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A-1294 Update on imaging
Wolfgang Hintringer, Austria
Wednesday, June 13, 2018 · 4:06 p.m. · 09m 36s
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the game would often on
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mostly
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the most people around coffee but
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i want to talk about the imaging and classification
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what do we need to play into treatment of radius fractures
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we need a classical it to play next raising the peons side view
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and i was very helpful to repeat the x. ray after receipt
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using the radios fractures because you can see a lot more
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uh then in the first week straight but especially need tropical a
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fracture we need to c. t. scans obligatory and um
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nowadays we have other opportunities like here you can
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see here sweetie v. construction does a printer
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the question is it's a good idea but the question is does
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that tell us to find out the right treatment option
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what this reduce fractures i saw the classification napoleon always
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sale classification not based on plane week's race
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but i think state classification will not help us to
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treat radios fracture well how to treat review structure
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you have other classifications lexis from my friend the a goal
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that was already a more functional classification but uh
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also does not help us a really
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uh to treat how to treat here um one
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of a not a another classification from atlanta
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um which is depending on the acting forces
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and uh shows us and there are more uh about the fracture than the other ones
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but what we found in the literature is is for corn
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the concept uh based on the combination of three cullen
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model from b. t. and breakouts only and uh milan's for part classification i and um
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uh based on that concept we wanted to do with more precise classification
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if you look at a axial view of the c. t. scan and sees a fracture lines
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we have to ask ourselves if there is a distinct fashion
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of the fracture lines or use are the lines somehow randomised
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so uh in a paper from gregory pain you can see that the
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factual curve right in the area between the legal mentors insurgents
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says insurgents although say reinforce opponents also
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to fracture lines call between sam
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some birds some time mechanical considerations uh
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there is a tendency of sick compost applied will only and will only
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and uh ah against says tendency works towards
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all the so called dorsal be ligament
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and of all early the extrinsic polls extrinsic ligaments to
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proximal and distal be legal meant in detects it's specially
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here on the all knock or not that will not part of sicily comments
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you will see is very important first that belie seeing the rest
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and uh to get the the torso and voila ligaments of forming a
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sling which worked okay the uh to hold the coppers imposition
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soul what happens if you fall on the outstretched hand depending on
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the direction of acting forces to get radial last sighted fractures
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and here again it depends if the forces work more or less a little act more towards a little lonely
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uh which factual curve on the right side you see a central impact and this is central force
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so now to our classification in a partial in
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tropical fractious six different patterns can be described
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at least one whole or not remains intact and in continually
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t. we say shaft here are the displaced oh
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uh out parts off the fractures and uh the white one are the non displaced um
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uh i'm in relation to the shaft null displaced i
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saw a ah what the r. t. fragments
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depending on an axial view of c. c. t. scan you
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can see the friend fragments which we call key fragment
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and a key fragments and fragments which takes a cop was and the lunar that's the
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central spawn off the whole system to different direction you here you can see
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that uh on the wall and marjorie normal apart the staff uh to a little late
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goals to the wall aside or depending on the dorsal
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t. fragment the capo school do the total side
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and here you can see that a fragment also can have dual key corner
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the key corner is or was a fragment which remains parallel to the loom it so
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we have here and ball a key fragment here had the other dorsal key fragment
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here we have no keep reckon maybe we can call so centrally protection as a key fragment
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so some of 'em examples use you to whistle
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key fragment and here you see that
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is no key fragment because illuminates the lisa taped it on the board a ligament
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and what they are so important on the key fragment because they
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direct action where you have to start belies your fracture is depending on the key fragment you can
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you should go in bali visible okay fragment you can
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call or you should going on but also side
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if you have the dorsal key fragment sometimes you can manage it also from the ball aside but
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uh you will see later on that this is very difficult
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so one of the most overlooked key fragment this it will not oriented and ball us
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situated fragment it can't be a good peak fragment or a small ream fragment
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and uh says says illusion is that this fragment this it'll reach an
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awful portent ligaments as i say it you'd explain sickly comments insert
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here in to ski fragment which protect the cop was from all a dislocation
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you can see it will sell key fragment uh which
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is insertion point of sit dorsal loop track
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literally comment and keeps the cop pulls from this
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location to the dorsal side in position
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yeah we have a typical dorsal key fragment
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they're also all lady other key fragments here that the corrupt cop pulls
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is sliding the cool cop was is sliding to the radial side
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uh uh uh with the key fragment to at least eyepiece set one when
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no offset fragment uh has a contacts to the radio show off
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here you have to use you will see that late on plates which support
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the whole area uh with a lot of screws from tools to hold it in place
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one special type of sources centrally action type um where
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uh maybe the article to call this is intact
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that is a type robin eat really a good a
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c. t. scan to detects that fragments and again
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perfect reposition sometimes also and the apples cortical you so
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you can see here altogether ah radial style word fragment the sick with not
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waller which can be also the ream the torso luna fragment and
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that on t. types radial pulse all complain that the fees you'll and pistol common lucian
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then the very problematic very t. stall she uh
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fractures which needs plates very by t. style
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or other devices who can catch says small she uh fragments and will not fracture
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so the question is one plate for all t. fragments
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formally we had only one plate to try to catch
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these fragments nowadays we have a lot of plates
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what are the goals for effect just pacific treatment be one a plate
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which can be the checkoff or trade but is that existing
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important is recognition of the fracture pattern classifying is very
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important it's do we have to recognise sec t.
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fragments of the fracture and go do than any ten divided t. corner and call for it
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so now my friend crest of pit say depending on that classification beaded
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