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The first 25 slides, exactly as they appear. The full deck has 102 content slides.
Orthopaedics
Tibial Shaft Fractures
Built from Tang — Orthopaedic Trauma Vol 2: Lower Extremity
What’s inside
13 sections · 102 slides
Overview
- What this deck will teach you
Basic Theory and Concepts
The anatomy and biology that drive every treatment decision
- How common — and how exposed — these fractures are
- Overview: why the tibia breaks and why it heals badly
Applied Anatomy
Shape, medullary canal, blood supply and the leg compartments
- Cross-sectional shape of the tibia along its length
- The tibia's shape decides where the plate goes
- Intramedullary nailing of proximal tibial fractures
- The medullary canal: an hourglass that guides nailing
- Blood supply to the tibia
- A single lifeline: the tibial blood supply
- The four fascial compartments of the lower leg
- Compartment anatomy: why swelling turns dangerous
Mechanism of Injury
How the force applied predicts the fracture pattern
- Direct vs indirect injury
Assessment
Clinical examination, soft-tissue grading and vascular checks
- Clinical assessment: look beyond the obvious break
- Gustilo–Anderson classification (open fractures)
- Tscherne grading of closed soft-tissue injury
- Vascular and nerve assessment: do not miss the artery
- Diagnosing compartment syndrome by compartment
- When must you cut open the leg to release pressure (fasciotomy)?
- Imaging: one full-length film, many questions answered
AO-OTA Classification
A structured map of every shaft fracture pattern
- AO-OTA classification of tibial shaft fractures
- Reading the AO-OTA code: A, B, C
Surgical Treatment
Indications, timing, strategy and step-by-step technique
- Surgical indications
- Timing: operate early, but respect the soft tissue
- Choosing the fixation method
- Selecting a surgical strategy: match tool to injury
Open-Fracture Soft-Tissue Management
Antibiotics, debridement, irrigation and wound closure
- Antibiotics, debridement and irrigation
- Is high-pressure pulsatile lavage (HPPL) better for washing out open fractures?
- Wound closure and negative-pressure therapy
- High wound tension and its salvage
- Wound closure: when to sew, when to vacuum
Lower-Leg Fasciotomy
Releasing compartment pressure through two incisions
- Double-incision compartment decompression
- Fasciotomy: the two-incision release, step by step
- Fasciotomy with negative-pressure drainage
- After fasciotomy: fix bone, watch for crush
External Fixation
A frame outside the leg — temporary or definitive
- External fixation: what it is and its trade-offs
- What makes an external fixator stable
- Safe zones for external-fixator pin placement
- Safe pin corridors, level by level
- Pin insertion and external-fixator assembly
- Placing pins and building the frame
- External fixation of a simple fracture
- Correct insertion depth of threaded pins
- Bridging the ankle to the first metatarsal
- T-shaped clamp fixation for metaphyseal fractures
- T-frame external fixation of a proximal open fracture
- External-fixation pearls and special situations
Intramedullary Nailing
A load-sharing rod inside the bone — the workhorse for shaft fractures
- Patient positioning on the traction table
- Positioning for nailing
- Parapatellar tendon approach
- The two approaches to the nail entry point
- Correct entry point for the intramedullary nail
- Finding the entry point — millimetres matter
- Opening the cortex over the guide wire
- Confirming the opening under fluoroscopy
- Opening the cortex
- Fracture reduction techniques before nailing
- Blocking-screw technique and central wire position
- Reducing the fracture and steering the wire
- Reaming the medullary canal
- Reaming — widening the canal safely
- Advancing the nail to the centre of the distal tibia
- Distal interlocking by the full-circle technique
- Compressing the fracture ends after distal locking
- Inserting, locking and compressing the nail
- Nailing of a middle-to-lower shaft fracture
- Reamed vs non-reamed nailing: the verdict
- How far nailing now reaches
Plate-Screw Fixation
Anatomical reduction for distal and complex fractures
- Supine positioning for plate fixation
- Incisions for open and minimally invasive plating
- Positioning and incisions for plating
- Plate placement and the MIPPO technique
- Surgical technique: exposure and implant choice
- Pre-shaping the plate to the distal tibia
- Reduction, pre-shaping and after-care
- Minimally invasive plating of a distal spiral fracture
- Outcome after minimally invasive plating
- Dynamic compression plating of a transverse fracture
- Where to put the plate — hard-won experience
Complications
Infection and non-union — prevention and salvage
- Deep infection after plating of an open fracture
- Postoperative infection
- Infected non-union: double plate and bone graft
- Non-union: why bone fails to knit, and what to do
- Key takeaways
- References (1/5)
- References (2/5)
- References (3/5)
- References (4/5)
- References (5/5)
- Orthopaedic Trauma Surgery — Volume 2: Lower Extremity