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Old 10-28-2011
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Rheumatology/Orthopedics I don't understand the treatment of fractures

I don't understand the treatment of fractures. I mean internal fixation, external fixation, closed versus open reduction, cast. Please let me know the criteria or any link available.

Thank you
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Old 10-28-2011
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Well dear friend its a bit tough question but if u want to solve it i must say that MTB 2 has made it much easier...
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Old 10-28-2011
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thankyou! actually i read surgery from kaplan and then mtb 3.didnt do mtb ck for surgery.
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Old 10-28-2011
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No problem but i would suggest if u would have time just have look at MTB 2 i haven't gone thru MTB 3 so can't tell u...
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try bailey's surgery textbook.

it explains why u choose a certain type of fracture treatment. some bones need a minor alignment then time to form a callus before we go ahead with internal fixation. so for these traactions for femur or long arm casts for humerus should be ok. internal fixation is also generally not done when there are too many parts of the broken bone (communited with more than 3 parts) due to allowing time for a callus development, then perhaps if interna fixation is needed.

skin traction for femur fractures should be done with caution because you mite pull their skin off, but generally tractions are done here because the bone has its ability to heal.

so perhaps if u wanted to make it easy, just know that orthopaedics love to allow the bone to do what it can first before intervening.
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thats Bailey ad love's short practice of surgery
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thankyou seetal. i v read it in partially during my final yr. but tht is nt at all short practice of surgery.may b i try i find my book and review orthopaedics chapter.
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Quote:
Originally Posted by A_a_ View Post
thankyou seetal. i v read it in partially during my final yr. but tht is nt at all short practice of surgery.may b i try i find my book and review orthopaedics chapter.

hahaha,.... thats the irony of the title of the book. but actually if u really read only the fracture section, it is kinda short.

good luck
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Old 10-29-2011
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Its easy

Internal Fixation - Surgical fixation of fracture that needs making an incision, ex. fixation of fracture using plate and screws, or rod, or K-Wires (Kirschner Wires)

example: this is internal fixation of distal femur using screws






example 2 internal fixation using plate, screws and wires (for olecranon fracture)







External fixation is surgical method of fracture fixation, without going to fracture site (used ex for high risk on infection), Fixation with Illizarov's apparatus is good example



or other rod and pin apparatus






External reduction is nonsurgical reduction of dislocation (with maneuvers)


Internal reduction is surgical reduction of dislocation (ex, when maneuvers fail)
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thanks alot! if u guide me abt wat to do where. normally they ask in usmle upper limb and lower limb fractures. right so where we do internal fixation and wen we do external.?
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Well Its not so easy, I don't want to confuse you, so
I can recommend you to take a look at Current Diagnosis and Treatment In Surgery, as far as I remember there is very brief chapter about fractures (several pages), with clear cut information that you will need : )
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Quote:
Originally Posted by A_a_ View Post
thanks alot! if u guide me abt wat to do where. normally they ask in usmle upper limb and lower limb fractures. right so where we do internal fixation and wen we do external.?
im not so sure if the usmle questions will ask us about internal external fixation which requires surgery. because this in fact is rather debatable depending on the surgeon. i think we need to know more about reductions whether internal or external.

fractures that i have come across in UW are colles fracture (external reduction), olecranon fracture (ok this needs internal fixation), femur fracture (skin traction + external fixation).

oh and for scaphoid injury, we need immediate action because it can cause necrosis of the bone.

hope that helps a bit. next i come across a bone question ill post it up here as an example ok.
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