plate

Operative Management of Humeral Shaft Fractures

Options

Definition

Metaphysical

Extra-articular

Treatment options

IMN

Plate

Results

Jindal et al. Indian J Orthop 2020

- systematic review

- no different in malunion

- infection more common in plate

Distal Tibial Fractures

Definition

Metaphyseal

Extra-articular

Intra-articular Extension

AO Classification

Types

1. Supracondylar

2. Unicondylar

3. Intracondylar

Xrays

Supracondylar / Extra-condylar

Epidemiology

Most common long bone fracture

Aetiology

Young patients / sports

Elderly / simple falls

MVA - often compound

Tscherne Soft Tissue Classification

Grade 0

- nil ST injury

Grade 1

Epidemiology

2 groups

1.  Elderly

- low velocity injury

- osteoporotic

- need to start bisphosphonates

2.  Young patients

- high velocity injury

Anatomy

Distal Radius Angles

- radial volar tilt 11°

- radial inclination  22°

- radius is 11 mm longer than ulna 

- ulna variance 2mm positive on average

Non operative Management

Indications

< 20^o sagittal

< 30^o coronal

< 3 cm of shortening

Options