¿Puedes responder correctamente a esta pregunta diaria de nuestro Free QBank? …

by | 22 de Oct, 2022 | 10 comments

Can you answer this daily question from our Free QBank correctly?

A 38-year-old man falls from a ladder and presents with the injury depicted in Figure A. On examination, his skin is intact, with moderate swelling, and limited elbow range of motion due to pain/swelling. He elects to undergo surgical intervention. A CT is obtained for preoperative planning and there are no signs of trochlear involvement or posterior comminution. Which of the following provides ideal visualization and least morbidity for this fracture pattern with respect to patient positioning and surgical approach for his injury?

1. Prone with olecranon osteotomy
2. Lateral decubitus with olecranon osteotomy
3. Lateral decubitus with triceps elevation
4. Supine with medial epicondylectomy
5. Supine with Kaplan approach

QID: 211562
**The answer will be posted in 24 hours.
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¿Puedes responder correctamente a esta pregunta diaria de nuestro Free QBank? Un hombre de 38 años se cae de una escalera y presenta la lesión que se muestra en la Figura A. En el examen, su piel está intacta, con hinchazón moderada y un rango de movimiento del codo limitado debido al dolor/hinchazón. Él elige someterse a una intervención quirúrgica. Se obtiene una TC para la planificación preoperatoria y no hay signos de compromiso troclear o conminución posterior. ¿Cuál de los siguientes proporciona la visualización ideal y la menor morbilidad para este patrón de fractura con respecto al posicionamiento del paciente y el abordaje quirúrgico de su lesión? 1. Prono con osteotomía de olécranon 2. Decúbito lateral con osteotomía de olécranon 3. Decúbito lateral con elevación de tríceps 4. Supino con epicondilectomía medial 5. Supino con abordaje Kaplan QID: 211562 **La respuesta será publicada en 24 horas. #orto #cirugíaortopédica #ortopedia #cirujanoortopédico #ortopedia #ortopedia #ortopedia #ortholife #orthobullets #orthresidents #orthresident #orthresidency #medicalschool #medicalstudent #medstudent #doctor #medical

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10 Comments

  1. Anónimo

    I would do none of those…

    Reply
  2. Rodrigo Belo

    arthroscopic fixation with cannulated screws

    Reply
  3. Orthobullets

    The preferred response is:

    5. Supine with Kaplan approach

    This patient has sustained a capitellar coronal shear fracture, as depicted by the double arc sign in Figure A. The classically described position and approach for his injury is supine using a lateral column Kaplan or Kocher approach.

    Capitellar coronal plane fractures can be treated by anterolateral, lateral (Kaplan or Kocher), and posterior surgical approaches. The most commonly preferred approaches are the lateral approach for isolated capitellum fractures and capitellum fractures that extend to the trochlear ridge, and the posterior approach for the fractures that involve both the capitellum and trochlea. When a lateral column approach is used, the origin of the wrist extensors is stripped off the lateral epicondyle and the elbow is translated medially. This approach facilitates the manipulation, anatomic reduction and fixation of the fractured fragment as the instruments can be used more easily.

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    Reply

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