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  1. Non-op tibia fractures
    • <5deg varus
    • < 10deg AP
    • <10deg rotation
    • <1.5cm initial shortening
    • >50% cortical contact
    • fractured fibula
  2. Proximal tibia fx falls into:
    • valgus (pull from pes insertion)
    • procurvatum (patella tendon pull on tibial tubercle)
  3. Distal tibia fx falls into:
    • varus
    • recurvatum
  4. Tscherne Classification of closed fx
    • C0 simple fx with little/no soft tissues injury
    • C1 mild/mod fx pattern with superficial abrasion
    • C2 mod/severe fx pattern with deep contaminationand skin/muscle contusion
    • C3 severe fx with extensive/crushing skin/muscle
  5. Four compartments of the leg
    • Anterior - tib ant, EDL, EHL, deep peroneal N, ant tib art
    • Lateral - peroneus longus, peroneus brevis, superfic peroneal N
    • Superficial posterior - gastroc, soleus, plantaris
    • Deep posterior - tib post, FDL, FHL
    • between post compts - peroneal and post tib art, post tib N
  6. Irreducible subtalar dislocation
    • Lateral - post tib tendon, buttonhole thru retinaculum
    • Medial - EDB, extensor retinaculum, talar head button hole through capsule of talonavicular joint
  7. Current treatment of tibia fx
    • 1. long leg cast, PTB casting, fracture brace
    • 2. plate fixation
    • 3. IMN
    • 4. ex fix
  8. Ulna fractures
    • aka nightstick fractures
    • operative indications: >10deg angulation, >50% displacement of cortex
    • greater displacement associated with rotational instability of IOM
    • central band of IOM 70% stability, goes prox radial to distal ulna
    • LCDC plate goes dorsally
  9. Radius fractures
    • Galeazzi fractures - distal 1/3 radius fracture with DRUJ disloc/sublux
    • LCDC plate, K-wire DRUJ if unstable
    • volar Henry approach - between BR and flexor/pronator mass, protect radial art
    • dorsal Thompson approach - between ECRB and EDC, PIN at risk
  10. Radiographic signs of DRUJ disruption
    • 1. displaced fracture of ulnar styloid at its base
    • 2. widening of DRUJ space on AP
    • 3. Dislocation of radius relative to ulna on true lateral
    • 4. shortening of radius 5mm relative to radius
    • if displaced dorsally, DRUJ stable in supination
    • irreducible DRUJ - ECU tendon entrapped

Card Set Information

2010-04-03 23:30:41

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