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Fractures of the Lateral Condylar Physis

Fractures of the Lateral Condylar Physis

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Published by: drnareshkumar3281 on Nov 03, 2008
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11/22/2012

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FRACTURES OF THE LATERAL CONDYLAR PHYSIS
REASON FOR VISIT:
Trauma to the elbow
Fracture of elbow
RISK ASSESSMENT
Bleeding disorders
Anemia
Heart diseases
Pulmonary insufficiency
Allergies to medication
Allergies to anesthesia
PREPARATION OF THE PATIENT:
Blood tests
Urine tests
X-ray chest
ECG
X-ray distal end of humerus
Arthrogram
MRI
Aspirin was stopped before procedure
Blood thinning medication was stopped before procedure
Patient was on fasting for _______hrs before procedure
Part was prepared and draped in sterile fashion
ANESTHESIA:
General anesthesia
POSITION OF THE PATIENT:
 
Supine position
THE PROCEDURE
Cast treatment:
Non-displaced fracture was found in X-ray
Log arm cast was prepared
Immobilization was done with cast with elbow in 90
o
flexion andforearm in pronation
X-ray was takenOperative Treatment: 
Posterior incision was made which curves along the medial sideof olecranon
And proximally dissected through the brachioradialis - tricepsinterval
Ulnar Nervewas identified and protected;
Tricepstendon was transected 1 cm from its insertion
Remaining triceps insertion was elevated medially /laterally;
The proximal portion of the tendon was mobilized proximally
Posterior capsule was opened transversely from medial to lateral
Posterior aspect of fracture fragment was left undisturbed
Initially stabilized the fracture fragment with a towel clip;
Stabilized the anatomic reduction with two K-wires placedthrough puncture wounds in skin posterior and lateral to theinitial skin incision
Triceps tendon was closed securely with non absorbable sutures
Arm was immobilized in a cast
FINDINGS:
Lateral condylar displaced/non displaced fracture was found
Damaged ulnar nerve was found
 
Damaged brachioradialis muscle was found
AFTER PROCEDURE:
Patient was shifted to intensive care unit
Heart rate, pulse rate, oxygenation, temperature was monitored.
DURATION
___________hrs
POSTOPERATIVE
 
CARE
 
Put cast for 6 wks
Take antibiotics as prescribed
Take pain medication as prescribed
Avoid heavy weight lifting
Do active and passive movements after cast was removed
COMPLICATIONS
Non union
Delayed union
Mal union
Infection
Ulnar nerve palsy
AVN of capitellum
Cubitus varus
Cubitus valgus
Deformity of elbow

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