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Re: Lost 1/2 of femur
Gobinder Singh 23 Август 2008, 19:40
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Dear Magdy,
Sounds ideal for an Ilizarov transport system.
Gobinder Singh
Kuala Lumpur
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Re: Lost 1/2 of femur
george therthanath 23 Август 2008, 22:26
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If technical expertise is available, microvascular fibular transfer wound be a much shorter and sweeter answer for this problem than and Ilizarov method of treatment.
Dr. T. I. George.
(Dr George T Ittoop,)
Sr Specialist, Orthopaedics,
Ibra Regional Hospital,
PO Box no: 3,
Postal code 413.
North Sharquia Region,
Sultanate of Oman.
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Re: Lost 1/2 of femur
Отправитель: Sereda Andrey 29 Август 2008, 23:22
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Yes of course. But, dont you think that fibular graft is too thick for femur? Or you mean double free fibula? Thanks.
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Re: Lost 1/2 of femur
Отправитель: Sereda Andrey 29 Август 2008, 23:24
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Sorry/ I had to write "too thin"
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Re: Lost 1/2 of femur
lokesh chowdari 23 Август 2008, 22:27
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dear MAGDY we have treated exactly similar case intially with debridement & ILIZAROV ring fixator by end of three months patient had exuberent callus along whole length of left out periosteal sleeve &fixator was removed walking spica was applied, unfortunately after one month in spica he developed break in the bridging bone and now we have treated him with locking plate &bone graft one month back and on CPM machine with knee movement of 90 deg.
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Re: Lost 1/2 of femur
Dr. A. Liberson 24 Август 2008, 09:05
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In My hands-Ilizarov will be the best, Soft tissue state is important
AL
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Re: Lost 1/2 of femur
Ivan Petrov 25 Август 2008, 15:46
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There are 3 main options:
1 Ilizarov bone transport
2 Vascular fibular graft+plating
3 Diaphyseal endoprosthesis - see photo (dangerous in soft tissue loss and infection)
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Re: Lost 1/2 of femur
Mangal Parihar 26 Август 2008, 09:48
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Magdy,
Similar case.
They do well with bone transport.
I do an acute or accelerated shortening to reduce the gap as much as proximal, and distract proximally to restore length.
In this particular case, notice the change of fixator - orthofix type of unilateral fixator worked well initially but did not allow me to compress beyond a point, which is when I changed to an ilizarov for further compression at the gap/nonunion site.
Mangal Parihar
Orthopedic surgeon, mumbai
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Re: Lost 1/2 of femur
DR C CHERIAN KOVOOR 30 Август 2008, 15:30
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George
I have done both for this problem and I feel Ilizarov bone trnapsort is the
best[ probably only ]answer. Vasc fib graft in the femur especially in this
regeon has a problem ie; inadequate fixation distal fragment and long period
to hypertrophy.
With Ilizarov you need a mid shaft corticotomy and trnasport. The frame
needs to extended down to the tibia with hinges across the knee
DR C CHERIAN KOVOOR
KOCHI
INDIA
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Lost 1/2 of femur
