings, or external wrappings, pain out of proportion to clinical situation is usually first symptom, difficult to assess in children (unable to verbalize), indicative of nerve ischemia in affected compartment, amputation usually inevitable in this case, unequivocally positive clinical findings should prompt, within 5cm of fracture site or area of maximal swelling, based primarily on physical exam in patient with, presentation not consistent with compartment syndrome, emergent fasciotomy of all affected compartments, clinical presentation consistent with compartment syndrome, within 30 mm Hg of diastolic blood pressure, intraoperatively, diastolic blood pressure may be decreased from anesthesia, must compare intra-operative measurement to pre-operative diastolic pressure, anterolateral incision over length of thigh, single incision technique for anterior and posterior compartments, expose and decompress anterior compartment, retract vastus lateralis medially to expose lateral intermuscular septum, incise lateral intermuscular septum to decompress posterior compartment, Associated with significant long-term morbidity, over 50% will experience functional deficits including, Adult Knee Trauma Radiographic Evaluation, Proximal Humerus Fracture Nonunion and Malunion, Distal Radial Ulnar Joint (DRUJ) Injuries. (OBQ04.157) She lives in an assisted living facility, and reports no other major medical problems. 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? Associated conditions. Physical examination is notable for laxity in his ankle and radiographs are unremarkable for fracture. He is 22-A2.3. 4/20/2020. 5% (176/3364) He underwent operative fixation of his fracture. Metaphyseal-diaphyseal junction. He denies any constitutional symptoms and his pain is well controlled. Nonoperative. Type A. Entire condylar fracture. 1203 plays. Web(OBQ17.175) A 22-year-old collegiate football player presents with persistent left lateral ankle pain 6 months after sustaining an ankle sprain during a game. (SBQ18SP.25) A 48-year-old tree surgeon is evaluated in the trauma bay after falling from 20 feet onto his back. Coronoid level. He has not done any physical therapy nor received a corticosteroid injection. Clinical. typically, low-energy fall on outstretched hand, axial compression with the elbow in a semi-flexed position, radiocapitellar joint is an important static stabilizer of the elbow, potential block to motion and instability, essential to longitudinal and valgus stability of the elbow, can also lead to coronal plane instability with capitellar excision if medial structures are not intact, integral relationship with the posterolateral ligamentous complex of the elbow (i.e. Clinical. Calcaneus FX Other Trauma Topics Cierny-Mader Classification of Osteomyelitis (describes anatomic involvement, host, treatment, prognosis) Anatomic Location. Anatomic. The fracture is reduced and placed in a long leg splint in the emergency room. 7% (105/1485) 3. 1% (25/2927) 4. No vascular injury is identified. findings. Orthobullets Engineer (admin) Trauma - Gun Shot Wounds; Listen Now 20:10 min. He complains of right leg pain, and physical exam reveals no evidence of an open fracture. Preganglionic vs. postganglionic. usually high energy injury (MVA, contact sports) atraumatic subluxation. (OBQ05.178) A 42-year-old male sustains a closed, isolated ulna shaft fracture with 2mm displacement and 3 degrees valgus angulation. On examination, his skin is intact, with moderate swelling, and limited elbow range of motion due to pain/swelling. History of bleomycin treatment. account for 13-23% of talus fractures. 45% (664/1485) 2. Orthobullets Team Pediatrics - Accessory Navicular ; Listen Now 14:0 min. He recalls catching his foot on astroturf with a dorsiflexion and inversion moment about his ankle. Classification. account for 13 (OBQ05.191) An 11-year-old child has a tibia-fibula fracture following a fall from a swing. Diagnosis. posterior splint immobilization for < 3 weeks. A tibial plafond fracture (also known as a pilon fracture) is a fracture of the distal end of the tibia, most commonly associated with comminution, intra-articular extension, and significant soft tissue injury. (OBQ17.175) A 22-year-old collegiate football player presents with persistent left lateral ankle pain 6 months after sustaining an ankle sprain during a game. lateral support. Type IIA. Low velocity . Metaphyseal-diaphyseal junction. (OBQ12.195) (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. Classification. Type A. rings placed at the level of the plafond or calcaneus to distract and reduce the fracture. Web(SBQ12FA.67) A 35-year-old male fell and sustained an open talar neck fracture. He denies any fevers or chills. 