Faʻataʻaliʻu & Paʻu Paʻega Faʻamatalaga Faʻasolosolo & Faʻasalaga I | El Paso, TX.

Vaevaevaevaevae

• 10% o gaui uma. 2nd m / c mulimuli atu i le femoral neck Fx. Demographics: toʻaga talavou aliʻi ma matutua osteoporotic fafine
• Stable Fx: o le aotelega o suʻesuʻega e lelei
• Lelei Fx: manaʻomia le ORIF. 15% -20% avanoa o 2nd OA.
• Matafaioi o faʻataʻitaʻiga o le fuafuaina lea o le faigata, mautu ma tausiga fuafuaga (ie, faʻagaioiga vs. conservative)
• O le faʻavasegaga o Weber e manatu i le faalumaina o le gasegase-fibular syndesmosis ma le le mafai ona faʻamalosia
• Weber A - lalo ole syndesmosis. Fale o manu, masani avulsion o le distal fibular malleolus
• Weber B - i le tulaga o syndesmosis: atonu e i fafo syndesmosis ma mautu pe faʻavaivaia syndesmosis ma le mautu
• Weber C - i luga atu o syndesmosis. E le mautu i taimi uma d / t loimata o syndesmosis
• Fesuiaʻiga o malepe ono aofia ai le tulaga / matafaioi o le ponaivi ponaivi i le taimi o le Fx (eg, ave faʻamalosi, faʻaopoopoga, feauauaʻii, ma isi) o lenei lauiloa o Lauge-Hanson faʻavasegaina

Tibiofibular Syndesmosis & Ankle Mausali

• Denis-Weber faʻavasegaina o tapuvae vae

Falemaʻi Dx Faamaoni

• Vaevaevaevaevae mafai ona faʻafaigofieina e leOttawa Rule. "

Mortise & AP Manatu

AP, Medial Oblique & Faʻamatalaga Lautele

• Faʻaalia le frasyndesmotic Fx o le malleolus fibular (Weber A)
• Taʻaloga Stable
• Tausiga faʻapitoa i le tulaga o vae puʻupuʻu savali lafo / seevae mafai ona faʻaaogaina. Manuia lelei Afai e leai se faʻamaoniga o le osteochondral manuʻa, laʻititi maualalo avanoa o le post-traumatic OA
• E leai se isi ata e manaʻomia. E mafai e le MRI ona fesoasoani e faʻaalia le ivi o le ponaivi ma le manua osteochondral

Weber B i le Laasaga o le Syndesmosis

• E mafai ona mausali pe le maluelue. I nisi taimi, e faia le faaiuga i le taimi o suʻesuʻega faʻatautaia.
• E mafai ona fesoasoani le suʻeina o le CT i nisi suʻesuʻega
• Pulega: faʻalagolago i le mautu. E manaʻomia le faʻaopoopoina o le faʻamautinoaga pe a faʻamavae le syndesemosis

Weber C

• AP, medial oblique and lateral views faʻaalia Weber C - suprasyndesmotic manuʻa ma le masani soʻoga faʻalauteleina d / t faʻalavelaveina o le tib-fib syndesmosis. Manuʻa le mautonu.
• Mai lea taimi i lea taimi, pe a tuʻu le Weber C Fx i le 6-cm mai le pito o le lateral malleolus, e ono faʻaigoaina o le tapuvae vae o Pott (faʻaigoa i le igoa o Percival Pott's o ia lea na fautuaina le faʻavasegaina muamua o tapuvae vae e faʻavae i luga o le mautu ma le tikeri o le feauauaʻiga). O le faaupuga ua fai si leva.
• Puleaina: faʻatautaia ma le faʻaleleia atili o le syndesemosis

Faleneuve Fracture

• E tele taimi e afaina ai le afaina o le vavalalata vavalalata faʻatasi ma le manua o le tapuvae
• Leai se gau vave i luga o le uila, e mafai ona misia i luga o le tapuvae ma e manaʻomia le tibia ma le mafaufau
• Rad mea: faʻalauteleina o le tapuvae faʻanoanoa d / t syndesmosis loimata ma o nisi taimi faʻalavelave faʻaleagaina o le ligament. O le membrane interasseous o loʻo faʻamaʻaʻaina ma le Fx filati faʻapitoa e mafua mai i le igoa faʻatasi ma le malosi o fafo
• Pulega: faagaoioia

