paul tornetta iii - orthopaedic trauma association (ota) · 2/2/2016 3 tibial ct’s 47 male 42...
TRANSCRIPT
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Reduction Tricks and Tips
Paul Tornetta III
Intracortical Screwsand Miniplates
Paul Tornetta III
Professor
Boston Medical Center
Disclosures!
• Publications: Rockwood and Green, Tornetta and Ricci TIFS, Tornetta
and Einhorn; Subspecialty series, Court-Brown, Tornetta; Trauma, AAOS; OKU Trauma, ICL Trauma, Tornetta; Op Techn in Ortho Surg, OTA Slide project
Journals:; JOT; Deputy editor, CORR, JAAOS, JBJS; Reviewer
• Research: OTA, FOT, AIOD, Smith Nephew
• DesignerSmith and Nephew, Kinespring
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Intracortical Screws
• Lag screws
• Tibia
• Humerus
• Femur
Intracortical Screws
• Lag screws
• Tibia
• Humerus
• Femur
Intracortical Screws
• Lag screws
• Tibia
• Humerus
• Femur
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Tibial CT’s
47 Male 42 Female
Tibial CT’s
47 Male 42 Female
12mm
Tibial CT’s
47 Male 42 Female
6mm6mm
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2.0mm – 2.7mm
2.0mm – 2.7mm
2.0mm – 2.7mm
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2.0mm – 2.7mm
Injury
• 24M
• Grade IIIC
• Arterial repair
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Postop
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Dynamization
• 161 Days
• RUST = 5
Union
• 334 Days
• RUST = 10
Injury
• 29M
• Femur
• 3B Tibia
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Clamp to Nail
Clamp to Nail
Three Loose Fragments
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Healed
Beware! Hard Bone!
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GSW: Ex Fix + Minifixation
GSW: Ex Fix + Minifixation
GSW: Ex Fix + Minifixation
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POP!
POP!
Healed
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Miniplates• Can be used temporarily
• Support reductions
• Plate over or around them
• Unicortical screws
• Accessory fixation
• Add to stability
• Hold a fragment reduced
Miniplates• Can be used temporarily
• Support reductions
• Plate over or around them
• Unicortical screws
• Accessory fixation
• Add to stability
• Hold a fragment reduced
Miniplates• Can be used temporarily
• Support reductions
• Plate over or around them
• Unicortical screws
• Accessory fixation
• Add to stability
• Hold a fragment reduced
2.0, 2.4, 2.7
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Temporary Help
AP Lateral
Temporary Help
AP Lateral
Temporary Help
AP Lateral
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Miniplate While Nailing
Miniplate While Nailing
Miniplate While Nailing
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Nailed!
Nailed!
48 YO Alcoholic
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Leave it in!
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Accessory Antiglide Plates
Accessory Antiglide Plates
Accessory Antiglide Plates
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Accessory Antiglide Plates
Summary• Intracortical screws
• Miniplates
• Strength
• Flexible
• Reduction tools
• Temporary fixation
• Leave it in?
Boston Medical Center