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Re: вывих головки эндопротеза
Nikolaj Wolfson 13 Июль 2004, 12:15
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Privet Alexander:
My comments:
1. AP X ray of the Pelvis is a must. It will likely show that right hip/ femur is longer than left. Even based on Rt Hip AP X Ray it is my impression.
2. 2. Acetabular component is not vertical but rather anteverted, and also small ( small size was likely used because of the deficient posterior wall of the acetabulum).
3. Femoral component is malaligned relatively to the acetabular and combination of this factors (head is also small for this patient) is the reason for dislocation.( was likely anterior)
My suggestions:
1. Revise acetabular component: appropriate version, larger cap (this will give also more poly thickness for 50 year old patient, unless you have ceramic cap and head). (Have structural allograft available for the posterior wall deficiency).
2. You may have to revise femoral component, or at list use a head, which will allow you to bring the leg to the appropriate length.
3. Use larger head (32-36), this will provide additional stability. If you find intraoperativly , after replacing acetabular side with a larger size, that the leg is lengthened, this will force you to revise the femoral component anyway.
4. Good luck and let us know how did it go.
Nikolaj Wolfson
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