Talar Neck Fractures

Posted: Sep 23 2021 #(C101790)

Right Traumatic Talus Extrusion and Humeral Shaft Fracture in 64F

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Travis Jones MD

Utah Orthopaedic Specialists

HPI

64 yo F presents to trauma bay status post MVC with right arm and foot pain and deformity

PMH

HTN Depression

Right arm: Visible deformity and ecchymosis arm. No open wounds or lesion. Compartments soft. 5/5 ain/pin/m/r/u. SILT MRU. 2+ radial and ulnar pulses Right foot: Visible deformity with extruded bone medial hindfoot. Numbness and tingling sa/su/sp/dp/t throughout. 1+ DP. PT pulse not palpable

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1 of 5

Assuming the patient has NKDA, what antibiotic would you administer?

1 1st generation cephalosporin

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2 1st generation cephalosporin + aminoglycoside

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3 1st generation cephalosporin + aminoglycoside + high dose penicillin

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4 piperacillin + tazobactam

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P: 136626

Would you attempt a reduction in the trauma bay?

1 Yes

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2 No

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P: 136627

Following thorough irrigation and debridement, how would you manage the talus extrusion?

1 non-operatively

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2 Open reduction with capsular repair

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3 External fixator only

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4 K wires and screw fixation

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5 K wires only

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6 Screw fixation only

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7 External fixator + capsular repair

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8 External fixator + K wire and screw fixation

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9 External fixator + K wires

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10 External fixator + screw fixation

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P: 136628

Would you fix the medial malleolus?

1 Yes

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2 No

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P: 136629

How would you manage the humerus fracture?

1 Non-operatively

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2 Antegrade IMN

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3 Retrograde IMN

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4 ORIF through anterolateral approach

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5 ORIF through posterior approach

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P: 136630

PROCEDURE #1

ORIF humurus + CRPP/Ex-fix Talus

Intra-procedure P1

OUTCOMES

Post-procedure P1

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