Musculoskeletal case studies for medical students

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History

A 24 year old male involved in a pedestrian motor vehicle accident.

The fracture was closed.

Neurovascular intact, no other injuries.
Initial X ray
Description A P X ray
X ray
Description Lateral X ray
Problem The fracture is unstable as evidenced by the oblique nature of the fracture seen on the lateral
X ray after treatment
Description AP Xray after intramedullary rod fixation.
Post management further view
Description
Classification Tibial Shaft fracture. The fracture is unstable as evidenced by the oblique nature of the fracture seen on the lateral.
Discussion of management To treat this conservatively with an above knee plaster would be challenging - it would be difficult to maintain length. The surgeon opted for an IM nail. This assures good alignment, and the locking screws ensure that length is maintained. Oblique and butterfly fragment fractures are difficult to treat conservatively and , if possible, refer them to an orthopaedic surgeon for intramedullary fixation.

 

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