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Published byJessica Bertha Chase Modified over 9 years ago
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Lower limb fractures types
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Fractures Of The Femoral Neck (Intra-Capsular) Gardens Classification: grade1: incomplete impacted fracture of the femoral neck. grade 2: complete undisplaced fracture. grade 3: complete fracture with moderate displacement. grade 4: severely displaced fracture. 1+2 – AO screws 3+4 - hemiarthroplasty Clinically the patient complains of pain in the hip and the limb may be shortened and externally rotated.
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Femur – intertrochanteric (extracapsular) Less commonly associated with AVN Mx – dynamic hip screw Jensons
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Femoral Shaft fractures Spiral – twisting w/ anchored foot Transverse/oblique – direct trauma Communited/segmental
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Supracondylar fractures Transverse or communited
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Tibial plateau Often from MVA, varus or valgus force Type 1: Wedge fracture of lateral tibial plateau. Lag screws alone suffice for fixation Type 2: lateral tibial wedge fracture with a associated depression. Fixation is with a buttress plate and bone grafting. Type 3: Depression of lateral.tibial plateau but no associated wedge fracture Type 4: Medial tibial plateau fracture Type 5: bicondylar fracture of both plateau. Type 6: The hallmark of this fracture is the separation of the metaphysis and the diaphysis
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Patella fractures Direct/indirect trauma to knee Most commonly transverse #, rarely vertical Displaced fracture of patella treated with circalage wire and screws
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tibfib Fairly common cos tib is superficial, most common open fracture of longbone. Ring principle Most often spiral fractures from rotational force Weber Classification Weber A Fibula Fracture below syndesmosisFracture Weber B Fibula Fracture at syndesmosis, may tear ligamentFracture Weber C Fibula Fracture, above syndesmosis, ligament tornFracture Unstable
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Ankle The ankle is usually injured by indirect forces with the foot either being externally rotated, inverted, everted or less commonly internally rotated on the tibia. CLASSIFICATION First degree: fracture of one malleolus, no talar shift with a stable ankle mortice. Second degree: bimalleolar fracture or a fracture of one malleolus with ligament tear leading to instability of the ankle. Third degree: trimalleolar fracture with instability in the mediolateral and anteroposterior direction. Fourth degree: supra-syndesmotic fracture of the fibula, possible tearing of the inferior tib- fibular ligament and diastasis. Fifth degree: vertical impaction fracture of the distal articular surface of the tibia. bimalleolar
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