Indications: Surgical planes: Lowa/Iowa/Weinstein-Ponseti (Anteromedial) Ludloff (Anteromedial) Ferguson (Posteromedial) Developed in 1979 1908 1973 Superficial interval Between sartorius (anterior) and adductor longus (posterior) Between sartorius (anterior) and adductor longus (posterior) Between adductor longus (anterior) and gracilis (posterior) Deep interval Between femoral neurovascular bundle (anterior) and pectineus (posterior) Between pectineus (anterior)…
Author: Dr. Sulabh Kumar Shrestha, MS Orthopedics
Floating Knee – Quick Review
The term “floating knee,” introduced by Blake and McBryde in 197 is used to describe fractures of the ipsilateral femur and tibia. Fractures can occur anywhere along the femur and the tibia and must occur in both bones to be considered a floating knee injury. Classification of Floating Knee Types…
Ipsilateral Femoral Neck and Shaft Fracture
General Treatment Options 1. Reconstruction/cephalomedullary nail 2. Plate + screw/DHS fixation Other strategies include: Which Fracture First? For a displaced femoral neck fracture, reduction and temporary stabilization with guidewires can prevent further displacement. A practical sequence is: Stabilizing the shaft can facilitate reduction of the displaced neck fracture and help…
Polyethylene Insert Exchange for Acute PJI After TKA: Indications, Timing & Outcomes
Key concept Irrigation and debridement with polyethylene insert exchange (IDPE) or Open debridement and polyethylene insert exchange (ODPE) is a form of DAIR (Debridement, Antibiotics and Implant Retention) used for selected acute periprosthetic joint infections (PJI) after TKA. When to consider and when not to consider IDPE or ODPE? Favorable…
Crescent Fractures (Trans-iliac Fracture Dislocation of Sacroiliac Joint)
Definition: Transiliac fracture dislocation of the SI joint, which combines a ligamentous disruption of the inferior part of the SI joint with a vertical fracture line of the posterior ilium, extending from the SI joint and reaching the iliac crest at different levels. The posterior superior iliac spine (PSIS) remains…
Letournel and Judet Classification of Acetabulum Fractures and Simplified Algorithm
5 Simple or Elementary fracture types: 20% of acetabular fractures 5 Combined fracture types: 80% of acetabular fractures Algorithm for acetabular fracture classification Iliopectineal/Ilioischial line breakage Obturator ring (inferior pubic ramus) Posterior wall Ilium Spur sign Fracture classification Isolated iliopectineal line Intact Anterior wall (AW) Broken Anterior column (AC) Isolated…
Total Knee Arthroplasty (TKA) in Obese Patients
Nearly 50–60% of patients undergoing total knee arthroplasty (TKA) are obese, making obesity one of the most important factors influencing perioperative planning and outcomes. These obese patients often require TKA at a younger age. It is a major risk factor for knee osteoarthritis due to: High BMI can be classified…
Fixing the Wing: ORIF of an Iliac Wing Fracture Using the Lateral Window of Anterior Approach
Today’s case involved a 63-year-old female presenting with a right iliac wing fracture (Tile A2) and a left distal radius fracture following trauma. The pelvic injury was managed with open reduction and internal fixation using reconstruction plates and a screw via the lateral window of the anterior approach. The distal…