K-WIRES FIXATION / HAUBANAGE

HAUBANAGE / TENSION BAND STITCH / TENSION BAND WIRING

PATELLAR FRACTURE (Simple / Multifragmentary)

Procedure:

• Place the patient in a supine position with the knee flexed 30° under spinal anesthesia
• Skin antisepsis by betadine scrubbing
• Incision through the skin and fascia in mid-axial longitudinal approach
• Irrigated and cleared of blood clot and small debris to allow exact reconstruction
• Reduce the fracture fragments then anatomical reduction of the articular surface is monitored by palpating the joint from inside.
• Drill the first K-wire in an axial direction then drilled the second K-wire parallel to the first.
• Confirm with C-arm AP/ Lateral
• Place wire in figure (8 / 0) around the k-wires and tighten booth loops simultaneously.
• Verification of reduction by knee movement with flexion and extension
• Washing with normal saline
• Close the wound by suturing layer by layer with vicryle 1.0 and 2.0 then skin suture closing with nylon 3.0
• Washing with normal saline and apply betadine then dressing with sterile compressive.

Olecranon fractures 

Medial malleolus fractures 

Greater trochanter fractures

Post Operation Treatment:

1. PIV NSS 0.9% 1000ml/24H
2. Ceftriaxone (1g): 1fl x 2 (IVL)
3. Gentamycine (80mg): 1A x 2 (IM) (FOR 5 Days)
4. Metronidazole (500mg): 1fl x 2 (PIV)
5. Paracetamol (1g): 1fl x 3 (PIV)
6. Tramadol (100mg): 1A x 2 (IM)