Concluded Case

Thanks to all ortho surgeons sir how long will it take to recover.

A young boy of 18 RTA 5DAYS ago pl opine on treat.

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compound Intraarticular distal Femur #, patella #and proximal tibia # with bone loss in distal Femur BY the soft tissue appearance and bone loss probably grade 3b compound # if no neurovascular injury ATLS Protocol to be followed..check Airway breathing circulation Rule out head chest abdominal injury Whole blood transfusion, w/f new respiratory neurological manifestations after 48hrs (fat embolism features) Stabilise in emergency ward with Thomas splint ,Take CT (to know Intraarticular involvement and fracture pattern) and also MRI knee (to look for cruciate and meniscal injury) and shift to emergency ot for knee Spanning external fixator with thorough wound Debridement and Articular surface distal Femur screw fixn maintaining the Articular congruity which is the most important step Once the wound is settled tibia # plan.-PLATING VIA MIPPO Patella # can be treated conservatively as its Articular surface is well maintained Treatment options for Femur are 1)fibular strut graft and Plating 2)LRS conversion, corticotomy This is a case of floating knee and the key to initial surgical management is the maintenance of Articular surface... Later address the cruciate and meniscal injury via arthroscopy if present
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compound Intraarticular distal Femur #, patella #and proximal tibia # with bone loss in distal Femur BY the soft tissue appearance and bone loss probably grade 3b compound # if no neurovascular injury ATLS Protocol to be followed..check Airway breathing circulation Rule out head chest abdominal injury Whole blood transfusion, w/f new respiratory neurological manifestations after 48hrs (fat embolism features) Stabilise in emergency ward with Thomas splint ,Take CT (to know Intraarticular involvement and fracture pattern) and also MRI knee (to look for cruciate and meniscal injury) and shift to emergency ot for knee Spanning external fixator with thorough wound Debridement and Articular surface distal Femur screw fixn maintaining the Articular congruity which is the most important step Once the wound is settled tibia # plan.-PLATING VIA MIPPO Patella # can be treated conservatively as its Articular surface is well maintained Treatment options for Femur are 1)fibular strut graft and Plating 2)LRS conversion, corticotomy This is a case of floating knee and the key to initial surgical management is the maintenance of Articular surface... Later address the cruciate and meniscal injury via arthroscopy if present
Physis intact so rather not go for iln tibia? Conservative rx tibia not seem to be a good option for tibia as early mobilisn of knee is required after fixn to avoid stiffness? @@Dr. Sujith Rao @Dr. Manivannan Adhinarayanan @Dr. Sivaraman Gnanaprakasam @Dr. Riju N @
Floating knee injury Compound intraarticular fracture femur Fracture upper 3rd tibia Wound debridement External fixator spanning both fractures Distal femur reconstruction with screws Wait for wound healing After that bone grafting and internal fixation
Comminuted fr lower end femur with fr tibia adv B L plating with inter condylar fixation with bone grafting with interlocking nail tibia.