Chapter 43: Overview of MIO Principles Flashcards
What is ligamentotaxis?
Refers to closed reduction maneuvers used mostly for the treatment of intra- and or/juxta-articular fractures - Relies on traction forces applied across the fracture and on integrity of the soft tissue structures
What is the mechanical principle underlying indirect reduction?
Distraction
What are the principles termed to help minimize patient/personnel radiation exposure?
ALARA principles
The highest and most underestimated personnel exposure to radiation is from what?
Scatter (backward scatter can be 25-40% of energy of the primary beam and is the larger portion of the scatter)
Name ways to limit exposure?
Generator below table to reduce back scatter
Stand as far away as possible (inverse square distance law - double distance, decrease exposure by 75%)
Use lowest radiation amount necessary
Proper room set up
Mini C arm
Collimate on area of interest
Name three different reduction tools used in MIO?
Traction tables
ESF
Toothed reduction handles (used as “joysticks” for manipulating fragments)
Why are bicortical locking screws still recommended over monocortical locking screws?
In torsion the working length of monocorticals is limited to the thickness of the cortex - so working length is reduced in thin cortex which may jeopardize construct stability
How do you avoid the radial nerve when plating the lateral humerus in MIO?
Make sure the plate is under the brachialis muscle
What is considered the most significant challenge with MIO?
Malalignment
Malalignment in which plane (frontal, sagittal or transverse) is best tolerated?
Sagittal - Example: pro/re-curvatum
What does postoperative neuropraxia indicate?
Need for immediate revision - nerves are trapped.
What is “open but do not touch”?
An approach that opens the site but preserves the fracture hematoma.
