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Re: Еще несращение distal tibia
Mangal Parihar 15 Апрель 2005, 21:35
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Alex,
From your reply I get the idea that the procedure you are suggesting is actually similar to lenghtening over a nail, where the nail is used to protect the regenerate, and shorten the fixator time.
i.e. you use the fixator to do a gradual distraction and stimulate regenerate, followed by nailing to protect the regenerate; rather than fixator to achieve closed reduction and nailing to achieve fixation and union
It may sound like nit-picking but I suspect that it could have a bearing on outcome.
Is that right or am I misunderstanding it
Mangal Parihar
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Re: Еще несращение distal tibia
Alexander Chelnokov 15 Апрель 2005, 21:37
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DMP> From your reply I get the idea that the procedure you are suggesting is
DMP> actually similar to lenghtening over a nail, where the nail is used to
DMP> protect the regenerate, and shorten the fixator time.
Yes, though i wouldn't call it similar to lengthening over nail (LON).
Lengthening then nail (LTN) is much more convenient and comprehensive.
DMP> i.e. you use the fixator to do a gradual distraction and stimulate
DMP> regenerate, followed by nailing to protect the regenerate;
Exactly. And dynamize the nail if necessary.
DMP> rather than fixator to achieve closed reduction and nailing to
DMP> achieve fixation and union
This appoach we use for acute fractures and in acute angular corrections after perQ osteotomy, where even in case of ex-fix as definitive fixation we would prefer acute correction rather than open wedge regenerate.
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Re: Еще несращение distal tibia
Отправитель: Mangal Parihar 15 Апрель 2005, 22:35
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DMP> i.e. you use the fixator to do a gradual distraction and stimulate
DMP> regenerate, followed by nailing to protect the regenerate;
AC>Exactly. And dynamize the nail if necessary.
That's an interesting approach...
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