kadensmom
Networker
Lots of little pieces to be put back together...I was thinking maybe a transcondylar code and a peri-articular code? What do you think?
...Posterior incision was then performed in a radially deviated fashion of the olecranon. This was carried down through the subcutaneous tissue sharply. Attention was then carried down to identifying the ulnar nerve in the cubital tunnel. This was carefully identified. After identifying this was dissected proximally and distally. The nerve was noted to be in continuity without any evidence of innjury along its length. At this time an olecranon osteotomy was performed in a Chevron fashion after predfrilling with a 2.5 drill bit. Once this was completed the olecranon was completed with osteoplysis and this was then retracted proximally. The articular surface of the distal humerus was noted to have multiple comminuted fragments with shortening of the medial column. Attention was then turned at this time to begin adequate reduction of the joint. Once anatomic reduction of the joint had been obtained, a 1.25 guidewire was then placed across the articular fragments and this was then used to lag together the articular segment using a 4-0 cannulated screw after predrilling the radial side. Once this was complete and the joint was felt to be stably reduced, several periarticular and intraarticular fragments were then reduced and screwed together from an inside out tehnique using mini-frag screws. 24586? Once this was complete the condylar segment was then reduced to the shaft and a posterior lateral plate was then placed after being precontoured with an 8-hole 3.5 LCDC combination plate. This was secured proximally and a medial buttress plate awas then provided for any rotational stability along the medial column. Once this had been precontoured this was secured to the shaft using 3.5 cortical fixation and distally using 2.7 locking fixation. Once these were complete and secured distally using a 3.5 locking fixation. Once complete attentionw as then carried about filling the remaining holes on the plate. This was confirmed to be near anatomic in reduction and alignment on AP and lateral views. At this point the olecranon osteotomy was then reduced and fixed using attention band contruct, using a 3.5 cortical screw with #2 fiber wire. The patient's elbow was taken through range of motion and felt to be stably reduced. The wound was then irrigated. The ulner nerve was transposed in a subcutaneous fashion and secured. Subcu tissue was then closed using 2-0 Vicryl and the skin was then closed using 3-0 nylon. The patient was noted to have no evidence of infection at this tie. The wound was sterilely dressed, the patient was placed in a posterior splint, drape was taken down, and then the patient was awakened....
...Posterior incision was then performed in a radially deviated fashion of the olecranon. This was carried down through the subcutaneous tissue sharply. Attention was then carried down to identifying the ulnar nerve in the cubital tunnel. This was carefully identified. After identifying this was dissected proximally and distally. The nerve was noted to be in continuity without any evidence of innjury along its length. At this time an olecranon osteotomy was performed in a Chevron fashion after predfrilling with a 2.5 drill bit. Once this was completed the olecranon was completed with osteoplysis and this was then retracted proximally. The articular surface of the distal humerus was noted to have multiple comminuted fragments with shortening of the medial column. Attention was then turned at this time to begin adequate reduction of the joint. Once anatomic reduction of the joint had been obtained, a 1.25 guidewire was then placed across the articular fragments and this was then used to lag together the articular segment using a 4-0 cannulated screw after predrilling the radial side. Once this was complete and the joint was felt to be stably reduced, several periarticular and intraarticular fragments were then reduced and screwed together from an inside out tehnique using mini-frag screws. 24586? Once this was complete the condylar segment was then reduced to the shaft and a posterior lateral plate was then placed after being precontoured with an 8-hole 3.5 LCDC combination plate. This was secured proximally and a medial buttress plate awas then provided for any rotational stability along the medial column. Once this had been precontoured this was secured to the shaft using 3.5 cortical fixation and distally using 2.7 locking fixation. Once these were complete and secured distally using a 3.5 locking fixation. Once complete attentionw as then carried about filling the remaining holes on the plate. This was confirmed to be near anatomic in reduction and alignment on AP and lateral views. At this point the olecranon osteotomy was then reduced and fixed using attention band contruct, using a 3.5 cortical screw with #2 fiber wire. The patient's elbow was taken through range of motion and felt to be stably reduced. The wound was then irrigated. The ulner nerve was transposed in a subcutaneous fashion and secured. Subcu tissue was then closed using 2-0 Vicryl and the skin was then closed using 3-0 nylon. The patient was noted to have no evidence of infection at this tie. The wound was sterilely dressed, the patient was placed in a posterior splint, drape was taken down, and then the patient was awakened....