вверх  отправить  поиск  админ  главная  Предыдущее	Re: Дефект-псевдоартрз бедра Mehmet Kocaoglu 11 Сентябрь 2006, 22:20 According the pictures of the patients the cause of the recurrence of the infection is nonradical debridement of the bone. I recommend her three stage operation. 1st stage: I believe she needs a radical debridement which it consists wide resection of infected, dead bone until you will see ' paprika sign ' at the live bone end. At the same session you can put antibiotic rod and also antibiotic beads. 2nd session: In six weeks after a full recovery of the infection either clinically and also blood tests (cRP etc.) you can put a retrograde IM nail. With this long nail you can bone transport and also lengthen of the shortened thigh. 3rd session: Bone grafting of the docking site and interlocking of the IM nail	Сообщения о Ортопедия и травматология Также Mehmet Kocaoglu Связаться с автором
	Ответить Re: Дефект-псевдоартрз бедра Alexaander Chelnokov 11 Сентябрь 2006, 23:25 > wide resection of infected, dead bone until you will see ' paprika > sign ' at the live bone end. At the moment it is very difficult to estimate the resulting defect. From the other hand, we have two year period of tissue recovery - blood supply was restored everywhere at least partially. Distraction and tension stress can lead to further improvement of vascularization. So the approach with segmental resection should be reserved to a case of active infection. > At the same session you can put antibiotic rod and also antibiotic > beads. There already have been no signs of infection for 2 year period - why use local antibiotics now? > either clinically and also blood tests (cRP etc.) you can put a > retrograde IM nail. Retrograde nailing is problematic in case of knee stiffness in extension. Why not antegrade? > With this long nail you can bone transport and also lengthen of > the shortened thigh. 3rd session: Bone grafting of the docking site > and interlocking of the IM nail A viable scenario of course. Though bone transport and lengthening procedures can be performed without a nail inside. And the nail can be inserted when all the manipulations are completed. It allows not to be limited with only longitudianl traction-comression. "Lenthening then nail" allows to use a nail of proper length and diameter. It is interesting, when reaming and nail insertion have more positive influence - before or after distraction? [ Ответить ] ( Ответить )

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