X-rays are taken during surgery show re-alignment of the previously displaced fragments. She became alarmed with the ankle joint started to displace with she was walking. She had not experienced a lot of pain because of the condition that diabetics can suffer from called neuropathy. The first set of images is pre-operative x-rays, which demonstrated the displacement.Ī staged provisional reduction was performed using an external fixator to control swelling and allow for a proper medical workup. The following images are a case of a diabetic patient with a grossly displaced ankle fracture who initially thought she had suffered an ankle sprain. These are final intraop x-rays showing excellent positioning and reduction of this devastating injury, These are intraoperative x-rays showing the repair as well as small stab incisions used under the fluoroscopic guidance These are pictures of reduction with Ex-Fix This is preop x-rays of the displaced pilon fracture This is a minimally invasive surgery that only requires small stab incisions to place the hardware. This significantly decreases the chances of complications. After, the definitive repair was performed using percutaneous plates and screws. This injury was initially stabilized using an Ex-Fix. This a series of x-rays in a woman with diabetes, poor vascularity and neuropathy. Preop CT Scan of Metaphysis fracture prior to repair belowīelow is a post-surgical x-ray of a fracture of the metaphysis after repair with screws and wires, one of which is a wire that was placed percutaneously (through the skin) and was then later removed.īelow is post-surgical film several weeks after repair after the percutaneous fixation pin was removed. This was treated with an IM rod and plate and screw fixation of the fibular fracture.įracture of the Tibial Metaphysis after traumatic injury Pic of a 60-year-old woman who fell getting out of bed and broke the shaft of her tibia and has a distal fibular fracture. This was treated with an Intramedullary rod as well as a surgical plate and fixation with screws of the fibular fracture.ĭisplaced Tib-fib fracture that was treated with IM rod of the Tibia (below) Pictures below show a 60-year-old woman who fell getting out of bed and broke the shaft of her tibia as has a distal fibular fracture. This will stabilize and re-align the fracture fragment allowing appropriate healing. Immediate After Injury and 6 months post Injury back to normal activityīelow is a post-surgical x-ray of a tibial fracture repair with screws and plate. We wedge the cast on a side if there is malalignment early on in the fracture healing to realign the fracture Wedging of cast to keep a tibia fracture well aligned. The white arrows show the area where the cast is wedgedĦ Months Post Injury and Back to Normal Activity The first 2 films show the displacement in the fracture of the tibia. After an above knee cast is applied, the cast is wedged under fluoroscopy and new xrays show the near perfect reduction of the fracture. The patient presented to the office 8 days after injury with a displaced fracture. It can be fixed with plates and screws, pins or a large intramedullary “IM” nail to place it in the correct position.īelow, Tibia and Fibula Fracture in a 16-year-old injured skiing. If the fracture is displaced, it may need to be treated in the operating room. If there is no displacement, these can be treated non-surgically with nonweightbearing cast and crutches. Diaphyseal fractures can occur due to direct impact or a twisting or falling injury. The diaphysis is the long central portion of the tibia that attaches the proximal or rear portion of the bone to the distal or far part of the bone.
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