0%
PRESENTATION
4
0%
POLLS
25,961
0%
OUTCOMES
11
0%
EVIDENCE
58
0%
Comments
15
CASE DESCRIPTION
AGE 27 / Male
CC Right thigh pain
HPI A 27-year-old male is involved in MVC at 50 mph.
PMH N/A PMH Social ETOH
PE RLE - inspection shows thigh swelling and deformity with ecchymosis - 2+ DP and PT pulse - 5/5 ankle DF/PF and EHL
Pre-procedure IMAGES:
https://devupload.orthobullets.com/cases/101292/ba94c4bf-831f-4938-a505-4e6d98e79461_zc_1.jpg https://devupload.orthobullets.com/cases/101292/4718b953-869d-4f21-9b74-613831734fff_zc_2.jpg https://devupload.orthobullets.com/cases/101292/c2089e44-738a-438a-9a38-f241ce3c6c09_zc_3.jpg https://devupload.orthobullets.com/cases/101292/9d8f8ddf-2e0c-4c3a-8e2c-49a349a9ec8e_zc_4.jpg
POLLS
OB Community
1) Would you get additional imaging of the Femoral FX to determine treatment?
Other
2) Would you get additional imaging to rule out an Ipsilateral Femoral Neck FX?
Other
3) Would you use a classification system to guide your treatment of the femur fx?
Other
4) How would you manage this patient?
Other
5) If you chose Operative management, would you temporize this patient prior to definitive fixation?
Other
6) If you choose to temporize with Skeletal Traction, what type would you use?
Other
7) If you choose Operative management, what Definitive Fixation technique would you use?
Other
8) If you choose IM Nail fixation or External fixation, would you perform Open Reduction of the fracture site?
Other
9) If you choose IM Nail fixation, what approach would you use?
Other
10) If you choose IM Nail fixation, how would you position the patient and what table would you use?
Other
11) If you choose IM Nail fixation, what would be your PRIMARY method to get your femoral LENGTH correct?
Other
12) If you choose IM Nail fixation, what would be your PRIMARY (most valuable) method to get your femoral ROTATION correct?
Other
13) In this patient, if you choose IM Nail fixation, when would you begin FULL Weight Bearing as Tolerated?
Other
14) In this patient, if you choose IM Nail fixation, how long would you prescribe postoperative DVT prophylaxis?
Other
CASE OUTCOMES
PROCEDURE 1: Intramedullary Nailing of Right Femoral Shaft Fx
Intra-procedure P1
https://devupload.orthobullets.com/cases/101292/09b1b5c0-6b70-49e1-bce2-6df982c67e7b_zc_5.jpg https://devupload.orthobullets.com/cases/101292/ccacd683-4d7f-480f-b96b-2535f5cfa815_zc_6.jpg https://devupload.orthobullets.com/cases/101292/e6e49fa3-895f-46d1-a2da-bb1193aba8a4_zc_7.jpg https://devupload.orthobullets.com/cases/101292/47c2f331-dff2-4a9e-bb0e-4a66caa66a02_zc_10.jpg https://devupload.orthobullets.com/cases/101292/ff160a7a-ca4c-4ec6-bd9f-27d4b907115c_zc_8.jpg https://devupload.orthobullets.com/cases/101292/de2f17fb-56d3-45af-ac8c-b28b15930391_zc_9.jpg https://devupload.orthobullets.com/cases/101292/28191841-e09b-4781-a7c1-c0076a7398c3_zc_11.jpg
Post-procedure P1
https://devupload.orthobullets.com/cases/101292/f4f5ecbc-f046-4bab-bd55-b343fcfe433b_zc_12.jpg https://devupload.orthobullets.com/cases/101292/b63bcac6-251e-42c5-a87e-648ebd36f2a6_zc_13.jpg https://devupload.orthobullets.com/cases/101292/61054e9d-904d-415f-9e84-0e8976c5e1cb_zc_14.jpg https://devupload.orthobullets.com/cases/101292/d915e44b-a2ea-48fe-a628-9960ef8e4a8b_zc_15.jpg
EVIDENCE (58)
EXPERT COMMENTS