Posted: Jun 17 2016 #(C2607) Trauamtology

Proximal tibia metaphyseal-diaphyseal junction open fx

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HPI

Proximal tibia metaphyseal-diaphyseal junction open fx due to farm accident

PMH

patient had coronary by-pass surgery 2 years ago

patient was neurovascularly intact with large swelling at the antreolatreal cruris which can lead acute compatment syndrome

Poll

1 of 6

What is the Gustillo classification of this injury?

1 Type I

2 Type II

3 Type III

4 Type IIIA

5 Type IIIB

6 Type IIIC

Other

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P: 9046

What would be your initial treatment for this injury following debridement and irrigation?

1 Intramedullary nail

2 External fixation

3 Fine wire fixator

4 ORIF

Other

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P: 9047

What would be your definitive treatment for this injury?

1 Intramedullary nail

2 External fixation

3 Fine wire fixator

4 ORIF

Other

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P: 9048

Based on the clinical photo and radiograph, how long would you prescribe antibiotics for assuming the wound can be closed?

1 24 hours

2 48 hours

3 2 weeks

4 None needed

Other

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P: 9049

If choosing to place an external fixator prior to definitive fixation, what type of construct would you use?

1 Knee spanning uni-planar

2 Knee spanning multi-planar

3 Tibia uniplanar

4 Tibia multiplanar

Other

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P: 9050

When placing external fixator pins/wires, what is the minimum distance should you be from the zone of injury?

1 >1 cm

2 >2 cm

3 >3 cm

4 It does not matter

5 As far as possible without compromising fixation

Other

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P: 9051

PROCEDURE #1

Tetanous vaccine with intravenous cefazolin and metronidazole within the four hours were administred. The two posterior compartments are approached through fractured side , and The anterior and lateral compartments are approached through a single longitudinal incision on the outer aspect of the leg and fasciotomy was performed ,the irrigation of the wound was performed with saline+rifampin solution , the reduction performed through the wound and stabilized with triaxial +moduler external fixator . Careful use of elastic retention sutures (elastic vessel loop woven through skin staples) were used to decrease to size of the defect .

Intra-procedure P1

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