9% .63) A 34-year-old man is involved in a motor vehicle accident and sustains an open tibia fracture and is treated with intramedullary nailing. (SBQ18SP.25) A 48-year-old tree surgeon is evaluated in the trauma bay after falling from 20 feet onto his back. Associated conditions. A 20-year-old man falls from his bicycle. WebAnatomic classification. Mason Classification (Modified by Hotchkiss and Broberg-Morrey) Type I. Nondisplaced or minimally displaced (<2mm), no mechanical block to rotation A 51-year-old female sustained a comminuted radial head fracture with 4 fragments and an associated elbow dislocation. (SBQ18TR.43) A 33-year-old motorcyclist is involved in a motor vehicle accident and sustains a Grade III open fracture of his tibia that is treated surgically. talar body fractures . Type IIC. He elects to undergo surgical intervention. 1203 plays. Ligament disruption. Initial radiographs are shown in Figures A and B, and intramedullary nailing of the fracture is planned. second most common tarsal fractures after calcaneus fxs. Which of the following is the most appropriate management? Gustilo Classification Tscherne Classification Calcaneus FX Other Trauma Topics important to distinguish from medial clavicle physeal fracture (physis doesn't fuse until age 20-25) mechanism. (OBQ05.191) An 11-year-old child has a tibia-fibula fracture following a fall from a swing. A galeazzi fracture is a distal 1/3 radial shaft fracture with an associated distal radioulnar joint (DRUJ) injury. 26% (874/3364) 5. Loss of sensation of ring and small finger, weakness of hand intrinsic muscles, Inability to flex the thumb and index finger IP joints, Laceration of the extensor indicis proprius tendon. (OBQ13.63) 26% (874/3364) 5. (SBQ18BS.6) (OBQ05.178) A 42-year-old male sustains a closed, isolated ulna shaft fracture with 2mm displacement and 3 degrees valgus angulation. A 45-year-old homeless hemophiliac male presents with chronic tibial osteomyelitis. He has pain and swelling at the elbow without evidence of instability. 7% (105/1485) 3. Her symptoms returned with ballet activity following a 1 month course of full rest, nonsteroidal anti-inflammatory medication, and physical therapy. A 38-year-old man falls from a ladder and presents with the injury depicted in Figure A. talar body fractures . 9% Navicular fracture. Her symptoms returned with ballet activity following a 1 month course of full rest, nonsteroidal anti-inflammatory medication, and physical therapy. Anatomic location. Classification. Spiral (A1) Oblique (A2) Transverse (A3) Type B. Wedge fracture. He now complains of 12 months duration of pain in the thigh and recent ulceration and drainage of the skin near the site of his gunshot wound. Distal to coronoid. Debridement and lavage, addition of ring fixator, intravenous antibiotics for 6 weeks. The patient walks with an antalgic gait. 1% (25/2927) 4. fracture identified on post reduction plain films. (OBQ12.156) A 36-year-old male sustains an open segmental tibia fracture associated with an overlying 8 cm soft tissue avulsion that requires skin grafting for soft tissue coverage. Jupiter Classification of Type II Monteggia Fracture-Dislocations. WebHis surgical wounds appear well-healed with a small sinus tract over the open fracture site. The post-operative radiographs demonstrate that the lag screw is superior in the femoral head with a tip-apex distance of 40 millimeters. Type IIA. 4/20/2020. Simple fracture. OTA classification of radius/ulna. Treatment. Osteomyelitis is the infection of bone characterized by progressive inflammatory destruction and apposition of new bone. Imaging is shown in Figure A. He has not done any physical therapy nor received a corticosteroid injection. obtain post reduction CT for characterization of fracture. He denies any constitutional symptoms and his pain is well controlled. Greater than 10mm of articular depression. from a handgun with a muzzle-velocity of 1000 feet/second if he is neurovascularly intact and radiographs reveal no fracture? Her symptoms returned with ballet activity following a 1 month course of full rest, nonsteroidal anti-inflammatory medication, and physical therapy. 22-A2.3. 