ORIF - Open reduction and internal fixation of left olecranon
PREOPERATIVE DIAGNOSIS
Left olecranon fracture.
POSTOPERATIVE DIAGNOSIS
Left displaced olecranon fracture with intra-articular extension.
PROCEDURES
Open reduction and internal fixation of left olecranon.
ANESTHESIA
General.
INDICATION FOR PROCEDURE
This patient is an elderly male who sustained a widely displaced olecranon fracture. Because of the likelihood of disability with nonsurgical treatment, decision was made to proceed forward with treatment.
DESCRIPTION OF PROCEDURE
The patient was met in preoperative area. Operative extremity identified and marked. Informed consent discussed and signed including the risks of, but not limited to, pain, infection, bleeding, weakness, stiffness, numbness, tingling, need for further surgery. Malunion, nonunion, arthritis, loss of limb or life. Patient consented. The patient was taken to the operative theater, general anesthesia given. The patient's sterilely prepped, anesthetized in lateral decubitus position. Time-out performed. First posterior incision was created over the olecranon, this was carried down sharply to the fascial layer. There, the fracture was identified. This was cleaned of clot and callus tissue. Next, a reduction maneuver was performed to reduce it, this was transfixed with two K-wires. This was visualized on fluoroscopic imaging. Next, a Synthes olecranon plate was fixed distally in the oblong hole with a nonlocking 3.5 screw. This was then further fixed proximally with a locking screw through the proximal fragment. The distal screw was then fully tightened to fully compress the construct. X-rays were taken that showed good alignment at the joint. Following this, further two locking screws were placed at the proximal end of the plate and further two nonlocking screws in the shaft of the plate to secure the fracture, it was taken throughout an arc of motion and found to be quite stable. Final x-rays were taken. The patient was then copiously irrigated. The deep fascial layer was closed over the plate with interrupted 0-Vicryl suture followed by interrupted 2-0 Vicryl suture followed by interrupted mattress 3-0 nylon. The patient was placed into a dry sterile bulky dressing and Ace wrap with sling. At the end the procedure, all sponge and instrument counts were correct. The patient tolerated procedure well.
Left olecranon fracture.
POSTOPERATIVE DIAGNOSIS
Left displaced olecranon fracture with intra-articular extension.
PROCEDURES
Open reduction and internal fixation of left olecranon.
ANESTHESIA
General.
INDICATION FOR PROCEDURE
This patient is an elderly male who sustained a widely displaced olecranon fracture. Because of the likelihood of disability with nonsurgical treatment, decision was made to proceed forward with treatment.
DESCRIPTION OF PROCEDURE
The patient was met in preoperative area. Operative extremity identified and marked. Informed consent discussed and signed including the risks of, but not limited to, pain, infection, bleeding, weakness, stiffness, numbness, tingling, need for further surgery. Malunion, nonunion, arthritis, loss of limb or life. Patient consented. The patient was taken to the operative theater, general anesthesia given. The patient's sterilely prepped, anesthetized in lateral decubitus position. Time-out performed. First posterior incision was created over the olecranon, this was carried down sharply to the fascial layer. There, the fracture was identified. This was cleaned of clot and callus tissue. Next, a reduction maneuver was performed to reduce it, this was transfixed with two K-wires. This was visualized on fluoroscopic imaging. Next, a Synthes olecranon plate was fixed distally in the oblong hole with a nonlocking 3.5 screw. This was then further fixed proximally with a locking screw through the proximal fragment. The distal screw was then fully tightened to fully compress the construct. X-rays were taken that showed good alignment at the joint. Following this, further two locking screws were placed at the proximal end of the plate and further two nonlocking screws in the shaft of the plate to secure the fracture, it was taken throughout an arc of motion and found to be quite stable. Final x-rays were taken. The patient was then copiously irrigated. The deep fascial layer was closed over the plate with interrupted 0-Vicryl suture followed by interrupted 2-0 Vicryl suture followed by interrupted mattress 3-0 nylon. The patient was placed into a dry sterile bulky dressing and Ace wrap with sling. At the end the procedure, all sponge and instrument counts were correct. The patient tolerated procedure well.
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