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Re: LISS?
послал Enes M. Kanlic 13 Ноябрь 2004, 19:43
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Dear colleagues,
1. Percutaneous nailing is truly minimally invasive technique, but, unfortunately, nails are not reliable in many hands.
Attached are few examples from our Hospital:
A. Difficult reductions, even in retrograde nailing (my preference, easier control of "small" distal fragment) and it is much, much harder to do it anterograde (Alex, do you have one good case in your collection of anterograde nailing in very distal fractures - as you have suggested that I
should have done it in my previously posted case?
Malpositioning is much too common (recurvatum, varus - valgus).
B. Fixation loosening: distal cutting of the nail, non-unions do happen (cases attached).
Locking Plating has more distal screws than any nail, fixed angles and provides much better fixation, especially in osteoporotic bone.
Dr. Melamed: Principles for LISS and LCP are the same, again - LISS has outrigger helping for more percutaneous technique.
Sincerely,
Enes M. Kanlic,
MD, MS, PhD, FACS
Associate Professor
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