IMG-20260731-WA0006.jpg
Surgery
analyse_media
Here is the transcribed and interpreted content of this surgical operation note:
Operation Note - Transcription
Surgeon: Dr. Sandeep Cherely
Case: Fracture Radius (communited) - "Fracture Radius" written top right
Position / Prep:
- GA/ANS with patient in supine position, painting + draping done
Procedure:
- Volar incision over radius
- Soft tissue dissected
- Fracture site exposed
- Comminution noted (+)
- Fragments reduced
- 3-hole DCP plate - Titanium Applied
- 3 distal screws (cortical) - 14 mm
- 3 proximal screws (cortical) - 14 mm
- Wash given
- Dorsal incision over ulna
Clinical Interpretation
This is an ORIF (Open Reduction Internal Fixation) of a comminuted distal radius fracture, with an additional dorsal approach to the ulna - suggesting a likely both-bone forearm fracture (radius + ulna).
| Step | Details |
|---|---|
| Approach | Volar (Henry's approach) for radius; Dorsal for ulna |
| Fracture pattern | Comminuted |
| Implant | 3-hole DCP (Dynamic Compression Plate), Titanium |
| Fixation | 3 distal + 3 proximal cortical screws, 14 mm each |
| Irrigation | Wash given before closure |
Key Points:
- DCP (Dynamic Compression Plate) allows axial compression at the fracture site, promoting primary bone healing
- Volar approach (Henry's) for radius gives access to the anterior surface, protecting the radial nerve and artery
- Dorsal approach over ulna - the ulna is subcutaneous, so a direct dorsal/posterior approach is standard
- 14 mm cortical screws are appropriate for forearm bone fixation
- Comminution noted intraoperatively, meaning the fracture had multiple fragments - this increases fixation complexity
IMG-20260731-WA0005.jpg
Surgery
analyse_media
Here is the transcribed and interpreted content of this second page of the operation note:
Operation Note - Page 2 Transcription
(This is the continuation from the previous page - ulna side of the operation)
Procedure (Continued - Ulna):
- Fracture site with soft tissue dissected
- Fracture site exposed
- 3-hole DCP applied
- 3 distal screws (12 mm / 14 mm)
- + 3 proximal screws
- Wash given
- Closure in layers - Vicryl subcutaneous + subcuticular
- Dorsal incision over Ulna - subcutaneous Sutures
Printed Form Fields:
INTRAOPERATIVE DIAGRAM (section header, top right - partially cut off)
/ Instrument count verified: Yes / No - No (circled/marked)
Estimated Blood Loss:
- (blank)
Replaced: (blank)
Closure:
- Layers - (filled in)
- Type - Interrupted simple / Mattress / Continuous
- Material used - (blank)
HISTOLOGY SPECIMEN: 1.
- Material used: (blank)
At end of surgery: (fields numbered 2, 3, 4, 5, 6)
Combined Summary (Both Pages)
This is a complete ORIF of Both-Bone Forearm Fracture (Radius + Ulna):
| Feature | Radius | Ulna |
|---|---|---|
| Approach | Volar (Henry's) | Dorsal |
| Fracture | Comminuted | - |
| Implant | 3-hole DCP, Titanium | 3-hole DCP |
| Distal screws | 3 × 14 mm cortical | 3 × 12/14 mm |
| Proximal screws | 3 × 14 mm cortical | 3 × proximal |
| Wash | Given | Given |
| Closure | - | Vicryl subcutaneous + subcuticular |
Closure Details:
- Subcutaneous layer: Vicryl (absorbable)
- Skin: Subcuticular (absorbable, no external sutures needed)
- This is a standard closure for forearm ORIF - minimises wound complications and gives good cosmetic result
Note on Instrument Count:
- The form shows instrument count verified as "No" - this would typically require documentation/explanation in a standard operative record
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