Check out our panel discussion and case presentations on lower extremity rotational flaps! AO Trauma NA Webinar—Soft Tissue Coverage Procedures an Orthopaedist Cou... via @YouTube @AOTrauma @aotraumana1 @JosephHsuMD @LimbDeformity

@bonesmith_ @orthobullets @uc_health @DrAJ26001405 @schulte_ss @DrFraneNicholas @eric_novack @stevemchale @FractureDoc @itius @rkh_md Intramedullary*

RT @orthobullets: Here is a new case by Dr. Michael Beltran and @uc_health. LOWER EXTREMITY POLYTRAUMA WITH IPSILATERAL FEMORAL NECK AND S…

@schulte_ss @orthobullets @uc_health @DrAJ26001405 @bonesmith_ @DrFraneNicholas @eric_novack @stevemchale @FractureDoc @itius @rkh_md Agreed. My concern would be the medial fem condyle is hanging on those interlocks which are also providing fixation for a nail that’s doing a lot of work. I wouldn’t have added a plate, but some independent lag screws to maintain compression at the joint. Obv it all worked out.

@orthotraumamd @orthobullets @rkh_md @OrthoStrelzow In this case (complex polytrauma) the assumption is that he has an arterial line. I wouldn’t get a BD without a lactate, which is just a venous draw. So in this case, I’d have both. In patients less severely injured, we sometimes don’t have a A-line making a BD painful to get.

@orthotraumamd @DrFraneNicholas @itius @traumaticum @IU_Health #sportstraumatology

@DrFraneNicholas @orthobullets @uc_health @FOREonline @DrAJ26001405 @schulte_ss @bonesmith_ @eric_novack @stevemchale @FractureDoc @itius @rkh_md Most of the time, our guys just tell us to fix the fractures and they’ll worry about the knee later. My experience is these guys get super stiff no matter the timing. How soon would your guys address the knee ligamentous injury?

@orthobullets @xlgriffin @docfarrow @rish_parmar @DrConnos @summitwv @peter_a_cole @aqueipot @Trauma_Pagaza @EauClaireOrtho @dr_learned Once physiologically stabilized, mini Swashbuckler to reduce distal femur. Fix with lag screws. Reduce and nail femur w/ MetaTAN. Once nail is seated, then start working the fem neck. Can attempt CR but prob needs open reduction. Can place cannulated screws around MetaTAN screw.

@orthobullets @xlgriffin @docfarrow @rish_parmar @DrConnos @summitwv @peter_a_cole @aqueipot @Trauma_Pagaza @EauClaireOrtho @dr_learned I like calcium sulfate beads with vanc/gent in the larger wounds that aren’t initially definitively closed. I like wound vacs too (I know it decreases local Abx depot) because I feel it keeps the wounds cleaner in the ICU.

@orthotraumamd @orthobullets @FootAndAnkleMD @dr_nls @anklefootmd @IMNailR @pmangoneMD @Drlyndonmason @MassFeet Looks mostly ligamentous. Once soft tissues are amenable, it’s midfoot fusions for me.

@orthotraumamd @orthobullets @FootAndAnkleMD @dr_nls @anklefootmd @IMNailR @pmangoneMD @Drlyndonmason @MassFeet Not the focus of the case, but this foot injury is likely to be the determining factor of his outcome.

@rkh_md @orthotraumamd And if it doesn’t, we’ll never speak of it again…

@schulte_ss Definitely on the wider side but not as wide as Altra. My forefoot seems to be getting wider as I get older so I need a touch more room. I’ve shifted away from Altra since my knee surgeries as I need a touch more cushion but that means increasing the drop more than I’m used to.

@orthotraumamd @IUMedSchool I still use Brinker’s workup. Some of those labs can be tough to get. I’ve caught an undiagnosed hypothyroidism from a nonunion workup. Almost everyone’s Vit D is low. I know some surgeons adamantly refuse to offer nonunion surgery to smokers. What do you all do?

@GearinMD @EmoryGradyOrtho Ended up being relatively slow. Surprisingly, the highways never shut down.

@GearinMD @EmoryGradyOrtho It’s usually one extreme or the other. Jury is still out for today…

@IMNailR @eric_novack @orthobullets @BrandonYuanMD @MayoClinic @FOTNorthAmerica @DrAJ26001405 @DrFraneNicholas @stevemchale @FractureDoc @rkh_md @KrystinHiddenMD I can say from experience (my own surgery) that “mobilizing” the pes makes them sore as shit for a month. Not sure if that’s better or worse than transecting them. The sports guys don’t seem too worried about it.