[Ortho] протез или синтез?

[Dan Schlatterer]

Hello,
I had a similar situation about a year ago except my patient was in his late 40s early 50s. He had long delays because of cardiac issues. Anyhow, I made a 2 cm incision anteriorly to assist with reduction and then percutaneous pinned with numerous threaded guide wires from the DHS set. Fracture healed with heterotopic bone no less. His issue was range of motion but it improved. Very lucky for us.

Your pt is younger and would hold pins just as well. I realize it is multipart and my case was unique. But, no bridges burned by small incision ORPP. A full open reduction, big dissection procedure runs the risk of ensuring AVN. I opted for a minimal soft tissue insult in my case. Maybe something else contributed to the good outcome. But given the young age of your patient I would lean towards pinning.

There is a video somewhere on the internet demonstrating pinning 4 part fxs. It may be on Vumedi.com.

Best of luck.

Dan