Percutaneous quilting is a simple but very useful technique in large Morel-Lavalle lesions like these. Addresses the primary pathology. Mark out the boundary of the lesion first using a suction tip. Then apply sutures using 1 ethilon or similar from periphery to centre. 1/2

SOAR 2025: THA for Post-traumatic arthritis with acetabulum plates insitu https://t.co/cHqSK6jzDe via @YouTube THR for failed acetabular fracture fixation through posterior approach

What’s the likely reason for the uncontrolled slide (assuming lateral x rays are OK)? Negative cortical reduction? Screw impinging lateral cortex?

@Laumonerie_p I love the art of medicine. We all see it different. Very nice reduction. For me this plate (pink) is only holding medial epicondyle and proximal fragment. A bit “Picasso” for me. Remove red and pink, replace with green and blue.

A 7 yr old Girl had a traumatic closed Elbow dislocation with avulsion # of medial epicondyle with intact DNVS I did closed reduction & applied an above elbow Fiber cast check xrays posted along #orthotwitter Should I manage the medial epicondyle avulsion # conservatively?

ChatGPT vs Orthopods: Who's winning on @orthobullets?

19M. Pain rt arm 4 yrs. Management @centerofhip @childortho @Davembmd @IhabFathiSulima @InvictaOrtho #orthotwitter

🧵2/2 This one was openly reduced in lateral. A Schanz pin was helpful to manipulate the distal frag. Clamps were used to compress. Fixed with a DHS with further compression through the DHS screw. Getting a lateral of hip needs a good radiographer .

LT splitting intertroch- reverse epsilon- fractures are hard to reduce supine on a fracture table(first pic), but much easier when put in a lateral position (last pic) #orthotwitter what forces make reduction difficult in supine? 🧵1/2

So bad it’s - Great case TRANSULNA BASAL CORONOID. Worse than that , lateral column radial head not gonna be great and the coronoid has split into buttress and sublime tubercle frags.

Morning Case: 🥶 34-year-old male, he has elbow fracture ( olecranon fracture and radial head fracture) due to fall down. What’s your further management? @DrBhavinJadav @pratikorho @anilbhatortho @ojedathies @centerofhip @traumaticum @itius @orthotraumamd @HariPra44439237

According to this study, the AA is not associated with superior recovery or early-term outcomes in hip fx patients. At present, widespread adoption of the AA in this population is not recommended. https://t.co/kZzpEZXmMS

So I hear you love the hintermann? 1.8mm k-wire into the radial radial head is the last thing that’s going to influence the outcome of this joint Primary goal - achieve good exposure to reconstruct the joint #orthotwitter #orthopedics

Painful scoliosis in an adolescent is pathological and warrants further investigation. Spot the missing part of the vertebra in this 17 yr old boy. He has back pain since 6 months and a mild scoliosis #orthotwitter Apologies about the X-ray quality

Surgeons sometimes avoid placing screws through the cement mantle during ORIF of PPFx around a cemented stem due to concerns about stem loosening. This study from JBJS (cohort of 28) shows that screws through cement doesn't increase loosening. #orthotwitter

Fortunately, the quote is far less true than it used to be.

40 yo 6 months post open segmental tibia fx. Now with healed prox fx and hypertrophic nonunion mid shaft fx. Labs NL. Anyone think removing prox screws and fibular ostectomy enough or exchange nailing needed? @InvictaOrtho @traumaticum @orthotraumamd #orthotwitter

14F. Pain rt knee joint from 2 months. Dx & management @centerofhip @childortho @Davembmd @IhabFathiSulima @orthobullets #orthotwitter

@orthobullets @centerofhip #orthotwitter

Thanks for the inputs. Did an in situ osteotomy and removed the head piecemeal. The canal was blocked by corticated fibula with dense bone all around. Used a high speed burr to open. Uncemented trial appeared to have too many voids around. So decided to go for a cemented Exeter.

@stevemchale @Orthodoc2031 @hipdoc75 @bonesmith_ Short stem or long stem? If long stem , would you consider an osteotomy to correct that slight varus remodelling?