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The first 25 slides, exactly as they appear. The full deck has 91 content slides.
Orthopaedics
Fracture of the Radial Head and Terrible Triad Injury of t
Built from Tang — Orthopaedic Trauma Vol 1: Upper Extremity
What’s inside
9 sections · 91 slides
Overview
- What this deck will teach you
The radial head
A small bone that keeps the elbow stable
- Why the radial head matters
- Shape of the radial head and the neck-shaft angle
- Shape drives function
- The 'safe zone' for fixation
- The safe zone for plate-screw fixation
- The radial head as the anti-valgus pivot
- The radial head as the anti-valgus pivot
- What happens when supports fail
- How ligament and bone loss destabilise the elbow
- Load sharing and the Essex-Lopresti injury
- Axial load sharing and Essex-Lopresti injury
- The ligaments that stabilise the elbow
- Ligamentous stabilisers of the elbow joint
- Medial vs lateral: know the key bundles
- Protecting the posterior interosseous nerve
- Protecting the posterior interosseous nerve
How these injuries happen
The mechanics of the fall
- How radial head fractures happen
- The posterolateral rotatory mechanism
- Posterolateral rotatory mechanism of elbow dislocation
- The four stages of posterolateral dislocation
- Mechanism of the terrible triad
Classification
Naming the fracture guides the treatment
- The Mason classification
- Mason classification of radial head fractures
- Mason types at a glance
- Morrey and Johnston refinements
Assessment
Examining and imaging the injured elbow
- Clinical assessment
- Aspiration point and instability test
- Special tests to run
- X-ray and the fat pad sign
- Fat pad sign and radiographic alignment lines
- Greenspan oblique view and checking the wrist
- CT and MRI
- Imaging the terrible triad
Deciding on surgery
Matching the treatment to the fracture
- Goals and guiding principles
- Surgical indications by Mason type
- Repair, resect or replace?
Surgical technique
From positioning to fixation of the radial head
- Positioning and preparation
- Patient positioning for radial head surgery
- Two approaches to the radial head
- Surface marking for the Kocher and Boyd approaches
- The Kocher approach, step by step
- Kocher approach exposure
- Kocher approach: reaching the radial head
- The Boyd approach
- Boyd approach for complex injuries
- Fixing a Mason II head (neck not involved)
- Reducing and lag-screw fixing the radial head
- Confirming the screws stay in the safe zone
- Fixing a Mason II head involving the neck
- Plate fixation for radial neck fractures
- Plate fixation of a radial neck fracture
- Mason III/IV: resect or replace
- Radial head replacement technique
- Implanting a modular radial head prosthesis
- Sizing and orienting the prosthesis
- Getting prosthesis height right
- Radial head replacement with medial epicondyle repair
- Iatrogenic fracture from an oversized stem
- Closure: repair the annular ligament
- Repairing the annular ligament
The terrible triad
Rebuilding a dislocated, multiply-fractured elbow
- Approach and order of repair
- Order of repair for the terrible triad
- Surgical workflow for the terrible triad
- Repairing the coronoid process
- Repairing the radial head within the triad
- Ligament repair and reconstruction
- Repairing the lateral collateral ligament
- The hinged external fixator
- Aligning a hinged external fixator to the flexion axis
- Fixing a complete terrible triad
- Postoperative care
Complications and outcomes
Avoiding the classic pitfalls
- Preventing complications of fixation
- Complications after replacement
- Outcomes: fix, replace or resect
- Three ideas to carry away
- Why must a comminuted radial head with a torn medial collateral ligament be replaced rather than excised?
- Key takeaways
- References (1/3)
- References (2/3)
- References (3/3)
- Orthopaedic Trauma Surgery — Volume 1: Upper Extremity