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Tibial Plateau Fracture
Published in Raymond Anakwe, Scott Middleton, Trauma Vivas for the FRCS (Tr & Orth), 2017
Raymond Anakwe , Scott Middleton
I would protect the fixation with a period of 6 weeks non-weight bearing in a hinged knee brace set between 0 and 90 degrees of flexion in order to maintain range of movement followed by a gradual increase in weight bearing and range of movement with physiotherapy supervision. More comminuted fracture types or where the fixation is tenuous may require a longer period of protection.
Principles of fractures
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Boyko Gueorguiev, Fintan T. Moriarty, Martin Stoddart, Yves P. Acklin, R. Geoff Richards, Michael Whitehouse
The bone is split into two or more fragments. The fracture pattern on X-ray can help predict the behaviour after successful reduction: in a transverse fracture the fragments usually remain in place after reduction; in an oblique or spiral, they tend to shorten and redisplace even if the bone is splinted. In an impacted fracture the fragments are jammed tightly together and the fracture line is indistinct. A comminuted fracture is one with more than two fragments with interlocking of the fracture surfaces; it is often unstable.
Fractures and Joint Injuries
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
The bone is completely broken into two or more fragments. The fracture pattern helps to tell how the fracture occurred and how it is likely to behave after reduction. If the fracture is transverse, the fragments usually remain in place after reduction; if it is oblique or spiral, they tend to slip and re-displace even if the bone is splinted. In an impacted fracture the fragments are jammed tightly together and the fracture line is indistinct. Double fractures in a long-bone diaphysis, leaving an isolated segment between the breaks, is called a segmental fracture. A comminuted fracture is one in which there are multiple fragments; because there is poor interlocking of the fragments, these fractures are inevitably unstable.
Interosseous wiring for fragmented proximal phalangeal fractures
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Hidetoshi Teraura, Hideki Sakanaka, Hiroyuki Gotani
In the present study, we assessed the clinical outcome of 5 patients with a comminuted fracture of the proximal phalanx (at least three fragments) treated with open reduction and interosseous wiring. We observed successful bone healing and excellent outcomes in all patients and no postoperative complications or deformities. Fractures of the proximal phalanx of the fingers are often seen in daily clinical practice; however, if not treated properly, they might lead to tendon adhesions which cause limited ROM. For a good clinical outcome, the bone fracture must heal properly while retaining as much function as possible. For bone healing, accurate reduction and proper fixation are necessary. For functional recovery, joint contractures and tendon adhesions must be prevented with adequate postoperative therapy combined with proper immobilization [5].
Treatment of Patellar Lower Pole Fracture with Modified Titanium Cable Tension Band Plus Patellar Tibial Tunnel Steel “8” Reduction Band
Published in Journal of Investigative Surgery, 2019
Jiaming Li, Decheng Wang, Zhiliang He, Hao Shi
The morbidity of lower patella fracture, which usually refers to the long axis of 1/4 distal fractures of the patella, is 9.3%∼22.4%. The morbidity is due to the long axis of 1/4 distal fractures that do not have patellar articular cartilage surface, thus unable to form a joint and femoral condyle. This type of fracture belongs to a special type of extra articular fractures of lower patella fracture, which is the comminuted fracture. The fracture block of the formation is very small, in addition, the lower stress is relatively concentrated and belongs to the starting point of the patellar tendon. Because it is a special type of patella fracture, the selected mode of operation will be directly related to the recovery of patient's knee joint functions.
Vascularized medial femoral condyle graft for nonunion after failed radiolunate arthrodesis
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Akito Nakanishi, Shohei Omokawa, Kenji Kawamura, Takamasa Shimizu, Yasuhito Tanaka
A 32-year-old man fell from a high place and sustained a comminuted fracture in the right distal radius (AO classification type C1). He underwent open reduction and internal fixation using a volar plate at an emergency hospital. He visited the outpatient clinic of our department 24 months after the initial surgery because wrist pain had increased during his work. Radiographs showed an irregular articular surface of the distal radius due to poor reduction in the initial surgery (Figure 1). An examination revealed a restricted range of motion of the wrist joint (flexion/extension 40°/30°) and grip strength had decreased to 20% of the healthy side.