0%
PRESENTATION
7
0%
POLLS
9,115
0%
OUTCOMES
8
0%
VIDEOS
6
0%
EVIDENCE
31
0%
Comments
78
CASE DESCRIPTION
AGE 25 / Male
CC Left thigh and knee pain
HPI A 25-year-old male had an ATV accident and injured his left leg. He presents to the trauma bay complaining of isolated left knee and thigh pain. He was unable to ambulate immediately after the accident. He denies any pain in any other extremity. He denies any head trauma or loss of consciousness.
PMH No significant past medical history
PE A focused physical exam reveals intact skin without open wounds. Swelling and deformity are present over the distal thigh. Tenderness to palpation is present over the distal thigh and knee. Thigh and leg compartments are compressible. Pain with range of motion is present at the knee. No pain with palpation of the leg or ankle. Sensation and motor are intact distally. Distal pulses are palpable and present.
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/102024/887a8363-46cf-45a4-a1ff-8a1d4e8e3ede_screen_shot_2022-03-22_at_7.23.12_pm.jpg https://upload.orthobullets.com/cases/102024/8d9c032e-f5da-43fa-90bb-ae1a61f2bf31_screen_shot_2022-03-22_at_7.23.19_pm.jpg https://upload.orthobullets.com/cases/102024/59d767d5-49ea-45fa-a658-202156d28f0a_screen_shot_2022-03-22_at_7.24.01_pm.jpg https://upload.orthobullets.com/cases/102024/df42e2a5-74ff-4446-aa22-165167a9ca45_screen_shot_2022-03-22_at_7.24.14_pm.jpg https://upload.orthobullets.com/cases/102024/adc90e7a-c426-4e4a-ae15-401702e9ff82_screen_shot_2022-03-22_at_7.24.26_pm.jpg https://upload.orthobullets.com/cases/102024/968d1d02-4b9f-4ebd-bcbb-92ad02fd8983_screen_shot_2022-03-22_at_7.24.42_pm.jpg https://upload.orthobullets.com/cases/102024/4b570edf-143f-4821-8fb0-718a74e8acef_screen_shot_2022-03-22_at_7.24.53_pm.jpg
POLLS
OB Community
1) In addition to the plain film radiographs, would you obtain any additional imaging to guide management?
Other
2) Would you use a classification system to guide management?
Other
3) How would you manage this injury?
Other
4) If you choose Operative management, how would you definitely manage this injury?
Other
5) If you choose Open reduction internal fixation (ORIF), what approach would you use?
Other
6) If you choose Intramedullary nail fixation (IMN), what technique would you choose?
Other
7) If you choose Intramedullary nail fixation (IMN) with Retrograde technique, how many distal interlock screws would you place?
Other
8) If you choose Hybrid fixation (IMN + ORIF), what would your locking screw configuration be?
Other
9) If you choose Operative management and attained the construct shown below, when would you initiate range of motion post-operatively?
Other
10) If you choose Operative management and attained the construct shown below, when would you initiate weight bearing post-operatively?
Other
CASE OUTCOMES
PROCEDURE 1: Left distal femur intramedullary nailing and open reduction and internal fixation
DOP: 3/14/2022
Intra-procedure P1
https://upload.orthobullets.com/cases/102024/7e8be05f-c7d1-49b5-9d84-7e8a4501590b_screen_shot_2022-03-22_at_7.48.22_pm.jpg https://upload.orthobullets.com/cases/102024/48ee444e-b9dc-4f2d-95d4-569763449292_screen_shot_2022-03-22_at_7.48.41_pm.jpg https://upload.orthobullets.com/cases/102024/58fd4cd6-88c5-44c7-b0ea-8f69e6984347_screen_shot_2022-03-22_at_7.49.00_pm.jpg https://upload.orthobullets.com/cases/102024/a065facc-2579-403b-9d54-254e00977309_screen_shot_2022-03-22_at_7.49.11_pm.jpg
Post-procedure P1
https://upload.orthobullets.com/cases/102024/799b3e02-3df8-4887-825a-3a42b033eba7_screen_shot_2022-03-22_at_7.25.06_pm.jpg https://upload.orthobullets.com/cases/102024/617ade2f-495b-43db-94db-c5faebbb38c6_screen_shot_2022-03-22_at_7.25.15_pm.jpg https://upload.orthobullets.com/cases/102024/63ccc786-e3a9-4371-bdde-039ce77bf8d5_screen_shot_2022-03-22_at_7.25.22_pm.jpg https://upload.orthobullets.com/cases/102024/46bca337-6c01-4fea-b55b-04abb6dd6ca5_screen_shot_2022-03-22_at_7.25.30_pm.jpg
VIDEOS & PODCASTS (6)
EVIDENCE (31)
EXPERT COMMENTS