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Re: Подвертельный перелом
Tom DeCoster 07 Июнь 2004, 16:56
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Alex
"subtotal resection of the femur for osteosarcoma" How much femur was removed or left? It's hard to tell from the radiographs.
Is the intramedullary device seen on the AP radiograph of the hip a component of the total knee replacement or something else?
What is the tumor status/prognosis?
A cable plate could provide stabilization of the remaining fractured proximal femur. Fixed angle device proximally (blade, screw or locking plate) with distal fixation of the plate to the bone/bone replacement prosthesis by means of cables. If there is bone in the subtrochanteric region (hard to see on the radiographs) then unicortical screws might also be possible. Of course, remove the wires in the femoral neck and head.
It won't "solve" all of his future problems but might get you through this episode.
Amputation is also a reasonable option.
TD
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Re: Подвертельный перелом
Alexander Chelnokov 07 Июнь 2004, 20:39
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TAC> "subtotal resection of the femur for osteosarcoma" How much femur was
TAC> removed or left? It's hard to tell from the radiographs.
I'll request more informative views. But at the presented view of the
proximal femur the bone end can be seen - just below the "collar".
TAC> Is the intramedullary device seen on the AP radiograph of the hip a component
TAC> of the total knee replacement or something else?
Yes, it is a long stem onco implant.
TAC> What is the tumor status/prognosis?
I missed the date of the initial surgery - 1993, so resection was
radical enough and as i realize there is no sign of tumor progression
to date.
TAC> A cable plate could provide stabilization of the remaining
TAC> fractured proximal femur. Fixed angle device proximally (blade,
Can it be fixed to the stem?
TAC> Amputation is also a reasonable option.
As i realize they want to avoid it by any means.
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Re: Подвертельный перелом
Отправитель: Tom DeCoster 07 Июнь 2004, 21:01
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The cables could also be wrapped around allograft cortical struts.
TD
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Re: Подвертельный перелом
Отправитель: Tom DeCoster 07 Июнь 2004, 21:25
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The cables could be wrapped around the stem of the prosthetic.
TD
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