HPI: Patient 1: Restrained MVC. Presented with knee pain and swelling. Patient 2: Fall from height and chief complaint of shoulder and knee pain. Physical Exam: Patient 1: Swollen left knee with tenderness to palpation. Patient 2: Knee visibly deformed, swollen, and bruised. Small open deformity w/ active bleeding. High risk for compartment syndrome. Imaging: Patient 1: Schatzker type 2 fracture (see table below for classifications of Schatzker fracture) Patient 2: Schatzker type 6 fracture Dispo: Patient 1: Admitted. Splinted w/ ORIF as inpatient. Patient 2: Admitted. Splinted w/ closed reduction and external fixation. Plan for definitive repair in ~2 weeks after soft tissue swelling has subsided. Treatment: 1) Hinged knee brace w/ passive ROM - for patients w/ minimally displaced or split depressed fractures or minimal baseline mobility. 2) External fixation - for patient w/ open or comminuted fractures or significant soft tissue swelling. 3) ORIF - for >3mm articular step off or varus/valgus instability. Types of Schatzker Fractures:
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Orthopedics BlogAuthorCMC ER Residents Archives
June 2018
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