Orthopedic Traum a I have nothing to disclose. David Miller - - PDF document

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Oct 08, 2022 107 likes •394 views

3/7/2018 Orthopedic Traum a I have nothing to disclose. David Miller Memorial Trauma Symposium 2017 James Black, MD Mercy Orthopedic Trauma - Springfield 10/ 27/ 2017 Objectives W hat is Orthopedic Traum a? What is orthopedic trauma?

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Orthopedic Traum a

David Miller Memorial Trauma Symposium 2017

James Black, MD Mercy Orthopedic Trauma - Springfield 10/ 27/ 2017

I have nothing to disclose. Objectives

What is orthopedic trauma?
The role of the orthopedic

traumatologist

Quick review of hip fractures
Lower extremity and pelvis examples

W hat is Orthopedic Traum a? W hat is Orthopedic Traum a?

Orthopedics: Surgical specialty dealing with disorders of the musculoskeletal system – bones, muscles, tendons, ligaments… Orthopedic surgery subspecialties

Arthroplasty
Spine
Sports medicine
Shoulder
Hand/Upper extremity
Oncology
Foot/Ankle
Trauma

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3/7/2018 2 Orthopedic Traum a

Acute injury to the musculoskeletal

system after an accident

Orthopedic Traum a Orthopedic Traum a Orthopedic Traum a Orthopedic Traum a Orthopedic Traum a

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3/7/2018 3 Orthopedic Traum a Orthopedic Traum a Orthopedic Traum a

Historically, all orthopedic surgeons are trained in fracture care, so what makes the orthopedic trauma surgeon different?

Orthopedic Traum atologist

Acute care management of fractures

and musculoskeletal trauma

Managing injuries in a polytrauma

patient

Resuscitation, ICU care
Temporary versus definitive fracture fixation
Specialized fixation techniques

Orthopedic Traum atologist

Understanding of how MSK injuries,

and the required fixation, affects the mortality and morbidity in a multiply injured patient

Team player in multidisciplinary

trauma care

Orthopedic Traum atologist

Fracture Specialist ! Take the “worst of the worst” and put them back together to maximize recovery and future function.

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Complex extremity fractures

Orthopedic Traum atologist

Complex extremity fractures

Peri-articular

Orthopedic Traum atologist

Complex extremity fractures

Peri-articular

Orthopedic Traum atologist

Complex extremity fractures

Peri-articular

Orthopedic Traum atologist

Complex extremity fractures

Peri-prosthetic

Orthopedic Traum atologist

Complex extremity fractures

Peri-prosthetic

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Complex extremity fractures

Open fractures

Orthopedic Traum atologist

Complex extremity fractures

Open fractures

Orthopedic Traum atologist

Complex extremity fractures

Segmental or comminuted fractures

Orthopedic Traum atologist

Complex extremity fractures

Segmental or comminuted fractures

Orthopedic Traum atologist

Soft tissue injuries Mangled extremities Traumatic amputations

Orthopedic Traum atologist

Pelvic and Acetabulum Fractures

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Pelvic and Acetabulum Fractures

Orthopedic Traum atologist

Fracture Complications

Nonunion
Malunion/ deformities
I nfection

Let’s see som e broken bones! Proxim al Fem ur Fractures

The spectrum of hip fractures…

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Fem oral Head Fractures Fem oral Head Fractures Fem oral Head Fractures Fem oral Head Fractures Fem oral Head Fractures Fem oral Neck Fractures

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Fem oral Neck Fractures Fem oral Neck Fractures Fem oral Neck Fractures Fem oral Neck Fractures The Young Fem oral Neck Fracture The Young Fem oral Neck Fracture

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The Young Fem oral Neck Fracture The Young Fem oral Neck Fracture The Young Fem oral Neck Fracture The Young Fem oral Neck Fracture Older patients? Total hip arthroplasty

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Hem iarthroplasty I ntertrochanteric Hip Fractures I ntertrochanteric Hip Fractures I ntertrochanteric Hip Fractures I ntertrochanteric Hip Fractures I ntertrochanteric Hip Fractures

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I ntertrochanteric Hip Fractures

Pelvis and Acetabulum

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3/7/2018 12 Acetabulum Cases

3 6 yo fem ale, m otorcycle accident 3 6 yo fem ale, m otorcycle accident

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7 5 yo m ale, fall off ladder 7 5 yo m ale, fall off ladder

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2 9 yo m ale, m otor vehicle accident 2 9 yo m ale, m otor vehicle accident

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3/7/2018 15 Pelvis Cases

2 5 yo m ale, m otor vehicle accident 2 5 yo m ale, m otor vehicle accident

In Binder

Pelvic Binder

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1 5 yo m ale, peds vs auto 1 5 yo m ale, peds vs auto

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3 months postop 3 months postop

3 4 yo m ale, m otorcycle accident

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3 4 yo m ale, m otorcycle accident

In Binder

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4 months postop 4 months postop 4 months postop

Other w ays to fix a fem ur…

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6 9 yo fem ale, standing level fall 6 9 yo fem ale, standing level fall

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6 weeks postop

2 2 yo m ale, GSW to distal fem ur 2 2 yo m ale, GSW to distal fem ur

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I&D, bullet removal from quad tendon, ORIF distal femur

Tibias!

6 0 yo m ale, m otor vehicle accident 6 0 yo m ale, m otor vehicle accident

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s/p In External Fixator

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2 0 yo m ale, m otor vehicle accident 2 0 yo m ale, m otor vehicle accident 3 1 yo m ale, fall off balcony

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s/p In External Fixator

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3/7/2018 26 Not everyone show s up w ith just one fracture…

4 0 yo m ale, MVA polytraum a 4 0 yo m ale, MVA polytraum a

Right distal tibia facture Right medial femoral condyle fracture

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Left distal femur, tibial plateau fractures Right tibia Right tibia Postop Right medial femoral condyle Right medial femoral condyle

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Postop Left distal femur and proximal tibia Postop