Orthopedic Trauma. I have nothing to disclose. Objectives 3/7/2018. What is Orthopedic Trauma? What is Orthopedic Trauma? Trauma

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1 Orthopedic Trauma I have nothing to disclose. David Miller Memorial Trauma Symposium 2017 James Black, MD Mercy Orthopedic Trauma - Springfield 10/27/2017 Objectives What is Orthopedic Trauma? What is orthopedic trauma? The role of the orthopedic traumatologist Quick review of hip fractures Lower extremity and pelvis examples What is Orthopedic Trauma? 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 1

2 Orthopedic Trauma Orthopedic Trauma Acute injury to the musculoskeletal system after an accident Orthopedic Trauma Orthopedic Trauma Orthopedic Trauma Orthopedic Trauma 2

3 Orthopedic Trauma Orthopedic Trauma Orthopedic Trauma Historically, all orthopedic surgeons are trained in fracture care, so what makes the orthopedic trauma surgeon different? 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 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 Fracture Specialist! Take the worst of the worst and put them back together to maximize recovery and future function. 3

4 Complex extremity fractures Complex extremity fractures Peri-articular Complex extremity fractures Peri-articular Complex extremity fractures Peri-articular Complex extremity fractures Peri-prosthetic Complex extremity fractures Peri-prosthetic 4

5 Complex extremity fractures Open fractures Complex extremity fractures Open fractures Complex extremity fractures Segmental or comminuted fractures Complex extremity fractures Segmental or comminuted fractures Soft tissue injuries Mangled extremities Traumatic amputations Pelvic and Acetabulum Fractures 5

6 Pelvic and Acetabulum Fractures Fracture Complications Nonunion Malunion/deformities Infection Let s see some broken bones! Proximal Femur Fractures The spectrum of hip fractures 6

7 Femoral Head Fractures Femoral Head Fractures Femoral Head Fractures Femoral Head Fractures Femoral Head Fractures Femoral Neck Fractures 7

8 Femoral Neck Fractures Femoral Neck Fractures Femoral Neck Fractures Femoral Neck Fractures The Young Femoral Neck Fracture The Young Femoral Neck Fracture 8

9 The Young Femoral Neck Fracture The Young Femoral Neck Fracture The Young Femoral Neck Fracture The Young Femoral Neck Fracture Older patients? Total hip arthroplasty 9

10 Hemiarthroplasty Intertrochanteric Hip Fractures Intertrochanteric Hip Fractures Intertrochanteric Hip Fractures Intertrochanteric Hip Fractures Intertrochanteric Hip Fractures 10

11 Intertrochanteric Hip Fractures Pelvis and Acetabulum 11

12 36 yo female, motorcycle accident Acetabulum Cases 36 yo female, motorcycle accident 12

13 75 yo male, fall off ladder 75 yo male, fall off ladder 13

14 29 yo male, motor vehicle accident 29 yo male, motor vehicle accident 14

15 25 yo male, motor vehicle accident Pelvis Cases 25 yo male, motor vehicle accident In Binder Pelvic Binder 15

16 15 yo male, peds vs auto 15 yo male, peds vs auto 16

17 3 months postop 3 months postop 34 yo male, motorcycle accident 17

18 34 yo male, motorcycle accident In Binder 18

19 4 months postop 4 months postop 4 months postop Other ways to fix a femur 19

20 69 yo female, standing level fall 69 yo female, standing level fall 20

21 6 weeks postop 22 yo male, GSW to distal femur 22 yo male, GSW to distal femur 21

22 I&D, bullet removal from quad tendon, ORIF distal femur Tibias! 60 yo male, motor vehicle accident 60 yo male, motor vehicle accident 22

23 s/p In External Fixator 23

24 20 yo male, motor vehicle accident 20 yo male, motor vehicle accident 31 yo male, fall off balcony 24

25 s/p In External Fixator 25

26 40 yo male, MVA polytrauma Not everyone shows up with just one fracture 40 yo male, MVA polytrauma Right distal tibia facture Right medial femoral condyle fracture 26

27 Right tibia Left distal femur, tibial plateau fractures Right tibia Postop Right medial femoral condyle Right medial femoral condyle 27

28 Postop Left distal femur and proximal tibia Postop Thanks! 28