FRAKTUR PEDIS PDF

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He has pain and difficulty walking, and deformity correction with a ring fixator is planned. When considering the principles of deformtiy surgery, it should be noted that angular corrections performed as opening or closing wedges NOT at the level of the apex of the deformity will create which of the following secondary deformities?

Review Topic Tested Concept. Radiographs are seen in Figures A and B. You decide to treat this fracture with intramedullary nailing. In order to prevent a missed injury that should be addressed during the same surgery, you order the following test Review Topic Tested Concept. He was transported to a Level I trauma hospital where he was given intravenous antibiotics and tetanus at PM. He underwent irrigation and debridement of the wound with 9L of saline solution and was treated with reamed intramedullary nail fixation at PM.

A vacuum assisted dressing was placed over a 5x3cm skin deficit. It is the point at which the proximal mechanical axis and distal mechanical axis meet.

It is the point at which the proximal anatomical axis and proximal mechanical axis meet. It is always the point on the cortex at the most concave portion of the deformity. It is the point at which the distal anatomical axis and distal mechanical axis meet. It is always the point on the cortex at the most convex portion of the deformity.

He was subsequently treated with an irrigation and debridement, and un-reamed intramedullary nail. At 4 months follow-up, despite some signs of healing, the fracture is not fully united. Which of the following is true? He is also noted to have a grade 1 splenic laceration and lung contusion. He is cleared by the trauma team, and undergoes early total care with reamed femoral and tibial nailing.

A tourniquet is used for the tibial nailing portion of the case, and the tibial isthmus is over reamed to accept a larger nail. The use of a tourniquet in this case has been most clearly shown to be associated with which of the following? At his 6-week follow-up, he is noted to have peroneal nerve deficits that were not present preoperatively.

Which of the following findings is most consistent with a diagnosis of transient peroneal nerve neurapraxia as the result of his intramedullary nailing?

She undergoes simultaneous external fixation and ORIF using minimally invasive plate osteosynthesis. Following surgery, she complains of numbness along the dorsum of her medial and lateral foot. He is initially taken to a local hospital. The treating surgeon, concerned that his hospital does not have a plastic surgeon available for soft-tissue coverage, arranges for transfer of the patient to a nearby level I trauma center for definitive care.

Upon arrival at the definitive treatment center, the patient is taken for formal debridement and external fixator application. Which of the following options has the greatest effect on this patient's risk of infection? Radiographs of the tibia and fibula are provide in Figures A and B. A closed reduction is performed and the patient is placed in a long leg cast. Radiographs following cast placement are provided in Figures C and D. The decision is made to proceed with closed treatment instead of operative.

Which of the following is most likely to occur with nonoperative management? A clinical photo and radiograph are shown in Figure A and B. What is the most important factor in a surgeon's decision of determining between limb salvage and amputation? Infected tibial shaft nonunion 6 months status post intramedullary nail fixation. Oligotrophic humeral shaft nonunion 7 months status post non-operative management.

Hypertrophic tibial shaft nonunion 7 months status post intramedullary nail fixation. Comminuted open tibial shaft nonunion with segmental bone loss 8 months status post intramedullary nail fixation. Supracondylar femoral shaft nonunion 6 months status post intramedullary nail fixation with 4 distal locking screws. This laceration is able to be closed during initial surgery. What adjunct treatment has been shown to improve outcomes when using an intramedullary nail? After debridement and external fixation, he is taken to the operating room for definitive soft tissue flap coverage and intramedullary nailing.

Administration of recombinant human Bone Morphogenetic Protein-2 rhBMP-2 at the time of fracture fixation will lead to which of the following? Following placement of this implant, what is the best technique to confirm it is not too proud proximally? The patient is at greatest risk of developing which of the following conditions as a result of this malunion? His injuries include the closed left tibial shaft fracture shown in Figure A. He is a smoker, but is otherwise healthy.

Intramedullary nailing is performed without initial complications. Which of the following puts this patient at greatest risk for tibial nonunion? Physical exam shows a deformed left lower extremity with a 1-cm open wound over the anterolateral aspect of his leg.

Radiographs are provided in Figures A and B. Which of the following interventions has been shown in the literature to decrease the occurrence of infection at the fracture site? He is treated with an intramedullary nail, and postoperative radiographs are shown in Figures C and D.

Which of the statements concerning reaming and nails is true? The patient returns to the office 2 weeks after the surgery and reports persistent numbness over most of the dorsum of the foot, but motor exam is normal.

What is the most likely explanation? Nine months after fixator removal, he presents with a painful oligotrophic nonunion. Laboratory workup for infection is negative. Passive knee range of motion is limited to 15 degrees. What is the most appropriate treatment for his nonunion?

Physical exam reveals a grossly deformed left leg with a 1 centimeter open wound over the anterolateral aspect of his tibia; no gross neurovascular deficits are noted. Injury radiographs are shown in Figures A and B. He undergoes immediate tibial nailing with debridement and primary closure of his traumatic wound.

Which of the following is the Gustilo-Anderson classification for his fracture? He undergoes reamed intramedullary nailing 4 hours after his injury.

Postoperative images are shown in Figures B and C. Compared to unreamed nailing, reamed nailing of this injury has been associated with which of the following? She has dopplerable posterior tibial and dorsalis pedis artery signals with less than 2 second capillary refill as shown in Figure B. Sensation is intact in the distribution of the tibial nerve but decreased in the distribution of the peroneal nerve.

She is cleared by the general surgery trauma team to go to the operating room for treatment of her leg. What is the most appropriate Gustilo classification and initial treatment for her injury? Gustilo 3A with spanning external fixation and delayed definitive fixation with soft tissue coverage.

Gustilo 3A with immediate medial and lateral plating followed by delayed soft tissue coverage. Gustilo 3B with spanning external fixation and delayed definitive fixation with soft tissue coverage. Gustilo 3B with immediate medial and lateral plating followed by delayed soft tissue coverage. Gustilo 3C with spanning external fixation and delayed definitive fixation with soft tissue coverage.

You have recommended intramedullary nailing of the tibia. What is the most common complication he must be advised about? Tibial Shaft Fractures. Ujash Sheth. Joshua Blomberg. Jan Szatkowski. Please rate topic. Please vote below and help us build the most advanced adaptive learning platform in medicine The complexity of this topic is appropriate for?

L2 - PGY3. L3 - PGY4. L4 - PGY5. L5 - Fellow. L6 - years in practice. L7 - years in practice. L8 - 10 years in practice. How important is this topic for board examinations?

How important is this topic for clinical practice?

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fraktur pedis

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: The patient is a 9-year-old female who comes from Oba District, Tidore island. Come to Emergency Department Ternate General Hospital with the right leg limbs which have blackened, some open wounds on the skin that give exposure to soft and hard tissue bone. According to the alloanamnesis,, before entering the hospital, she treated for three weeks in traditional bonesetter due to fractures. View PDF.

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Neglected fracture tibia dextra with gangrene pedis, post treatment by traditional bone setter

Riset Kesehatan Dasar Riskesdas. Spectrum penderita neglected fracture di RSUD dr. Cermin Dunia Kedokteran. Traditional system of medicine in Indonesia. Complications of fracture and dislocation treatment by traditional bone setters: A private practice experience. The Nigerian Health Journal. The practice of traditional bonesetting: Training algorithm.

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