Spanning a multitude of locations, types, and morphology, fractures require proper stabilization to achieve successful bony union after injury. A variety of different implants and fixation techniques are available to achieve successful fracture management when surgical intervention is indicated.
Fractures
Humerus
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Proximal Humerus Fractures
Proximal humerus fractures encompass a variety of different types, including unifocal, bifocal, and articular fracture patterns. Careful evaluation of the fracture pattern along with patient-specific considerations help determine the most appropriate t...
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Humeral Shaft Fractures
Careful evaluation of humeral shaft fractures and execution of surgical fixation are essential to avoid neurovascular involvement. Surgical management may involve a posterior approach, dissection through the triceps, and stabilization through plating a...
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Distal Humerus Fractures
Distal humerus fractures can present with highly variable patterns and may result in neurovascular involvement. A variety of surgical approaches and hardware choices can be used depending on intra-articular or extra-articular injury.
Radius and Ulna
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Olecranon Fractures
Olecranon fractures can affect the stability of the elbow by disrupting the articulation with the distal humerus. Proper surgical fixation of this bony projection is needed to maintain elbow mechanics and decrease injury risk to the ulnar nerve.
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Coronoid Fractures
While the coronoid process is a much smaller bony projection than the neighboring olecranon, fractures can similarly result in loss of elbow function. Proper fixation of coronoid fractures is essential to maintain upper extremity biomechanics and elimi...
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Radial Neck Fractures
Radial neck fractures vary in their level of bony displacement and effect on elbow function. If they impede elbow range of motion, surgical management is typically indicated to restore arm and forearm functions
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Radial Head Fractures and Terrible Triad Injuries
Posterolateral elbow dislocation, coronoid process fractures, and radial head fractures are grouped together and identified as terrible triad injuries. Successful outcomes depend on radiographic indications for varied surgical fixation techniques.
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Radial Shaft Fractures
Surgical approaches for radial shaft fractures vary depending on whether the proximal, middle, or distal third of the radial shaft is affected. Careful surgical planning is needed to preserve forearm musculature and avoid biceps tendon irritation with ...
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Distal Radius Fractures
One of the most common fracture types, distal radius fractures are often associated with concomitant hand and wrist injuries, frequently following a fall onto an outstretched hand. Successful outcomes depend on radiographic indications for conservative...
Femur
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Femoral Head Fractures
Due to their intra-articular nature, femoral head fractures often require surgical hip dislocation to allow for circumferential access of the hip. Careful execution of surgical techniques is paramount to preserve capsular blood supply.
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Femoral Neck Fractures
Because they are intracapsular, femoral neck fractures present an increased risk of nonunion and avascular necrosis and require proper surgical stabilization. Open reduction internal fixation and hip arthroplasty are viable treatment options for this c...
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Intertrochanteric Fractures
Occurring between the greater and lesser trochanters, intertrochanteric fractures are common following falls in older populations. Intertrochanteric nails are commonly used to stabilize this fracture pattern.
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Distal Femur Fractures
Distal femur fractures can be treated with a variety of surgical approaches. The level of comminution and intra-articular involvement will help determine plating and nailing fixation options.
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Subtrochanteric Fractures
Occurring within the 5 cm of femoral shaft distal to the lesser trochanter, subtrochanteric fractures can result from either low-energy or high-energy trauma. Intramedullary nails are commonly used to stabilize this fracture pattern.
Patella
Tibia
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Tibial Plateau Fractures
Proper management of tibial plateau fractures is crucial to restore stability to this intra-articular weight-bearing surface and restore function of the tibiofemoral joint. A variety of different surgical approaches and fixation techniques with plates,...
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Tibial Shaft Fractures
Surgical management for tibial shaft fractures typically involves the use of open reduction internal fixation or intramedullary nailing. Further surgical intervention is warranted in the presence of additional polytrauma.
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Pilon (Distal Tibia) Fractures
Pilon fractures are comminuted fractures of the weight-bearing surface of the distal tibia. These complex fractures are evaluated and treated differently than standard ankle fractures and typically require time-sensitive surgical fixation and reduction.
Pelvis
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Acetabular Fractures
Acetabular fractures are often the result of high-energy trauma frequently accompanied by soft-tissue considerations. Surgical fixation techniques will vary, especially if total hip arthroplasty or percutaneous fixation is indicated.
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Pelvic Ring Injuries
Pelvic ring injuries result from disruption of the articulation of the sacrum with the innominate bones and supporting ligamentous structures. These injuries require careful treatment planning to reduce pelvic instability and address concomitant urogen...
Hand and Carpus
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Metacarpal and Phalangeal Fractures
Metacarpal and phalangeal fractures require different treatment strategies depending on fracture type, location, and morphology. If radiographic indications for surgical intervention are present, various techniques are available, including external fix...
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Scaphoid Fractures
A scaphoid fracture is the most common fracture of the carpal bones. The type of fracture and amount of displacement will guide whether conservative treatment or surgical intervention is indicated.
Foot
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5th Metatarsal Fractures
Fractures of the 5th metatarsal encompass tuberosity avulsion fractures, Jones fractures, and diaphyseal stress fractures. Critical evaluation of the mechanism of injury, anatomic variations of the foot and ankle, and activity level of the patient is e...
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Ankle Fractures
Ankle fractures vary in location, type, and morphology, including unimalleolar, bimalleolar, and trimalleolar fracture patterns. Successful outcomes depend on radiographic indications for conservative treatment or surgical intervention.
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Calcaneus Fractures
Calcaneus fractures vary in severity depending on the amount of displacement and intra-articular involvement. Careful evaluation of the fracture pattern, along with patient-specific considerations, helps determine the most appropriate treatment plan.
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Lisfranc Injuries
Lisfranc injuries that affect the ligamentous complex supporting the tarsometatarsal articulation, or Lisfranc joint, can range from mild to severe. Operative fixation is often indicated to restore stability and function to the midfoot.
