Orthopedic help, please!

[Guest guest]

Hi y'all and Happy New Year:

I'm typing an orthopedics consult on a 10-year-old boy with a fractured

femur. I did just fine, right down to the recommendations, and I've got

THREE blanks.

Any suggestions will be very much appreciated:

At this point, for the femur fracture I would recommend closed flexible

nailing. The other options would be external fixation and closed

management with traction and conversion to a spica cast. Due to the

significant amount of shortening of the fracture, I would not recommend

cast treatment. ___________ [s/l X-trake] is a second option, but this

is a little more difficult because of _________ [s/l skin tract] care.

The risks of closed ___________ [s/l in-tu-ated???] nailing include

bleeding or vascular injury, leg length discrepancy, and malrotation.

These risks, as well as anesthetic risks, were discussed with the

patient and family. They understand this completely and have signed a

surgical consent. The patient will be taken to the operating room today

for the above procedure. Also of note is that the closed nailing will

require hardware removal in 4 to 6 months.

Thanks in advance.

Jayni