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Re: post-nailing fracture
Wojciech Glinkowski 18 Январь 2008, 01:37
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Dear all,
Interesting discussion, Thx.
Play with osteoporotic bone is always the challenge.
Images sent by Professor Kanlic look nice, very good job. Excellent achorage in distal fragment. However, unicortical screwing or bicortical
makes a difference, also for locked screws. Proximal fragment unicortical fixation may present stability not easlily predictable. Certainly its stability for wheelchair should be sufficient. Full weight bearing can not be mentioned for this case. If minimal bearing is allowed full weight
single step may happen in elderly.
Gamma nail exchange may probably fit the criteria of optimal and minimal invasivness, indeed. Removal could be relatively fast due to large intramedullary diameter seen on X-ray.
I do agree that distal locking of the nail in distal femur remains critical.
Best regards
Wojciech Glinkowski
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