By Michael J. Gardner MD, Robert Dunbar MD, M. Henley MD, Sean Nork MD
Harborview Illustrated counsel and tips in Fracture Surgery provides ideas built through orthopaedic surgeons on the collage of Washington Harborview sanatorium, the best orthopaedic trauma middle on the earth. The e-book focuses completely on exact descriptions of technical assistance and tips for fracture aid and fixation, implant administration, implant placement, and sufferer positioning. The easy-to-follow structure good points succinct bulleted textual content and thousands of illustrations.
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Extra resources for Harborview Illustrated Tips and Tricks in Fracture Surgery
J Orthop Trauma. 2008;22(7):487–493. indd 34 4/16/2010 6:59:52 AM Clavicle Fractures Chapter Michael L. Brennan 3 Sterile Instruments/Equipment ● ● Draping to include impervious stockinette and 4 inch elastic bandage wrap for forearm and hand. Selection of bone clamps for reduction. , from small external fixator) for manipulation and intramedullary fixation. Small distractor (especially for delayed treatment, nonunions or malunions). Implants. 5-mm. 5-mm cannulated screws (use largest size possible to gain endosteal purchase).
Anatomically contoured distal clavicle plates with a cluster of screws distally (locking screws may be beneficial in osteoporosis). Intramedullary screws or several threaded Steinmann pins to partially fill the canal. ● The intramedullary device(s) can be inserted lateral to medial prior to reduction and plate fixation. ● The screw or pins act as a stable post, such that the plate screws interdigitate with the IM wires, as well as the cortex to gain improved fixation (Fig. 3-6). ▼ Figure 3-6.
Note that the caudal segment of the scapula is lateralized, owing to the pull of the infraspinatus, teres major and minor, and latissimus dorsi. In most cases, this displacement should be reduced initially to allow space for the articular reconstruction. The medial extent of the transverse fracture line at the medial scapular cortex often offers an excellent reduction assessment. ● Frequently, the lateral scapular border must be reconstructed to enable accurate reduction of the glenoid neck component.