![]() ![]() tibial pins need to be placed just medial to tibial crest, never lateral to avoid injury to anterior tibial artery, vein, deep peroneal nerve with bicortical drilling and pin placement.palpate and mark out tibial crest anteriorly.determine what forces (varus/valgus) on AP fluoro are needed for reduction under traction.anticipate what will be used for definitive fixation and ensure pins do not imede.want pins to be at least 3cm proximal to fracture. ![]() mark out proximal extent of fracture in distal tibia using fluoro.patella pointed towards ceiling, often foot will be externally rotated through fracture site distally.supine with feet at the end of the bed, bump under ipsilateral hip to get limb into neutral rotation.compact or small external fixator system if foot pins needed.Stryker Hoffman 3, Zimmer, Synthes, Jet-X) c-arm from contralateral side perpendicular to table, monitor at foot of bed in surgeon direct line of site.decreased incidence of wound complications and deep infections with fixator treatment compared to ORIF, can combine with limited percutaneous fixation using lag screws.fixator to be left on until swelling resolves and return of skin wrinkles (10-14 days), can be used for definitive management if significant comorbidities.CT performed after fixator placement to better delineate fracture pattern and articular injury.fixator provides fracture stabilization and soft tissue ligamentotaxis to allow for decreased articular impaction and soft tissue swelling.1-2 wks: serial soft tissue checks, pin site cleanings and dressings.non-weight bearing in splint, CT of ankle afterwards.check AP/Lat fluoro of fracture site and pull traction while applying varus/valgus and anterior/posterior force.connect bars from stable base to calcaneal transfixtion pin medially and laterally.span tibial pins with bar, creating stable base.starting point 2cm inferior to medial malleolus and 2cm anterior to posterior border of calcaenus.transcalcaneal pin inserted from medial to lateral.ensure placement does not interfere with definitive fixation.tibial pins placed proximal to fracture and just medial to anterior tibial crest.supine on radiolucent OR table with feet at end of bed, bump under ipsilateral hip.setup OR with radiolucent table and C-arm perpendicular from contralateral side.CT performed after fixator to better delineate fracture pattern.commonly used for acute management of pilon and unstable ankle fractures or in presence of compromised soft tissues.Orthobullets Technique Guides cover information that is "not testable" on ABOS Part I RETIRE Transtibial Below the Knee Amputation (BKA) Tibial Plafond Fracture ORIF with Anterolateral Approach and Plate FixationĪnkle Simple Bimalleolar Fracture ORIF with 1/3 Tubular Plate and Cannulated Screw of Medial MalleolĪnkle Isolated Lateral Malleolus Fracture ORIF with Lag ScrewĬalcaneal Fracture ORIF with Lateral Approach, Plate Fixation, and Locking Screws ![]() ![]() Tibial Plafond Fracture External Fixation Tibial Plateau Fracture External Fixationīicondylar Tibial Plateau ORIF with Lateral Locking Plate Patella Fracture ORIF with Tension Band and K Wires Subtrochanteric Femoral Osteotomy with Biplanar Correctionĭistal Femur Fracture ORIF with Single Lateral Plate Intertrochanteric Fracture ORIF with Cephalomedullary Nailįemoral Shaft Fracture Antegrade Intramedullary Nailingįemoral Shaft Fracture Retrograde Intramedullary Nailing Femoral Neck Fracture Closed Reduction and Percutaneous Pinningįemoral Neck FX ORIF with Cannulated Screwsįemoral Neck Fracture ORIF with Dynamic Hip Screwįemoral Neck Fracture Cemented Bipolar Hemiarthroplasty ![]()
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