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Re: Arthrodesis?
послал Mangal Parihar 22 Сентябрь 2004, 21:16
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The situation at the ankle is now like a stiff non-union.
The cartilages destroyed by the infection, there is only bone proximal (tibia) and bone distal (talus)
Putting this under distraction would very likely lead to a consolidation of the 'gap' created with bone.
This supports Alex's proposal for closed distraction.
In one of my cases, with a non-union of the distal tibia, and a stiff ankle with equinus, as part of the treatment, I distracted the ankle, with the hope of 'loosening' up the ankle, and correcting the equinus,
To my surprise, this distracted area made bone, effectively converting a painful, stiff, fibrous ankle into a solidly fused, painless ankle.
Pic attached - the transarticular K wire/steinman pin was put in by the previous surgeon, to stabilise what was apparently a very unstable
ankle.
I don't have his pre-distraction pics, but take my word for it, the ankle space was seen, though hazy, and the patient had pain on attempted movts of the ankle.
Mangal Parihar
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