Surgical Indications for Open Reduction and Internal Fixation by Dr. S. Somlili

1. INDICATIONS FOR OPEN REDUCTIONS AND INTERNAL FIXATION OF #S DR S SOMLILI

2. Most #s can be treated no-operatively by close reduction and • application of an apropriate splint. • You must have an indication for treating a # surgically. • There are a few #s that cannot be treated non-operatively. • These #s require surgery from the beginning.

3. #S FRACTURES THAT ALWAYS REGUIRE SURGERY • Neck of femur #s (NOF) • Galeazzi # • Monteggia # • Lower limb #s in elderly patients

4. GENERAL INDICATIONS FOR OPEN REDUCTION AND INTERNAL FIXATION OF #S (ORIF) • Failure of close reduction. • Failure to maintain close reduction. • Displaced intra-articular #s,eg - Tibial plateau #s - Tibial plafond #s - Intra- articular distal radius - Radial head - Femoral/humeral intercondylar #s • Polytrauma • Pathological #s • Non-union of #s

5. ANKLE #S • Orif except for undisplaced lateral malleolus # without medial tenderness. FOOT #S • Talus orif,non-operative if undisplaced • Calcaneous orif,non operative if undisplaced

6. Lisfranc # - # dislocation of the tarso matatarsal joints. • - Treatment ORIF • Metatarsal #s - non operatively if undisplaced • - Orif with K-wires if displaced • Toe #s - mainly treated non-operatively with a back slab. • - Orif using K-wires if displaced.

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