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Fit plate to fracture, should be approx. 5mm inf to RC and lateral to LHBT
Hold plate in place using .016 k-wire be careful b/c you can fit .02 k-wire through plate hole,
but will get stuck!
Hold plate on with K-wire and get fluoro to look at A/P, Lat position of plate, reduction
Start with non-locking shaft screw in mid-plate (2.5mm gold drill) approx. 30mm
Then put in locking guide to put in calcar/kickstand screw first
When drilling, make sure you are co-linear and use bouncing technique goal is to go through
cancenllous head to the subchondral bone and then STOP. DO NOT GO THROUGH
SUBCHONDRAL BONE better to be short, really difficult to measure and easy to penetrate.
Make sure to take more fluoro then you probably need to check screw length (airball)
Eaiser to put in screws with IR and then check AP/Grashey view for screw length, but need to
fluoro to check b/c round head.
Fill all locking holes in head
Place 2-3 non-locking holes in shaft, may need to place 1-2 locking
USE FLUORO TO CHECK SCREW LENGTHS
Once happy with screw lengths, irrigate and get final AP/Lat shots
Use free needle to pass Ticron sutures through superior holes to tie down the RC
Use #2 Ethibond to repair Pec Major if you released earlier (Dont grab LHBT)
Close D-P interval with 0-Vicryl to close over cephalic vein
Irrigate
2-0 Victryl to subdermal layer
Staples v. 3-0 monocril
Use ultrasling for post-op immobilization
Post-op XR Make sure you fluoro for screw length!