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Review Question - QID 1004

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QID 1004 (Type "1004" in App Search)
A 28-year-old man is thrown from his motorcycle and sustains the closed injury seen in Figure A. The limb remains neurovascularly intact. What is the most appropriate initial treatment of this injury?
  • A

Bulky compressive splint

2%

47/2445

Open reduction and internal fixation

6%

150/2445

Closed intramedullary nailing

2%

53/2445

Spanning external fixation

86%

2108/2445

Hinged spanning external fixation

3%

81/2445

  • A

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Figure A shows a significantly displaced, high-energy proximal tibia fracture with intra-articular extension. Appropriate initial treatment includes application of a spanning external fixation device with fasciotomy if needed.

The referenced article by Egol et al noted a low rate of wound infection, improved access to soft tissues, prevention of further articular damage, and osseous stabilization. They reported the downside being residual knee stiffness.

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