Kronborg Short (amountmosque4)

easily accessed for later removal without injuring the adjacent physes. Position the patient and fluoroscopy machine to allow easy access to the elbow and wrist throughout the procedure.Use a sharp-pointed awl to access the medullary canal without injuring the adjacent physes of the distal end of the radius or proximal part of the ulna.Contour the radial implant to allow easy passage and to establish the anatomic radial bow.Traction and direct manual pressure can be used to reduce the fractured fragments to allow passage of the implants across the fracture site.A small open reduction of the fracture site should be performed after ≥3 failed attempts at obtaining a closed reduction.The nails should be cut so that they can be buried subcutaneously but easily accessed for later removal without injuring the adjacent physes. Lateral condylar fractures of the humerus are the second most common elbow fracture seen in pediatrics, behind supracondylar humeral fractures. All practicing orthopaedic surgeons should be able to identify and treat these injuries appropriately, as the intra-articular and transphyseal nature of this fracture pattern contributes to the relatively high complication rate. Treatment has evolved with time as classification systems better characterize the different types of lateral condylar fractures, aiding in decision-making for management. This video article reviews the diagnostic findings and classification systems for lateral condylar fractures and then details the surgical technique for open reduction and internal fixation of displaced lateral condylar fractures. Position the patient supine with the arm extended on a hand table with a sterile tourniquet. Center the incision over the capitellum. Follow the rent in the fascia to the fracture. Open the capsule anteriorly to view across the joint, avoiding eateral overgrowth is to be expected and results in no functional limitations to the patient. Most pediatric tibial shaft fractures (75%) can be treated nonoperatively; however, unstable and open fractures require surgical intervention. Titanium elastic nails have become a popular technique for fixation of pediatric tibial shaft fractures. They act as internal splints that impart relative stability to the fracture, promoting callus formation at the fracture site . After the patient is placed in the supine position, the proximal tibial physis is marked using fluoroscopy. find more An anteromedial and anterolateral incision are made distal to the physis. Entry holes are created in the proximal part of the tibia, and appropriately sized titanium nails are introduced into the bone. Nail size should be 40% of the width of the canal, yielding 80% canal fill when 2 nails are used. The nails are prebent into a gentle C-shape to increase cortical contact at the apex so that 3-point fixation is achieved. The nails are passed to the fracture site, and the fracture is then reduced. The nails are then passed across tf the bend should be positioned at the level of the fracture.During insertion, leave room to advance nails further after they are cut proximally.Do not bury the proximal nail tips beneath the cortex as extraction will be difficult.Ensure that the ends of the nails are not lying up against the proximal tibial physis as this may cause premature growth arrest.The most common type of rotator cuff lesion is a tear of the supraspinatus tendon, with arthroscopic rotator cuff repair representing an established treatment option1-3. Several double-row techniques have been described to achieve complete coverage of the rotator cuff footprint. Among these is the bridging, double-row, transosseous-equivalent rotator cuff repair, which has become one of the most popular techniques for its maximized contact area and initial fixation strength4-9. However, medial cuff failure is a common complication following this procedure9-14. To reduce medial strangulation and overall sur