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ВХОД ДЛЯ ПАЦИЕНТОВ вверх поиск админ главная
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Came to me in May 2004 with some pain at the # site. That time though clinically the fracture seemed sticky, the xrays did not show any callus. I had advised exchange nailing with a bigger nail. He went away and got bone grafting done with the implants in situ in June 2004. The weight bearing was started immediately. Check Xray taken in Aug 04 showed the distal screw broken as well as the nail just beyond the 2nd proximal screw. He was advised to continue wt bearing and wait and watch. He once again came to me 3 days ago because of pain at the # site and a feeling of movement at the #site. Clinically the fracture seems united with no pain on movem,ents. The xrays taken now are being enclosed. The AP view shows the # line still visible, though the callus is seen in between and the lateral view shows continuity. The nail break is obvious now. What do we do now? 1) Wait and watch and let the implants remain. 2) Do an exchange nailing with a thicker nail. Kindly note. a) the nail is going towards the medial aspect of the lower end thus causing a 5* varus at the # site. b) there is a slight overiding causing a centimeter of shortening.c) Implant removal may not be easy with the distal screw broken and the nail broken too. Regards V M Iyer . Iyer Orthopaedic Centre, 103,Railway lines Solapur India.413001.
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