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Re: Перелом предплечья
Marco Berlusconi 31 Август 2005, 08:42
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I've some questions because we have really no experience with nailing the forearm, but I think that in this case it could be a very safe option especially for the radial side.
I've learned from the AO principles that forearm fractures are like articular fractures so the reduction should be anatomic and the fixation stable. In this case the problem for a plate fixation is the radial nerve proximally but if soft tissues could be considered good there's no reason not to use a double plate. The postop xray is very nice but can we accept this reduction and this fixation as anatomical and stable? Can he move immediately the elbow and the wrist? The distal entry point is at the Lister site? which will be the result? Are they easy to remove?
I'd like to know if is there a guided device to lock the nails and the company that delivers those nails
Thanks
Marco Berlusconi
Traum Unit
Humanitas Institute
Milan Italy
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Re: Перелом предплечья
Alexander Chelnokov 01 Сентябрь 2005, 10:47
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mb> I've learned from the AO principles that forearm fractures are like
mb> articular fractures
Sounds like a dogmatic statement with religious rationale. Any shaft fractures definitely are not like articular ones.
mb> can we accept this reduction and this fixation as anatomical and stable?
Axis, length, radial bowing and rotation are restored. Stability is relative as in any nailing, but enough for early function.
mb> Can he move immediately the elbow and the wrist?
Sure. Though this particular patient in not very compliant
(alcoholic), and left the unit 3 days after the surgery.
mb> The distal entry point is at the Lister site?
Close to.
mb> which will be the result?
In our previus experience with non locking forearm nails usually resilts are pretty fine. Functional recovery is likely to 4 weeks.
mb> Are they easy to remove?
No experience. Since the nails have threaded canal at the end, so sliding hammer can be connected. Though i don't expect removal will be strongly needed - why touch asymptomatic implants?
mb> I'd like to know if is there a guided device to lock the nails
Yes. I attached such image with that message. See one more with the jig.
mb> and the company that delivers those nails
Nails produced by ChM (Poland) were used in this case. There are some more available on the market - Foresight (Smith & Nephew), SST (Biomet).
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