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Re: Неудачный остеосинтез голени гвоздем
William T Obremskey 20 Декабрь 2003, 13:04
The temporary ex fix is a good idea. I have used it for shaft fxs when an assistant is not available. I think it would be more difficult to control the proximal fragment intra and post op w/ a temporary fixator of any kind w/ these proximal fxs. Surgeons in North America are also in general less familiar w/ thin wire fixators.
Healing has not been a problem in these proximal metaphyseal fxs and dynamization not necessary. Dynamization could also be done in the segmental shaft component if needed.

Bill
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    Re: Неудачный остеосинтез голени гвоздем
    Alexander Chelnokov 23 Декабрь 2003, 00:18
    OWT> The temporary ex fix is a good idea. I have used it for
    OWT> shaft fxs when an assistant is not available.

    Yes, sterile team can include only a surgeon and a nurse.

    OWT> I think it would be more difficult to control the proximal
    OWT> fragment intra and post op w/ a temporary fixator of any kind w/
    OWT> these proximal fxs.

    I mean ex fix only intraoperatively, post op alignment is kept by the nail and locking screws. A poller screw(s) can be also added after nail insertion prior fixator removal if any doubts.

    OWT> Surgeons in North America are also in general less familiar w/
    OWT> thin wire fixators.

    :-) I think it was so 10-15 years ago because to date there is a lot of highest quality papers on the topic from North America.

    OWT> metaphyseal fxs and dynamization not necessary. Dynamization
    OWT> could also be done in the segmental shaft component if needed.

    The plate still remains a splint preventing axial compression. Of course i don't have any proves that this is crucial in the particular сircumstances.
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