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Re: Wrist problem
Виктор П. Волошин 07 Декабрь 2004, 00:58
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No objections
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Re: Wrist problem
Alexander Chelnokov 07 Декабрь 2004, 01:14
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VMI> in between which may be good enough. Continue ExFix till it is
VMI> solid.
I would use a small wire fixator (Ilizarov) but in general approach would be the same.
VMI> 2) If we find that no bone is forming by 2 weeks, we can
VMI> distract a bit faster Once the DRUJ is aligned and there is gap
VMI> left, we can put in a small piece of fibula
Why fibula? Iliac crest graft is also suitable.
VMI> plate can be used to fix the radius along with the graft. This
Exactly.
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Re: Wrist problem
George Tomas 07 Декабрь 2004, 19:51
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Is it possible to see an xray of the entire forearm including the elbow?
Regards,
George Tomas
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Re: Wrist problem
Отправитель: V. M. Iyer 07 Декабрь 2004, 21:25
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Dr George,
The image has been cropped and so it is not possible. The forearm and the elbow do not show anything abnormal,
Regards
V M Iyer
. Iyer Orthopaedic Centre,
103,Railway lines Solapur India
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Re: Wrist problem
David Nelson 08 Декабрь 2004, 09:50
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I think that your suggestion is reasonable. I doubt an acute correction will gain anatomic length of the radius. I would be inclined to plate and bone graft once length is attained.
David Nelson, MD
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Re: Wrist problem
John D. Douthit 08 Декабрь 2004, 16:33
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May not be able to get full length of radius but a good plan. End game may be to shorten ulna , plate and bone graft radius. Keep us posted from time to
time
John D. Douthit M.D. Denver CO
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Re: Wrist problem
Andrey 09 Декабрь 2004, 02:15
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I don`t think, that you will get the good result using ex-fix in this case.
The best way, IMHO, is to make open reducing of
radius fragments with filling the bone`s defect by cancell. bone graft, fixing it by T-plate, and with shortening of ulna.Radioulnar joint must be fixed by screw.
Kind regards, Andrey.
PS: 2 years ago I had the same case, and I`ve got a good result.
PPS: At first I tried to treat it by ex-fix without any result.
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Re: Wrist problem
Отправитель: alexandre sitnik 09 Декабрь 2004, 21:50
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I think that the plan is good. But there is no reason to wait for spontaneous healing after distraction. Probably the best way is just to distract radius with FiEx (1 mm/day) and then to fill defect with bone graft (tricortical from iliac crest) and plate radius. I had a case like this (patient is dentist) with good result.
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Wrist problem
