okoj, Volume 4, No. 3

Fractures of the Radial Head and Neck and Monteggia Fractures

Proximal forearm fractures are the least-common forearm fractures, collectively accounting for about 5% of forearm fractures. The types of proximal injuries include radial head and neck fractures, olecranon fractures, coronoid fractures. Monteggia fractures constitute about another 5% of forearm fractures. Monteggia injuries involve an ulna fracture with a radial head dislocation-fracture. Monteggia-equivalent injuries involve some variation of ulna fracture and proximal radius injury. This article reviews the clinical presentation and management options for proximal forearm fractures.

    • Keywords:
    • elbow fracture

    • elbow joint fracture

    • broken arm

    • broken elbow

    • proximal forearm fracture

    • proximal radius fracture

    • proximal ulna fracture

    • intra-articular fracture

    • Monteggia fracture

    • apophyseal olecranon fracture

    • metaphyseal olecranon fracture

    • coronoid fracture

    • Salter-Harris classification

    • casting

    • cast immobilization

    • Subspecialty:
    • Trauma

    • Pediatric Orthopaedics

The Gotfried Percutaneous Compression Plating (PCCP) Technique for Treating Pertrochanteric Hip Fractures

Trochanteric proximal femur fractures are very common and the incidence is increasing with the aging of the population. The average age of the patient with trochanteric fracture is greater than for femoral neck fracture, as are the problems of osteoporosis. The classic treatment of trochanteric proximal femur fracture is internal fixation with a hip screw and side plate. High union rates have been reported with current techniques of treatment, which are generally perceived to be effective. Settling at the fracture site has been considered acceptable and the positive impact on fracture healing has been emphasized. Under closer scrutiny of functional results, recent reports have indicated that many patients do survive and their fractures heal, but they are not able to return to their pre-injury ambulatory status or function.

A variety of alternative techniques have been developed, including intramedullary fixation with the advantage of less operative dissection and potentially improved stability. Problems with malunion and settling have persisted. The Gotfried percutaneous compression plate (PCCP) is another technique design to address some of the problems seen with dynamic hip screw (DHS) for treating trochanteric proximal femur fractures.

This topic reviews the Gotfried percutaneous compression plate system and provides video of the approach, including setup and percutaneous compression plating.

    • Keywords:
    • hip fracture

    • broken hip

    • fracture of the hip

    • femoral head fractures

    • trochanteric fracture

    • proximal femur fracture

    • Gotfried percutaneous compression plate fixation

    • PCCP

    • Subspecialty:
    • Trauma

The Use of Locking Plates in Fracture Care: Biomechanics, Techniques, Pearls, and Pitfalls

This OKO topic reviews the development of locked plating in surgical fracture care. The concept of a locked "internal fixator" changed the traditional approach to fracture plating. The authors describe the technique of locked plating, its indications and contraindications, pearls and pitfalls, and briefly discuss the outcomes achieved through its use.

    • Keywords:
    • locked plating

    • advantages

    • development of locked plates

    • indications

    • surgical techniques

    • PC-fix

    • Less Invasive Skeletal Stabilization system

    • LISS system

    • outcomes

    • Subspecialty:
    • Trauma

    • Basic Science