Orthopedics
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When open reduction is indicated the lateral malleolus fracture should be reduced as accurately as the medial or posterior malleolar fragments. The cerclage for displaced oblique or spiral fractures of the lateral malleolus is a simple, effective way of internal fixation with a minimal amount of metal implanted. Under direct vision an anatomical reduction is achieved and maintained. ⋯ In a displaced bimalleolar or trimalleolar fracture, the cerclage can be used in conjunction with various other internal fixation screws or nails applied to the medial and/or posterior malleolar fragment. The exact method varies depending on the type of fracture present. With increasing recognition of the importance of anatomic reduction of the lateral malleolus in the ankle fracture management, cerclage technique will contribute further toward the restoration of the normal ankle joint mechanics.
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Comminuted fractures of the distal radial metaphysis are inherently unstable. Reduction can be obtained utilizing traction, and then the fracture stabilized by placing pins proximal and distal to the fracture and incorporating these pins in a short-arm cast. The results of 36 patients treated in this manner were analyzed. An excellent result was achieved in 78% of the cases.