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 90o flexion and forearm in pronation X-ray was taken

Operative Treatment: • • • • • • • • • • Posterior incision was made which curves along the medial side of olecranon And proximally dissected through the brachioradialis - triceps interval Ulnar Nerve was identified and protected; Triceps tendon 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 placed through puncture wounds in skin posterior and lateral to the initial 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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