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Re: сложный перелом правого бедра
послал V.M.Iyer 14 Август 2007, 23:50
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Dr Romchuk,
We need to make a diagnosis of the lesion and also treat the fracture. If I had not noticed the luscent lesion, I would have straightaway treated him with a long PFNail.
Having noticed that lesion will not change my decision. Only that when my centering awl goes into the shaft thro the trochanter, I will be careful to save the material it comes out with and send it for histopathology. I would also do a
skeletal survey before the surgery to see any other lesion.
I had a similar case only 2 weeks ago - simple transverse fracture, not comminuted like yours. When we saw the post
operative film, we noticed the luscent lesion at the fracture site. This was a 16 yr old boy, so the most likely diagnosis
is SBC and the tretment has been done. In your case metastasis has to be excluded and the lesion has been noticed
preoperatively
Cheers!
--
Prof V M Iyer, Consultant Iyer Orthopaedic Centre
Retd HOD orthopaedic surgery. Govt medical college. Solapur. India.
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