Curbside Consultation in Fracture Management: 49 Clinical Questions

Walter W. Virkus, MD

  • $99.95
  • ISBN 10 1-55642-829-4
  • ISBN 13 978-1-55642-829-6
  • 240 pp Soft Cover
  • Pub. Date: 2008
  • Order# 18294

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional fracture management references? Are you seeking brief, evidence-based advice for complicated cases or controversial decisions? Curbside Consultation in Fracture Management: 49 Clinical Questions provides quick answers to the thorny questions most commonly posed during a “curbside consultation” between orthopedic surgical colleagues.

Dr. Walter Virkus has designed this unique reference which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with fracture management. The unique Q&A format provides quick access to current information related to fracture management with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references are included to enhance the text and to illustrate the management of fractures.

Curbside Consultation in Fracture Management: 49 Clinical Questions provides information basic enough for residents while also incorporating expert advice that even high-volume clinicians will appreciate. Practicing orthopedists, orthopedic residents, and non-physician personnel will benefit from the user-friendly and casual format and the expert advice contained within.

Some of the questions that are answered:

  • There is a patient in the ER with a femur fracture and humeral shaft fracture. Should I fix the humerus with a nail or a plate?
  • How do you decide which pelvis fractures need surgery?
  • What is your choice for a displaced femoral neck fracture in a 65-year-old: ORIF, hemiarthroplasty, or total hip arthroplasty?
  • I have a 45 Year-old woman with a bicondylar tibial plateau fracture. What type of fixation should I use?
  • I have a 38 Year-old woman with a distal tibia spiral fracture. Should I try to nail this or just plate it?
  • When do you use locking plates?

For a complete listing of all the books in the Curbside Consultation Series, please visit

About the Editor
Contributing Authors
by David L. Helfet, MD


Question 1

I Have a 50-Year-Old Male With a Surgical Neck Humerus Fracture in His Dominant Arm. Should I Operate on Him?
James Kapotas, MD

Question 2

What Approach Should I Use for Plating a Humeral Shaft Fracture in a Multiple Trauma Patient?
Adam J. Starr, MD

Question 3

How Would You Manage a Radial Nerve Palsy Associated With a Humeral Shaft Fracture in the Dominant Arm of a 25-Year-Old?
Laura Prokuski, MD

Question 4

On Which Clavicle Fractures Do You Operate?
Brian D. Solberg, MD

Question 5

What Is Your Postoperative and Rehabilitative Protocol for Distal Humeral Fractures?
Amon T. Ferry, MD and Mark S. Cohen, MD

Question 6

I Have a 4-Year-Old Who Fell Off the Monkey Bars With a Swollen Elbow and a Fat Pad Sign. If the X-Rays Are Normal, Is Additional Evaluation Needed?
Monica Kogan, MD

Question 7

How Do You Perform a Fasciotomy of the Forearm?
Rachel S. Rohde, MD

Question 8

Cast, External Fixator, or Open Reduction and Internal Fixation for a Nonarticular Distal Radius Fracture in a 60-Year-Old Female?
John J. Fernandez, MD, FAAOS

Question 9

When Do You Replace the Radial Head?
Mark S. Cohen, MD and Robert W. Wysocki, MD

Question 10

There Is a Patient in the ER With a Femur Fracture and Humeral Shaft Fracture. Should I Fix the Humerus With a Nail or a Plate?
Timothy Bhattacharyya, MD

Question 11

I Have a 30-Year-Old Patient Who Had a Posterolateral Dislocation of the Elbow. How Would You Treat Him?
Michael J. Medvecky, MD


Question 12

My Patient is 8 Years Old and Had a Salter-Harris III Fracture of the Distal Femur. How Long Should I Follow Him for Growth Abnormalities?
Andrea S. Kramer, MD

Question 13

What Is Your Initial Evaluation of Pelvic Fractures?
Andrew J. Furey, MSc, MD, FRCSC and Robert V. O’Toole, MD

Question 14

Which Pelvic Fractures Are Life-Threatening?
Andrew R. Burgess, MD

Question 15

How Do You Decide Which Pelvic Fractures Need Surgery?
Scott A. Adams, MD, FRCS and Steven J. Morgan, MD, FACS

Question 16

I Have a 40-Year-Old With an Anterior Fracture of the Femoral Head and Incongruity of the Hip Joint. How Would You Treat This?
Clifford Turen, MD and Andrew J. Furey, MSc, MD, FRCSC

Question 17

I Have a 26-Year-Old in the ER With a Displaced Femoral Neck Fracture. Do I Need to Perform an Open Reduction and Capsulotomy?
Robert E. Blease, MD and Peter J. Nowotarski, MD

Question 18

What Is Your Choice for a Displaced Femoral Neck Fracture in a 65-Year-Old: ORIF, Hemiarthroplasty, or Total Hip Arthroplasty?
Matthew L. Jimenez, MD

Question 19

How Would You Treat a Varus Femoral Neck Nonunion in a 50-Year-Old?
Michael Garcia, MD and Michael D. Stover, MD

Question 20

What Is Your Postoperative Management of Hip Fractures in the Elderly?
Daniel K. Laino, MD and Kenneth A. Egol, MD

Question 21

How Would You Treat a Femur Fracture in a 6-Year-Old?
Pradeep Kodali, MD; John F. Sarwark, MD; and Najeeb Khan, MD

