Distal Tibial Fractures
Distal Tibial Fractures
Definition
Metaphyseal
Extra-articular
Intra-articular Extension
Metaphyseal
Extra-articular
Medial Parapatellar
Medial
Lateral
Posterior
Modified Posterior
Indications
Synovectomy
Patellectomy
TKR
Technique
Theory
- want to traverse one muscle / one compartment
- keep away from NV bundle
- as a rule perform open biopsy through compartment the tumour is in
- this is the compartment that will require surgical removal in wide excision
- direct approach without going through muscle if possible i.e. tibia, distal ulna
Thigh
All possible length should be preserved consistent with clinical judgement
- function of amputated stumps decrease progressively with each higher level of amputation
- prosthetic rejection by patient increases with the more proximal amputations
- most ADL'S can be performed adequately with one limb, so don't use prosthesis
- all nerves are drawn distally into wound & sectioned so they retract well proximally to bone level of amputation