Hello Jeff,
Thursday, April 14, 2005, 7:58:25 AM, you wrote:
JR> Why the need for the Ilizarov if the nonunion is mobile?
Аs you can see it still doesn't allow alignement. So acute correction
will result with equinus. Scars also don't like acute goffer.
JR> I would correct the deformity acutely with a fibular osteotomy if
JR> necessary to correct the alignment and proceed with reamed IM
JR> nailing if there are no signs or history of infection.
My plan is very close to this except staged nailing after 10-15 days
of gradual correction with axial alignment and maybe lengthening.
Closed distraction can provide improvement of local blood supply.
JR> Minimum of 2 and preferably 3 distal locks, and put in a big
JR> enough nail to get a good isthmal fit.
I am with you.
JR> I reported a series of similar cases with an excellent success rate.
JR> Richmond J, Colleran K, Borens O, Kloen P, Helfet DL.
JR> Nonunions of the distal tibia treated by reamed intramedullary nailing.
I'd be happy to have a reprint of the article. THX in advance.
|
