ВХОД ДЛЯ ПАЦИЕНТОВ
вверх
поиск
админ
главная
исходное
|
Re: The patient with non-union of the distal femur
послал Mangal Parihar 08 Май 2007, 00:27
|
Interesting...
We've used the ilizarov method and fixator, to gain union in nonunions such as these, which were either caused by conservative (plaster) treatment or by some means of internal fixation.
If you have seen the earlier xrays - do you have an idea or opinion, why the previous two interventions failed?
With the distal fragment being intact, and fairly large. I would venture to use some form of 95 degree implant either a DCS or 95 degree angled blade plate.
The problem I would anticipate are - inability to gain a reduction due to the shortening which has been present for a long time. I would try with a femoral distractor to gain as much length as possible.
Also, I would try to make the fracture configuration more stable from the oblique fracture lines that exist now. This would be probably by excising parts of the ends to make the ends a little more transverse, or trying to dock the distal end into the proximal.
The other option is one of alexander's favorites - use the ilzarov fixator as a distractor to gain length over a few days, and then change to some form of internal fixation (I havent had the courage to try that as yet, due to the fear of infection)
Mangal Parihar
Orthopedic surgeon,
Mumbai, India
|
Послать ответ |
Обратите внимание: Поля с жирными названиями обязательны.
Старайтесь отвечать в рамках обсуждаемой темы, а не начинать новые обсуждения.
Указывайте адекватную тему сообщения, чтобы было ясно, о чем оно.
Не послайте сообщений не по теме (оффтопик), раздраженных, грубых или обидных комментариев. Здесь это неуместно.
|