RESUMO
The past century has seen many changes in the management of the polytraumatized orthopaedic patient. Early recommendations for non-operative treatment have evolved into early total care (ETC) and damage control orthopaedic (DCO) treatment principles. These principles force the treating orthopaedist to take into account multiple patient parameters including hypothermia, coagulopathy and volume status before deciding upon the operative plan. This requires a multidisciplinary approach involving critical care physicians, anesthesiologists and others.
Assuntos
Fraturas Ósseas/terapia , Traumatismo Múltiplo/terapia , Sistema Musculoesquelético/lesões , Ortopedia/métodos , Protocolos Clínicos , Diagnóstico por Imagem , Fraturas Ósseas/diagnóstico , Humanos , Equipe de Assistência ao PacienteRESUMO
Tibial plateau fractures are complex injuries that can affect both knee function and stability. In the past, surgeons have relied on radiographs, viewboxes, tracing paper, and scaled acetate templates to formulate a preoperative plan. With the advent of digital radiography, viewboxes, and standard radiographs are no longer routinely available. The availability of a digital format for preoperative planning has helped to address this, but fragment manipulation and implant templating are not features of most digital radiography systems. Digital surgical planning software allows for these functions thereby enabling the surgeon to formulate a preoperative plan for fracture reduction and fixation. Concomitant use of 3-dimensional (3D) imaging software permits unlimited inspection of the fracture by allowing for oblique or special views through manipulation of the software image as opposed to potentially painful positioning of the injured limb by the patient or radiograph personnel. This case report illustrates the advantages of these new software tools.