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CASE REPORT

Orthopaedic Surgeon - Trauma Specialty

OhioHealth Grant Medical Center

Cleveland Clinic, Ohio

6

(P: 214966) If you choose Fracture reduction internal fixation (FIX), what Reduction technique would you use?

I would not choose Fracture reduction internal fixation (FIX)

0%

0/460

Closed Reduction - Fluoro + Fx Table

69%

321/460

Closed Reduction - Percutaneous K-wires (joystick technique)

12%

58/460

Open Reduction - Watson Jones Approach

2%

12/460

Open Reduction - Direct Anterior Approach

0%

4/460

Open Reduction - Direct Lateral Approach

12%

56/460

Outside my area of expertise - best if I don't vote

1%

9/460

I would treat this with a recon nail, using supine positioning on a traction table. I would be prepared for the proximal segment to misbehave, require additional reduction maneuvers, and provisional fixation.

Looks nicely reduced and the nail is good proximally. In my opinion, it could be a length or two longer and for me personally an integrated two screw design is better but that’s totally subjective.

I like to use a large steam pen in the proximal fragment to make sure I get the varus completely resolved if not a bit of valgus. I agree with using at least a trochaformis point if not pure pitiformis, even if you’re using a CMN

depends on if I’m going conventional or trying to use a blade. If I’m trying to use a blade, I probably do it in Direct. Put the blade where it belongs end of story if it’s a more ““conventional nail case“ traction with the knee bent so yes, a skeletal pin. This relaxes the it band. That helps quite... a bit, and after that you need a couple of clamps to do the rest usually, you have to do something for the abduction and something for the residual flexion

Don't forget about using a troch entry nail through the piriformis fossa if you're trying to do something like this closed with traction, or if you just need to knock it a bit into more valgus. Works even more if you use a lateral entry nail like that.

Charcot-Marie-Tooth Disease

PMID: 11433149 J Pediatr Orthop. 2001 Jul-Aug;21(4):423-4.

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The cavus foot.

The cavus foot.

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Charcot-Marie-Tooth Disease Cavus Foot Deformity Introduction QID: 186 (OBQ06.75)

QID 186 (Type "186" in App Search)

Plantar flexion of the first ray is the i...

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The cavus foot.

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