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Treatment of Closed Tibial Fractures by Andrew H Schmidt, Christopher G. Finkemeier, and Paul Tornetta J Bone Joint Surg Am Volume 85(2):352-368 February.

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Presentation on theme: "Treatment of Closed Tibial Fractures by Andrew H Schmidt, Christopher G. Finkemeier, and Paul Tornetta J Bone Joint Surg Am Volume 85(2):352-368 February."— Presentation transcript:

1 Treatment of Closed Tibial Fractures by Andrew H Schmidt, Christopher G. Finkemeier, and Paul Tornetta J Bone Joint Surg Am Volume 85(2):352-368 February 1, 2003 ©2003 by The Journal of Bone and Joint Surgery, Inc.

2 Position for application of a cast for the treatment of a tibial fracture. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

3 Example of muslin wrapped around the ankle of a limb with a tibial fracture. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

4 Fig. 3-A Webril (Kendall Health Care Products, Mansfield, Massachusetts) is applied to provide padding with the ankle positioned in neutral. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

5 The padding and plaster are extended above the knee, which is slightly bent (10° to 15°). Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

6 Fig. 5-A Anteroposterior radiograph of unstable segmental fractures of the tibial and fibular shafts. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

7 Fig. 6-A A proximal tibial fracture with valgus angulation. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

8 Figs. 7-A and 7-B Sawbones model (Pacific Research Laboratories, Vashon, Washington) demonstrating the effect of a medial starting point on the angulation and displacement of a simulated proximal tibial fracture. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

9 Flexion of the proximal segment and translation of the fracture. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

10 Assessment of the ideal proximal entry portal on anteroposterior (Fig. 9-A) and lateral (Fig. 9-B) fluoroscopic views. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

11 Figs. 10-A and 10-B Clinical photographs showing the semiextended position used for tibial nailing. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

12 Algorithm for determining the steps necessary to avoid malalignment during nailing of proximal tibial fractures 46. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

13 Radiographs showing ipsilateral tibial plateau (lateral split-depression) and tibial shaft fractures. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

14 Radiographs made after intramedullary nailing with use of a lateral arthrotomy and a lateral starting point. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

15 Nailing of a very distal tibial fracture, with a Kirschner wire inserted to assist with reduction. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

16 Follow-up radiographs made after three months postoperatively. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

17 Fig. 14-A Anteroposterior radiograph of a comminuted diaphyseal tibial fracture. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

18 Fig. 14-B Radiograph made after internal fixation with a plate through a percutaneous technique. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.

19 Anterolateral (Fig. 15-A) and lateral (Fig. 15-B) radiographs made after reduction of a proximal metaphyseal fracture in a child with use of an external fixator for immobilization. Andrew H Schmidt et al. J Bone Joint Surg Am 2003;85:352-368 ©2003 by The Journal of Bone and Joint Surgery, Inc.


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