5% (176/3364) Prior to surgery, a CT scan of the knee is ordered for preoperative planning. Radius/ulna, diaphyseal, simple fracture of radius with dislocation of DRUJ Orthobullets Team However he is still having persistent anterior shoulder/arm pain that worsens with most activities. He is going to be scheduled for open reduction internal fixation. Operative. (OBQ11.253) A 17-year-old ballet dancer presents with 5 months of pain in the posterior aspect of the right lower extremity that is exacerbated with the ballet position shown in Figure A. His surgical sites are well healed and there are no signs of drainage. Classification of Low Ankle Sprains. Classification. obtain AP, inlet/outlet, judet views after reduction. calcaneus is osteotomized and rotated 50-90 degrees to keep posterior aspect of calcaneus distal. Entire condylar fracture. (OBQ12.156) A 36-year-old male sustains an open segmental tibia fracture associated with an overlying 8 cm soft tissue avulsion that requires skin grafting for soft tissue coverage. WebEssex-Lopresti classification. He is neurovascularly intact in his left arm and leg. .63) A 34-year-old man is involved in a motor vehicle accident and sustains an open tibia fracture and is treated with intramedullary nailing. (OBQ05.274) Wound culture reveals methicillin-resistant Staphylococcus aureus (MRSA). 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). 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). Orthobullets Team Ipsilateral calcaneus fracture. (OBQ18.141) A 48-year-old male returns to your office 8 months after sustaining a proximal humerus fracture that was successfully treated nonoperatively. The post-operative radiographs demonstrate that the lag screw is superior in the femoral head with a tip-apex distance of 40 millimeters. Anatomic. He presents at 2 months after surgery. Radius/ulna, diaphyseal, simple fracture of radius with dislocation of DRUJ Orthobullets Team Essex-Lopresti classification. Radiographs and a CT scan are obtained, shown in Figures A-C. talus. However he is still having persistent anterior shoulder/arm pain that worsens with most activities. WebA galeazzi fracture is a distal 1/3 radial shaft fracture with an associated distal radioulnar joint (DRUJ) injury. Spiral (A1) Oblique (A2) Transverse (A3) Type B. Wedge fracture. The patient walks with an antalgic gait. A galeazzi fracture is a distal 1/3 radial shaft fracture with an associated distal radioulnar joint (DRUJ) injury. History of bleomycin treatment. Gustilo Classification Tscherne Classification Calcaneus FX Other Trauma Topics 29th Annual Tampa Shoulder Course: Arthroplasty & Sports should be performed within 5cm of fracture site or area of maximal swelling. Calcaneus FX Other Trauma Topics OTA classification. Preganglionic vs. postganglionic. (OBQ06.70) A 33-year-old man sustains a femur fracture in a motorcycle accident. WebA tibial plafond fracture (also known as a pilon fracture) is a fracture of the distal end of the tibia, most commonly associated with comminution, intra-articular extension, and significant soft tissue injury. Jupiter Classification of Type II Monteggia Fracture-Dislocations. Figures A and B are the current radiographs. Presence of an acute open fracture and crush injury. He subsequently develops the post-traumatic condition shown in Figure A. Anatomic location. Entire condylar fracture. Talus fracture. Calcaneus FX Other Trauma Topics Cierny-Mader Classification of Osteomyelitis (describes anatomic involvement, host, treatment, prognosis) Anatomic Location. usually high energy injury (MVA, contact sports) atraumatic subluxation. AP and lateral radiographs are provided in Figure A. Type IIC. 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). 7% (105/1485) 3. Web(OBQ11.114) An 82-year-old nursing home resident falls onto his elbow while rising from a seated position. Simple fracture. What is the next step in treatment? 5.0 (2) See More See Less. Calcaneus fracture. (OBQ11.253) A 17-year-old ballet dancer presents with 5 months of pain in the posterior aspect of the right lower extremity that is exacerbated with the ballet position shown in Figure A. He presents to the ED the following afternoon with increased difficulty using his right arm and associated pain. Anatomic (based on dislocation direction of midfoot/forefoot) anterior process of calcaneus acts as fulcrum for the anterolateral corner of the talus to pivot around. The patient walks with an antalgic gait. (OBQ13.14) A 30-year-old man is brought to your level 1 trauma center with a closed left diaphyseal humerus fracture, a closed left midshaft femur fracture, right sided rib fractures, and multiple facial fractures following a motorcycle accident. Essex-Lopresti classification. He was treated with physical therapy and a controlled ankle motion boot for several weeks following the injury with minimal relief. 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. However he is still having persistent anterior shoulder/arm pain that worsens with most activities. findings. 