philosophy of malleolar1
DESCRIPTION
AO TalkTRANSCRIPT
Philosophy of Malleolar Fractures
AO North AmericaPodiatric Advanced Course
Orlando, FL
Shannon M. Rush, DPM, FACFAS
Department Of Orthopedics and Podiatric SurgeryPalo Alto Medical Foundation -Camino DivisionMountain View, CA
AO Philosophy
Atraumatic technique Biologic dissection
Anatomic reduction Articular vs extra-articular
Stable internal fixation Early joint motion and WB
Early functional rehabilitation Dependant on first three goals
Philosophy of Malleolar Fractures
Relevant preoperative factors
Patient’s age & health status
Co-morbidities (DM, PVD, BMI)
Associated injuries• Mobility
Has the patient ambulated on the ankle?• Compliance and stability
Philosophy of Malleolar Fractures
Relevant surgical issues Fracture pattern Soft tissue injury Imaging
• Stress views– Syndesmosis
Surgical planning• Incision approach
Fixation• Fracture mechanics
Ankle Biomechanics Subtalar Joint
Torque converter Influences talar rotation
Trochlear surface of talus Frustrum
Rotational/translational forces Fracture patterns
• Shear, compression, avulsion
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30