Delayed Distraction Bone Block Arthrodesis for a Sanders IV Calcaneus Fracture Nonunion Using Tricortical Iliac Crest Allograft and Reamer/Irrigator/Aspirator Femoral Autograft.

We present the surgical technique for arthrodesis of the subtalar and calcaneocuboid joints of a Sanders type IV calcaneal fracture nonunion via a distraction bone block arthrodesis technique with tricortical iliac crest allograft combined with reamer/irrigator/aspirator autograft from the patient's femur. A lateral extensile approach to the calcaneus was used for the exposure, which allowed the surgeon to follow the stepwise complex surgical plan outlined here. Calcaneal nonunions are difficult to treat, but good outcomes can be achieved if proper technique with bone grafting is used.

Operative Repair of a Schatzker II Tibial Plateau Fracture Using a Combined Anterolateral and Posterolateral Approach Without Fibular Head Osteotomy.

We present the case of a 49-year-old male pedestrian struck by a car while cycling, sustaining a displaced anterolateral tibial plateau fracture and a large coronal plane fracture of the posterolateral plateau involving approximately one-third of the anterior posterior dimension of the articular surface. The posterolateral approach without a fibular osteotomy allows direct access to the posterolateral plateau and avoids complications associated with a fibular head osteotomy. The combined anterolateral and posterolateral approach to the proximal tibia without fibular osteotomy is a viable technique to achieve biomechanically sound fixation for lateral tibial plateau fractures that involve the anterolateral and posterolateral aspects of the tibial plateau.

Repair of a Femoral Head Fracture Dislocation With an Associated Posterior Wall Acetabular Fracture (Pipkin 4) via a Kocher-Langenbeck Approach.

A case of a 27-year-old man with a right-sided largely infra-foveal femoral head fracture dislocation with posterior wall acetabular fracture repaired via a Kocher-Langenbeck approach is presented. This is an atypical approach for fixation of the femoral head and acetabulum used because of the size and displacement of both the posterior wall fracture and the femoral head fracture. Indications for fixation of both the femoral head and the acetabulum include a displaced acetabular fracture with: (1) a fracture of the weight-bearing portion of the femoral head and/or (2) a fracture of the femoral head that engages the anterior or posterior wall.

Partial Articular Fracture of the Distal Radius Treated via Dorsal Approach.

The case of a 60-year-old woman with an impacted, dorsally unstable, displaced intra-articular distal radius fracture with dorsal sheer treated via a dorsal approach. Literature comparing dorsal to volar plating of the distal radius is mixed. Dorsal plating may lead to a greater incidence of implant removal, although radiographic and clinical outcomes seem to be similar.

Flexible Nailing of Pediatric Both Bone Forearm Fracture.

This is the case of a 12-year-old boy presented with a displaced radial and ulnar shaft fracture. Historically, these fractures were managed conservatively with closed reduction and cast immobilization; however, there has been an increasing trend toward operative fixation. Malalignment is an indication for operative fixation of pediatric both bone forearm fractures.

Operative Fixation of Extra-articular Scapula Body Fracture Through a Modified Judet Approach.

We present the case of a 53-year-old male laborer who slipped and fell on ice and had acute right shoulder pain. Plain radiographs and a computed tomography scan of the scapula were obtained that demonstrated a comminuted and displaced extra-articular scapula body fracture with approximately 2 cm of medialization of the glenoid. The anatomy, examination, diagnosis, and surgical approach options are reviewed.