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Re: Перелом "около пластинки"
James Carr 05 Январь 2004, 15:28
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A good summary by Tom. Technically, the retrograde is much easier, and allows for exact reduction of the condyles by visualization. It also obtains fixation through the entry tunnel if the nail engages it. I have experienced cases of arthrofibrosis, and patellar ligament scarring though, so it is a trade off to be sure. Interestingly, as Alex points out, antegrade nails often have screw holes closer to the end of the nail. Jim Carr
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Re: Перелом "около пластинки"
Alexander Chelnokov 05 Январь 2004, 23:16
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JC> easier, and allows for exact reduction of the condyles by
JC> visualization.
Do you mean arthroscopiс control or incision for the nail is large enough to view/control the condyles? Can you pls describe the technique?
JC> It also obtains fixation through the entry tunnel
JC> if the nail engages it.
Didn't get the idea - could you pls explain?
JC> antegrade nails often have screw holes closer to the end of the nail.
So maybe it takes some re-design of the end of the nail to adopt features of distal/retrograde nails?
BTW can somebody point a source where definitions can be found whar first, second etc generations nails are. THX in advance.
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Re: Перелом "около пластинки"
Отправитель: James Carr 06 Январь 2004, 11:28
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Since the retrograde nail can be placed by arthrotomy, direct visualization of the fracture is made. No arthroscope is needed. Secondly, the retrograde nail is placed through a drill hole in the notch- an area that has good subchondral bone. This creates a snug fitting tunnel in which the end of the nail can be left, thus providing some fixation. Hope that helps. I am not aware of a source to define the various generations of nails. Jim
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