Bimalleolar & Trimalleolar Fx

• Luga o ata pito i luga Bimalleolar Fx v. Le mautonu, o le iʻuga o le faʻaupuga ma le ave faʻamalosi / faʻasolosolo i fafo. Rx: ORIF.
• Trimalleolar Fx: 3-vae tapuvae Fx. Medial ma lateral malleolus ma avulsion o le pito i tua vaega o le tibial plafond. Sili atu le mautonu. Rx: galue

Tillaux Fx

• Pediatric Fx afaina ai le tama matua pe a fai o le medial itu o le physis ua tapunia pe o le a tapunia ma le itu i tua seʻia matala. Avuliona e le pito i luma ligi-fibular ligament. Faʻafitauli: 2nd mago / vave vave OA. Rx: mafai ona faʻasao pe a mautu e ala i le faʻateʻa lafo immobilization.

Paʻu o le Tupulaga o le Tupulaga Pediatric

• Faʻavasegaina Salter-Harris e fesoasoani e faʻamaonia ma faʻamalosi maʻi manuʻa.
• Fesoasoani faʻapitoa: SALTR
• S: ituaiga 1-see i totonu o le tuputupu aʻe ipu
• A: ituaiga 2-luga, Fx faʻalauteleina i le metaphysis
• L: ituaiga 3-maualalo, FX faʻapitoa-faʻapitoa e faʻalauteleina e ala i le epiphysis
• T: type4, "through" Fx faʻalauteleina uma: physis, metaphysis, ma epiphysis.
• R: ituaiga 5, "faʻaleagaina." Tasi manuʻa i physis tau atu i le oti atoa o le tuputupu aʻe ipu
• Pusa 1 ma 5: tuʻuina atu e leai se gau
• Pusa 2: o loʻo i ai le faʻamatalaga sili ona lelei ma e sili ona taatele.
• Pulega: faʻasino i le fomai tipitipi o tamaiti
• Faʻamaumauga: faʻapipiʻi vave o le physis, faʻapuʻupuʻuga o le limasefulu, le vave o le OA ma isi.

Calcaneal Fracture

• Telefoni masani Fx. 17% tatala Fx
• Faʻatulagaga: faʻaaogaina o le axial (FX faʻapipiʻi i lalo ifo o le sub-talar and calcaneal-cuboid joints in 75% cases). Lafoaʻi e le tendon Achilles (m / c i le ponaivi osteoporotic). Faʻanoanoa (vaivai) Fx.
• O le Int--articular Fx e molimauina se faʻataʻitaʻiga leaga. E masani ona faʻaulu. Rx: galue.
• B / I calcaneal intra-articular fx ma fesoʻotaʻiga vavave fesoʻotaʻi Fx ma fesoʻotaʻiga vavaega fesoʻotaʻi Fx (T10-L2) masani faʻaigoaina Casanova aka Don Juan (Lover's) fx.
• Ata: x-radiography ma faʻaopopoina "mulivae vaʻaia" 1st sitepu. O le CT scanning e sili mo le Dx ma le muaʻi op fuafuaina.
• Radiography: Bohler's angle (<20-degrees) Gissane tulimanu> 130-tikeri. Faailoa Calcan, Fx

Tarsal Bones

• M / C gau ponaivi tao o Talusa. M / C faʻalapotopotoga: tala taumatau (30-50%). Faʻatulagaga: Faʻatatau le faʻaaogaina i le toe faʻaogaina. Faʻaiʻuga: Osesema o le Ischic (AVN) o le talus. Muamua (2nd OA). Ata: 1st laasaga: radiographs, CT e mafai ona fesoasoani i isi faʻamatalaga
• O le faʻavasegaina o Hawkins e fesoasoani ile Dx, vavalo ma togafitiga. “Hawkins saini 'luga o manino ata / CT scan mafai ona fesoasoani i le AVN Dx. (luga aʻe lanumoana aū faʻailoa lelei prognosis d / t laina radiolucent faʻailoa mai leai AVN ona o le ponaivi ua vascularized ma o lea resorbed)
• Rx: Faʻamau 1: Faʻamatalaga faʻatasi ma vae vaevae poʻo le pulou (faʻataʻitaʻiga o le AVN-0-15%), Pusa 2-4-ORIF (faʻamaonia o AVN 50% -100%)

Tapuvae & Ata o Ata