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Talar Neck Fractures
Posted: Nov 20 2019 #(C101334)
E

Contralateral Femur and Talus Fractures in 16F

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HPI

A 16-year-old female was brought to the ED by an ambulance after a head-on motor vehicle collision. She admits to left thigh and right ankle pain. She denies any numbness or tingling in either extremity. Additional trauma survey was negative for other neurologic or visceral injuries.

PMH

No relevant past medical history

PE

Focused examination of the left lower extremity shows mild deformity and significant swelling about the thigh. A thigh wound is noted laterally with exposed fat and venous ooze which probes down to bone. She is neurovascularly intact. Focused examination of the right lower extremity demonstrates deformity, swelling and ecchymosis about the right ankle. Significant tenderness is noted. The skin appears intact. DP/PT pulses are palpable but sensation and motor function are diminished.

Poll
1 of 13
In addition to plain film radiographs, would you obtain any further imaging to guide your treatment?
Other
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P: 104051
Would you use a classification system to help guide management for the femur fracture?
Other
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P: 118441
Would you use a classification system to help guide management for the talus fracture?
Other
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P: 118442
How would you manage this injury?
Other
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P: 118443
If you choose Operative management of the femur, would you stage the procedure?
Other
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P: 118444
If you choose Operative management of the femur, how would you definitively fix the fracture?
Other
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P: 118445
If you choose Intramedullary nailing (IMN) of the femur fracture, what approach would you use?
Other
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P: 118663
If you choose Intramedullary nailing (IMN) of the femur fracture and obtain the construct shown below, what would your postoperative weight-bearing status be?
Other
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P: 128042
If you choose Operative management of the talus, would you stage the procedure?
Other
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P: 128043
If you choose Operative management of the talus, how would you definitively fix the fracture?
Other
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P: 128044
If you choose Open reduction internal fixation (ORIF) of the talus fracture, what approach would you use?
Other
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P: 128045
If you choose Open reduction internal fixation (ORIF) of the talus fracture, which implants would you utilize?
Other
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P: 128046
If you choose Open reduction internal fixation (ORIF) of the talus fracture and obtain the construct shown below, what would your postoperative weight-bearing status be?
Other
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P: 128047
PROCEDURE #1

Irrigation and Debridement (CPT 11012), Intramedullary Nailing Left Femur (CPT 27245) & Open Reduction Right Talus Fracture with Application of Ankle Spanning External Fixator (CPT 20692)

Intra-procedure P1
PROCEDURE #2

Open Reduction Internal Fixation Right Talus (CPT 28445) & Open Reduction Internal Fixation Distal Fibula (CPT 27814)

Intra-procedure P2
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OUTCOMES
Post-procedure P1
Post-procedure P2
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