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Re: Еще несращение distal tibia
послал Mangal Parihar 14 Апрель 2005, 22:43
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Alex,
That must have been one hell of a dog.......! :-)
I would consider gradual correction by distraction, and when the fragments are well aligned, compress the fracture.
There are two fractures of the fibula. One the obvious one, and the second just above the syndesmosis. I would try to have a wire transfixing the lower tibial and fibular fragments.
(As you well know) The exfix would allow me to continue "adding" compression to the fracture site as needed, which I think is quite likely.
I know that you are a big fan of this combination (fixator for deformity correction followed by nailing) - in your experience, do most of your cases heal uneventfully after the nailing or is there a significant requirement for things like dynamisation or bone grafting.....
Also, how many other cases have you done with a long duration of nonunion (2 years as in this case)
Mangal
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