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Re: Огнестрельный перелом луча
Alexander Chelnokov 17 Март 2004, 12:28
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de> Why not an AO small DCP and a cancellous bone graft.
Is open plating+grafting any better than closed nailing?
de> BTW the hand looks rather good for a median n injury, good
de> looking thenar muscles !! What is the neyurologic deficit in the
de> hand?
Total lack of sensitivity.
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Re: Огнестрельный перелом луча
Отправитель: Abdelsalam Eid 17 Март 2004, 13:03
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We have no experience with interocking nails of the forearm and it is my belief that their role is still evolving. As for other forms of closed nailing, it would be in theform of a flexible intramedullary rod; e.g. Rush pin, which would offer little bending and torsional stiffness. A cast would be necessary to help augment this fixation. On the other hand, plates in forearm bones are a more or less standard policy in many centres. A well fixed plate with interfragmentary compression would offer what the AO call absolute stability. Bone grafting will hasten the healing process and overcome the disturbance of vascularity due to the inevitable soft tissue stripping. The stability provided by the plate will be desirable for the proposed nerve reconstruction. And finally, if you have rigid fixation, you do not need a cast which offers better wound care and less patient discomfort.
You mentioned complete loss of sensation. You mean ulnar distribution as well? And are the intrinsic muscles unaffected? Please tell us more about the proposed nerve reconstruction?
Good luck and thanks.
Abdelsalam Eid, MCh(Ortho)(Zagazig), AFSA(Ortho)(Paris V)
Assistant Lecturer
Zagazig University
Egypt
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