Re: Please HELP! closed vs open reduction vs percutatneous....Margie/Ruby?

edited May 2017 in Orthopedics
I believe for a procedure to be considered open, the cut has to be through
the subcutaneous tissue.

Open-cutting through the skin or mucous membrane and any other body layers
necessary to expose the site of the procedure

Percutaneous- entry by puncture or minor incision for instrumentation to
reach necessary site

Percutaneous endoscopic- entry by puncture or minor incision for
instrumentation to visualize the site of procedure



On Tue, Aug 23, 2016 at 11:02 AM, Lylia Leal wrote:

> I'm a bit confused on this one. Can someone please help?
> Is this closed reduction, open reduction or percutaneous?
>
> The procedure performed heading indicates closed reduction and screw
> fixation of lateral malleolus fracture. Doc indicates it is a closed
> reduction with percutaneous fixation. Just double checking based on the
> description of the procedure. Since two small incisions were made to
> rotate the fragment, is this an open or closed reduction?
>
> ...... Under fluoroscopic guidance we made two small incisions to place
> our abduction forceps. With the reduction forceps in hand we were able to
> rotate the fragment into position and keep it reduced manually. We then
> made a small incision distally. We placed a K-wire from distal to
> proximal, overdrilled the near cortex and then placed a 70 mm 4.0 screw and
> we were able to obtain good purchase proximally. Once that was done and
> fixed, we irrigated the wound with copious amounts of normal saline, closed
> the wound with 4-0 Monocryl suture. We placed Dermabond over the smaller
> incisions and then injected the areas with plain Marcaine roughly 20 mL
> total. We placed Betadine ointment and sterile dressing and Ace bandage.
> The patient was then placed into a Cam boot. She was then awakened from
> anesthesia and returned to the PACU in stable condition.
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