A 50M, morbidly obese, mild diabetic and Hep B positive met with a RTA. Sustained the following injuries:
1/ Bilateral, multiple rib #s
2/ Left subtrochanteric #
3/ Right # dislocation of hip
4/ Right distal radius and ulnar #
In a Haemo-dynamically stable condition.
After optimizing this patient, we performed 2 stage surgery to fix his fractures (at the gap of 2 days): Stage I: DHS/DRLP, Stage II: ORIF of Acetabular #s (through KL approach). (An attempt to do PFN on left side was unsuccessful due to complexity of fracture anatomy and reduction)
Nice Job!
BTW the acetabular fracture is not completely reduced, which calls for THA sooner or later: actual trends show a certain amount of cases, where anatomical reduction cannot be achieved, treated primarily also with THA. So that might have been an option.
AFA the wrist is concerned a certain amount of radial displacement, thus loss of height, was left and I suppose because the plate has that same inclination.
On the femur side, I agree DHS is the proper solution because of the pattern of the fracture, that still was inter-trochanteric even if quite distal.
Finally, it’s always easy to criticize when out of the OR, so again, good job!
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