Diandra
609 posts
Diandra
@breadandtonic
👩🏾⚕️ MD, MBA (PGY2 Orthopedics)
Manila, Philippines Katılım Haziran 2018
223 Takip Edilen136 Takipçiler
Complete multifragmentary articular fracture of the distal humerus. Currently on olecranon traction #orthotwitter
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@breadandtonic It maybe old fashioned.... but I’d like to know about the patient as well as their injury - age, health, occupation, expectations, as well as the condition of the limb that has the fracture?
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@krislovetine Dual plating + lag screw + bone graft ...... hahahahahhuhuhu at least not bag of bones 🤧😭
Filipino
@breadandtonic The principle is as much fixation as possible in a fracture that I believe is prone to failure. Basically the same way you treat neuropathic diabetics. I generally WB at six weeks, diabetics at 10 to 12.
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@InvictaOrtho Hi just wondering— what’s the principle behind 3 syndesmotic screws? Haven’t encountered here in our practice. And also curious when weightbearing was resumed? Thank you!
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[2/2] For these I err on side of more fixation. Bone so-so even proximally, so I do multiple syndesmotic screws for support to ensure ankle doesn’t go anywhere. I remove them later if pt young, or issues w/ROM. I left medial mal alone as small & not contributing to stability.
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Diandra retweetledi
An excellent trick to find the radial nerve in posterior triceps split approach, from paper by Frank Liporace: 2 fingerbreadths or 4cm proximal to where triceps aponeurosis meets septum between long and lateral heads of triceps. It’s neat; it has worked every time for me so far.
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Diandra retweetledi
Tibia fracture fixed with IM nail. Arrow shows the Herzog bend. It’s a little different depending on the nail, but this is frequently a culprit when it comes to proximal tibia fracture displacement if the bend is too distal. See figure on page 102 of this: eknygos.lsmuni.lt/springer/378/9…
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Diandra retweetledi
A great slide describing pilon exposures that I saved. I'm pretty sure it's from a talk by @FractureDoc! My most commonly used approaches are a mini-medial, anterolateral, and posterolateral.
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Diandra retweetledi
Healed ankle. Here I want to point out importance of placing screw in right place and not too medial in low transverse medial mal, otherwise screw won’t capture most of fracture & may even displace it into translation. You really have to abduct foot to get the right start point.
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The bulk of our in-service exam days ago hayayay
Yelena Bogdan, MD, FACS, FAAOS@InvictaOrtho
Judet views used for acetabular fractures. Obturator oblique shows anterior column (blue) & posterior wall (green). Iliac oblique shows posterior column (pink) & anterior wall (yellow). Because pelvis is tilted for view, iliac oblique of one side = obturator oblique of the other.
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Nope! Still do them at our ER 😁
Yelena Bogdan, MD, FACS, FAAOS@InvictaOrtho
External fixation is in my mind still great option for distal radius. The problem is that people flex wrist instead of translate, causing problem with finger motion. But if done right, people can use their fingers well. My residents haven’t seen one before—is this a dying art?
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Currently templating. DFLP + 2 lag screws outside the plate + bilateral autologous bone graft + bone substitute. We did aggressive debridement and minimal fixation at the ER (swashbuckler approach). She will be 4w post injury during surgery. #orthotwitter
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