II Lecture Chapter 21 Short Answer: Arm Surgery pp 467

What is the most common method of reduction for a Colles' fracture? What are the components of the device?

An external fixation device. A frame is placed over the pins and the clamps are secured. Tightening the clamps holds the fracture in reduction.

Describe a Colles' fracture.

A fracture of the distal radius that occurs at the epiphysis within 2.54 cm of the wrist joint, forcing the hand into a dorsal and lateral position.

Put the following steps of an open reduction internal fixation using plates and screws in order.

1. pass elevator so surgeon can elevate the periosteum using elevator of surgeon's choice, such as a key, hibbs, hoke, langenbeck, etc 2. reduce fracture using self-retaining bone clamps such as a lane, kern, lewin, or lowman 3. plate is selected and bent prn (as needed) to fit the angles of the bone using plate benders 4. pass plate, usually five or six holes, and bone- or plate- holding forceps to secure plate in place 5. pass drill with drill bit and drill guide for the first hole (after completing pretest- runs true with appropriate speed) 6. pass depth gauge to measure the length of the drill hole- surgeon will state the length, which should be recorded so the appropriate screw is selected 7. pass T-handle tap if not a self-tapping screw. (select correct size screw, confirm correct length by measuring, and load the screw while surgeon is tapping) 8. pass the first screw secured on screwdriver, ensuring safe if it becomes loose (hand under). state the size and length of screw 9. while surgeon is placing screw, prepare order again- drill with drill bit and drill guide prn (as needed), measure with depth gauge, tap prn (as needed) with T-handle tap, and screw 10. pass drill with drill bit, depth gauge, tap prn (as needed), and screwdriver with subsequent screws for subsequent holes 11.surgeon will remove clamps, pass irrigation and then suture to close. count