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Re: Огнестрельный перелом луча
Dr. T. I. George 19 Март 2004, 19:55
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Alex,
I have not been following this discussion in detail. However would like to give a comment on your statement.
AC : If the the stable aligned radius can be reached without excessive incision and open mobilization why neglect the option?
Having put the patient on ring fixator, the intervention required for nerve exploration, repair and grafting are delayed till the fixators are removed.
This is bound to affect the end result of nerve repair/ grafting. If an open procedure like plating was resorted to, then nerve intervention also could have been taken up simultaneosly and total recovery period could have been shorter with probably a better end result.
Dr. T. I. George.
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Re: Огнестрельный перелом луча
Alexander Chelnokov 19 Март 2004, 20:07
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t> Having put the patient on ring fixator, the intervention required for nerve
t> exploration, repair and grafting are delayed till the fixators are removed.
Exactly.
t> This is bound to affect the end result of nerve repair/ grafting.
Do you suppose the end result would be markedly affected if the fixator was applied in 5.5 months since the initial injury, and is to be removed within 2-3 weeks, in 6 months?
t> nerve intervention also could have been taken up simultaneosly and
t> total recovery period could have been shorter with probably a
t> better end result.
I would expect a better result if nerve/vessel repair would be
performed by a skilled team which is not available in my settings.
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Re: Огнестрельный перелом луча
Отправитель: Dr. T. I. George 20 Март 2004, 10:41
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Dear Alex,
If the fixator is going to come out in 2-3 weeks time, then it should not make a difference. If you are planning to internally stabilise at this time, then are you sure that the nail will be sufficient for the subsequent procedure?
I agree that it makes a difference to get an experienced person to do the nerve and vascular repair. If your centre has sufficient trauma load it may be worth to send someone for this training and he/she will be an asset to the team and centre.
Dr. T. I. George
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