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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 28/12/2024

Love it! How do you not block the screws from the rim plate with those cannulated screw in the head?

Daniel Gonzales-Luna MD @dgl1989.bsky.social · 28/12/2024

Okay I use Aptus too but had a feeling you might say tripod screw. Haven’t done it personally so thanks for sharing the case

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 27/12/2024

What’s your plate of choice for ORIF comminuted radial head?

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 10/12/2024

Thank you. Admittedly some futz getting the plate to sit correctly. Definitely has a cost of added time and soft tissue stripping so I try to use it sparingly.

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 04/12/2024

I find the radial butress help correct the radial translation and shortening. Also helps contain some of the comminution to fine tune the volar reduction. #orthosky

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 04/12/2024

Anyone add a radial butress for this or just volar plate?

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 03/12/2024

Awesome to get this to work over an exchange nail. You just do a position screw or lag? I’ve done this across the metaphysis of a supracondylar femur fx w/ delayed union w/ a 6.5 mm can. screw in a patient returning to the OR for a new fracture.Seemed to promote union albeit had only been 7 months.

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 01/12/2024

Nice even harder with poor bone quality like that. I like the A-P subchondral wires to help with the corrections. I’ll pocket that trick

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 01/12/2024

You can do that all while supine? That’s awesome, I need to step my game up

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 30/11/2024

Judging reduction quality of FNF on Fluoro can be challenging, as can be making the decision to open. #orthosky

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 30/11/2024

Agreed! The X-rays don’t it justice. Definitely took some extra energy. Hard to explain to the patient’s why so much hardware! The defect was like the size of a finger extending across the condyles

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 26/11/2024

Lateral and Posterior Medial Approach. Reduce Posterior fracture extension anatomically with Flexible fixation Expose medial and lateral metaphyseal crush, laminar spreaders to restore the joint line posterior slope. Lateral and Anterior Medial Plate with bone graft. #orthosky #trauma

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 26/11/2024

#Tibialplateau fracture , hypertension, varus, metaphyseal crush: Approach? Fixation? #ortho #orthosky

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 20/11/2024

Because cars don’t fix themselves if you get into fender bender. I get all my vaccines but don’t think you can get people to change with these kind of analogies

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 10/11/2024

Slight rotational mal reduction introduced by the screw corrected by loosening the screw, applying pointed clamp then advancing the screw.

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 10/11/2024

Smith Peterson approach, pre load k-wire and wire for a 6.5 partially threaded screw, then perform reduction and advance the wires. #orthosky #ortho #trauma

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Daniel Gonzales-Luna MD @dgl1989.bsky.social · 10/11/2024

#Femoralneck Fracture in young person (17 y.o) What’s your approach? Attempted closed reduction? Straight to open? What’s your preferred implant?

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