Question 22

How Would You Treat a Femur Fracture in a 12-Year-Old?
Najeeb Khan, MD; Pradeep Kodali, MD; and John F. Sarwark, MD

Question 23

I Have a 38-Year-Old With a Femoral Shaft Fracture Treated With an Antegrade Nail With No Evidence of Healing 8 Weeks Postop. What Should I Do?
Bradley R. Merk, MD

Question 24

What Is the Best Technique for Nailing a Femoral Shaft Fracture in a 28-Year-Old?
Michael T. Archdeacon, MD, MSE

Question 25

I Have a Tough Time With Subtrochanteric Fractures. Any Tricks?
Walter W. Virkus, MD

Question 26

When Do You Use a Spanning Fixator Across the Knee?
Anthony T. Sorkin, MD

Question 27

What Is Your Postoperative Management of Patellar Fractures?
Gerald J. Lang, MD

Question 28

What Is Your Postoperative Management of Tibial Plateau Fractures?
George Partal, MD and Marcus F. Sciadini, MD

Question 29

I Have a 45-Year-Old Female With a Bicondylar Tibial Plateau Fracture. What Type of Fixation Should I Use?
Edward A. Perez, MD

Question 30

What Is Your Criteria for Compartment Syndrome in the Tibia?
James Kapotas, MD

Question 31

What Are Your Tricks for Nailing Proximal and Distal Tibial Fractures?
Walter W. Virkus, MD and Ishaq Syed, MD

Question 32

I Have a 38-Year-Old Female With a Distal Tibia Spiral Fracture. Should I Try to Nail This or Just Plate It?
Heather A. Vallier, MD

Question 33

What Is Your Preoperative Management of a Bad Pilon Fracture?
Cory Collinge, MD

Question 34

How Do You Decide Which Surgical Approach to Use for Pilon Fractures?
Jeffrey M. Smith, MD and Anthony G. Sanzone, MD

Question 35

Do You Take Out Syndesmotic Screws in Adult Patients?
Joseph D. DiCicco, DO; Micah C. Hobbs, DO; and Matthew W. Heckler, DO

Question 36

I Have a Male Patient With a Trimalleolar Fracture, But the Posterior Malleolus Is Minimally Displaced. Do I Need to Fix It?
Rajeev Garapati, MD

Question 37

What Is Your Postoperative Protocol for Bimalleolar Ankle Fractures?
Rajeev Garapati, MD

Question 38

I Have an Insulin-Dependent 52-Year-Old Female With a Minimally Displaced Bimalleolar Ankle Fracture. Should I Treat Her in a Cast?
Simon Lee, MD

Question 39

On Which Calcaneal Fractures Do You Operate?
Robert Vander Griend, MD

Question 40

There Is a Patient in the ER With a Displaced Talar Neck Fracture. What Is the Technique for Fixation?
Armen S. Kelikian, MD

Question 41

Which Metatarsal Fractures Need Surgery?
Johnny L. Lin, MD

Question 42

Do You Ever Bone Graft Acute Fractures?
Dave Dean, DO and Bruce H. Ziran, MD

Question 43

I Have a 34-Year-Old Male With a Nonunion of a Plated Midshaft Tibia Fracture. How Do You Approach This Problem?
Stuart M. Gold, MD

Question 44

How Do I Treat a Child With a Twisted Ankle and Normal X-Rays?
Monica Kogan, MD

Question 45

How Do You Assess Compartment Syndrome of the Foot?
Johnny L. Lin, MD


Question 46

I Have a 38-Year-Old Male in an MVC With Multiple Orthopedic Injuries. Should I Fix Everything Now or Do Damage Control Orthopedics?
Jason W. Nascone, MD and John C. P. Floyd, MD

Question 47

Do Bone Stimulators Work on Nonunions?
Blane Sessions, MD and Craig Castleman Greene, MD

Question 48

When Do You Use Locking Plates?
Thomas F. Higgins, MD

Question 49

Which Fractures Require Anatomic Reduction?
Medardo Marota, MD and Walter W. Virkus, MD


"This format is refreshing and allows residents, fellows, and orthopedic surgeons the same access to the experts as they would get when walking rounds or in the hallway of a major meeting. This book is a comfortable efficient read that addresses common questions and current state of the art. Each case is presented in an easy to read conversational manner that makes getting through the entire 200 pages easy and pleasurable. This volume on fracture management is wonderful addition to the series. This format is a refreshing way to learn and keep up with the most current concepts and approaches to problems as guided by leading experts in the field. It’s a great new way to feel like you just walked on rounds with your mentor and had the privilege of getting an expert opinion about 49 issues in fracture care."

— Mark R. Hutchinson, MD, University of Illinois at Chicago College of Medicine, Doody Enterprises, Inc.

Walter W. Virkus, MD is an Associate Professor of Orthopaedic Surgery at Rush University Medical Center in Chicago, IL. His practice focuses on orthopedic trauma and orthopedic oncology. He did his residency at the University of Maryland, and trauma fellowships at Shock Trauma in Baltimore, MD and the Hospital for Special Surgery in New York, NY. He then did an oncology fellowship at the University of Florida.

Dr. Virkus is active in research with a special interest in applying trauma techniques to limb preservation in oncology patients. He is very active in resident education and serves as the Associate Program Director for the Rush Orthopaedic Residency.

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