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Chance Fracture (Flexion-Distraction Injury)

Flexion-distraction type injury First described by GQ Chance in 1948 (British Journal of Radiology) Commonly seen with seatbelt, especially lapbelt, injuries Radiographic hallmark is axial split seen on sagittal CT scan Unstable injury which necessitates surgical management.

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Animated Anatomy of Leg Muscles Anterior Compartment

This video is a sample from AnimatedAnatomy.com demonstrating a narrated and 3D explanation of the leg anatomy. The following anatomical structures and actions are described: Tibialis anterior medial cuneiform first metatarsal bone foot dorsiflexion foot inversion extensor digitorum longus interosseous membrane extensor hallucis longus fibularis tertius  

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Ankle-Spanning A-Frame External Fixator

The ankle-spanning external fixator is a versatile external fixation construct that is useful for fractures of the tibial plafond (pilon), unstable ankle fractures, and talus fractures. It can be adapted for other injuries including midfoot fractures. Tibial Schanz Pins Mark out the tibial tubercle. The most proximal pin will go 2-4 finger breadths distal to this point. Make a mark 1…

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Assessment of Instability Factors in Adult Distal Radius Fractures – Nesbitt et al (J Hand Surg 2004)

PMID 15576227 Lafontaine factors of instability initial dorsal angulation of greater than 20 degrees dorsal comminution radiocarpal intraarticular involvement associated ulna fractures age greater than 60 This study looked at 50 patients with radiographs at 1 week, 2 weeks, and 4 weeks after reduction Age was found to be a statistically significant predictor of secondary displacement Age was the only…

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Prediction of Instability in Distal Radius Fractures – Mackenney et al (JBJS 2006)

http://www.ncbi.nlm.nih.gov/pubmed/16951109 Prospective collection of data on 4000 distal radial fractures collected at the Edinburgh Orthopaedic Trauma Unit Outcome measures included radiographic measurements at 1 week and 6 weeks Results: Predictors of early and late instability were patient age, metaphyseal comminution, and ulnar variance. Minimally displaced fractures only had a 10% chance of later instability Displaced fractures had 43% chance of…

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Functional Outcomes for Unstable Distal Radial Fractures Treated with Open Reduction and Internal Fixation or Closed Reduction and Percutaneous Fixation – Rozental et al (JBJS 2009)

PubMed extraarticular or simple split intraarticular distal radius fractures ORIF (open reduction and internal fixation) has better functional (DASH) outcomes at 6, 9, and 12 weeks. outcomes were the same at a year  

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