1203 plays. account for 13 Talus fracture. Diagnosis. Gustilo Classification Tscherne Classification Calcaneus FX Other Trauma Topics 29th Annual Tampa Shoulder Course: Arthroplasty & Sports should be performed within 5cm of fracture site or area of maximal swelling. 5.0 (2) See More See Less. He presents to your clinic and given his age and the fracture characteristics, he is taken for open reduction with volar locking plate fixation. Radiographs and a CT scan are obtained, shown in Figures A-C. second most common tarsal fractures after calcaneus fxs. Classification. Type IIA. Greater than 10mm of articular depression. Hohl and Moore Classification of proximal tibia fracture-dislocations. Presence of an acute open fracture and crush injury. For the next 4 years, he continues to have pain and persistent discharge from a sinus over his shin. Classification. Orthobullets Team Ipsilateral calcaneus fracture. delineates fracture anatomy and classification. 10/16/2019. He has pain and swelling at the elbow without evidence of instability. The clinical appearance and radiographs are seen in Figures A and B. 45% (664/1485) 2. WebGustilo Classification Tscherne Classification Calcaneus FX Other Trauma Topics 29th Annual Tampa Shoulder Course: Arthroplasty & Sports should be performed within 5cm of fracture site or area of maximal swelling. medial or lateral clavicle in IV drug abusers, systemic conditions such as diabetes and sickle cell, may be due to bacterial or viral systemic illness, vertebrae are the most common hematogenous site in adults, associated with previous surgery, trauma, wounds, or, can be bacterial (most common), mycobacterial, or fungal in nature, bacteria attach to an inert substrate and undergo apoptosis to create a matrix for biofilm, biofilm is characterized by bacteria entering a no-growth, or sessile, phase, which makes them even more resistant to antibiotics that depend on replication to carry out their effect, biofilm is then made of an extracellular polymeric substance or exopolysaccharide, antibiotics are less effective due to difficulty penetrating the biofilm and bacteria lowering their metabolic rate, S. aureus, Enterobacter species, group A and B Streptococcus species, S. aureus, group A Streptococcus species, Kingella kingae, and Enterobacter species, S. aureus (80%), group A Streptococcus species, H. influenzae, and Enterobacter species, S. aureus and occasionally Enterobacter or Streptococcus species, Sickle cell anemia patients (S. aureus is still most common), IV drug use with AC or SC joint infection, HIV/AIDS patient following cat scratch or bite, Immunosuppressed, long-term IV medications, or parenteral nutrition, Cierny-Mader Classification of Osteomyelitis, (describes anatomic involvement, host, treatment, prognosis), Treatment is worse to the patient than infection, fever, tachycardia, and hypotension suggest sepsis, erythema, tenderness, and edema are commonly seen, if able to probe bone through sinus, chronic osteomyelitis is present, limp and/or pain inhibition with weight-bearing or motion may be present, assess the joints above and below the area of concern, assessment of vascular insufficiency locally or systemically, orthogonal plain radiographs of the affected extremity, bone lucency, sclerotic rim, osteopenia, periosteal reaction, and lysis around hardware, assist in diagnosis and surgical planning by identifying necrotic bone, sensitivity and specificity may be affected by hardware artifact and scatter, assists in the diagnosis and surgical planning, best test for diagnosing early osteomyelitis and localizing infection, T2 sequences will show bone and soft tissue edema, T1 - dark central abscess with bright internal wall and dark external sclerotic rim, if positive may overestimate the extent of osteomyelitis, when radiographs are normal and MRI is not an option, only elevated in 1/3 of acute osteomyelitis, usually elevated in both acute and chronic osteomyelitis, most sensitive test with elevation in 97% of cases, decreases faster than ESR in successfully treated patients, often negative, but may be used to guide therapy for hematogenous osteomyelitis, not reliable for guiding antibiotic therapy, live osteocytes with numerous acute inflammatory cells (neutrophils), no nuclei in osteocytes with fibrosis of marrow and chronic inflammatory cells (lymphocytes), biopsy all infection, cultures all tumors, success in the treatment is dependent on various factors, the severity of the injury as demonstrated by segmental bone loss, metaphyseal infections heal better than mid-diaphyseal infections. 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