Discusión entre pares / 24yrs/male presented with compound type 2 communited supracondylar fracture with intercondylar chunk with lateral hoffas + segmental distal 1/4th fracture femur ...

Indian-Orthopaedic Research-Group

Rahul B Tanga

24yrs/male presented with compound type 2 communited supracondylar fracture with intercondylar chunk with lateral hoffas + segmental distal 1/4th fracture femur and patient was B negative blood group with HB% 7.2gm%.patient was transfused 2 units of whole blood and was taken after 2 days of trauma. 2 units of whole blood and 2 units of packed cells was reserved for surgery.orif with 6.5mm cc screw + 4 mm cc screw fixation for lateral hoffas + 10 holed distal femur LCP + intercondylar chunk was fixed with k wire + primary BG .patient was operated under tourniquet and was transfused 2 units of blood intra op and two units post op.

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  Rahul B Tanga Critical comments?

  1 hora · Me gusta
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  Trimbak Patel Buttressing the posterior spike of hoppas fragment with washer & cc screw would have added more stability. The plate does not appear to locking, would have added to the rigidity. Job good doned.

  1 hora · Me gusta · 3
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  Anil Sood How much of trauma dear

  1 hora · Me gusta · 1
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  Praganesh KV Hoffa left unreduced... should have been fixed with priority..

  1 hora · Me gusta · 2
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  Anoop R. Nair Yes ..Hoffa needs to be tackled other wise A+

  59 min · Me gusta · 1
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  Ajeet Dhakar such fractures appear difficult on xray.. even more difficult to operate. well done

  58 min · Me gusta · 2
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  Praganesh KV when you are opening this fracture with such vast dissection, fixation of hoffa shouldnt be a problem... this will go in nonunion and result in stiff knee also... just giving critical comment.. not criticizing your job dr rahul..

  56 min · Editado · Me gusta · 2
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  John Rabadi Very Good

  54 min · Me gusta · 1
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  Arabind Shah Difficult case managed well.

  52 min · Me gusta · 1
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  M Bukhsh Shahwani Well done

  45 min · Me gusta · 1
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  Shriniwas Sandikar Good.

  42 min · Me gusta · 1
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  Anuj Agrawal There is a huge intra-articular step at the Hoffa's fracture. The anteroposterior screw intended to fix it has failed to engage it, and the screw head should have been countersunk, being placed in the trochlea. I am sorry to say, but both the reduction and fixation are not acceptable in this case.

  37 min · Me gusta · 3
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  Ashutosh Chaudhari Anuj don't u think that the X-ray is oblique not true lat , the countersinking yes but a really bad frac , my only question is why the kwire

  34 min · Me gusta · 1
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  Anuj Agrawal The view looks fine to me. A step visible in any view, is a step.
  Yes, the fracture was difficult, but not by the standards of Rahul. This reduction is not Rahulesque.

  27 min · Me gusta · 1
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  Rahul B Tanga Thanks everyone for your valuable inputs.hoffas reduction was checked under c arm and was satisfactory even in oblique views.anteriorly too much of communition so thin plate of bone was available to place hoffas screw and was scared to over drill to avoid splintering.as lot of BG is been stuffed posteriorly so it's appears to be unreduced. I will still would take oblique views and confirm hoffas reduction and if not satisfactory then will plan accordingly.as ashutosh has pointed out its not true lateral view.ashutosh k wire is holding intercondylar chunk of bone as it was unable to pass even 4 mm cc screw.trust me guys it was nightmare case for me on table due to fracture fro file and patient was B negative and had to finish within tourniquet time. I could count number of fragments on table.hope I will improve in my next case.thanks

  23 min · Me gusta · 1
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  Jignesh Patel Excellent skills...........

  20 min · Me gusta · 1
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  Rahul B Tanga I agree with you anuj step in any view is step. Will get oblique views and reassess and if required will revise hoffas.

  19 min · Me gusta · 1
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  Eslam Khalaf great effort, but it was 4 illezaroff

  17 min · Me gusta
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  Rahul B Tanga Anuj thanks for compliments.

  15 min · Me gusta · 1
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  Prafull Meherishi Was it externally compound....?post op infection

  12 min · Me gusta
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  Prafull Meherishi Did u use distractor to achieve perop reduction

  10 min · Me gusta

Implants was made of "German Silver"

 Implants was made of "German Silver"

 

 

una publicación de Orthopaedic Cases Discussion.

CMS updates Pennsylvania licensure rules

http://www.healio.com/orthotics-prosthetics

BREAKING NEWS
	CMS updates Pennsylvania licensure rules CMS has notified the Pennsylvania Orthotic and Prosthetic Society on the updated status of Medicare requirements for orthotic, prosthetic and pedorthic providers in licensing states. Read more
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http://www.biomedcentral.com/1471-2474/15/189#abs

Research article

Improved lag screw positioning in the treatment of proximal femur fractures using a novel computer assisted surgery method: a cadaveric study

 Mejora de posicionamiento tornillo de tracción en el tratamiento de las fracturas de fémur proximal utilizando un nuevo método de cirugía asistida por ordenador: un estudio de cadáver

Matthias Regling^1*, Arno Blau², Robert A Probe³, James W Maxey⁴ and Brian D Solberg⁵

• *Corresponding author: Matthias Regling matthias.regling@stryker.com

Author Affiliations

¹Stryker Trauma GmbH, Schoenkirchen, Germany

²Stryker Leibinger GmbH & Co. KG, Freiburg, Germany

³Department of Orthopaedics, Scott & White Memorial Hospital, Temple, TX, USA

⁴University of Illinois College of Medicine, Peoria, IL, USA

⁵Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA

For all author emails, please log on.

BMC Musculoskeletal Disorders 2014, 15:189  doi:10.1186/1471-2474-15-189

The electronic version of this article is the complete one and can be found online at:http://www.biomedcentral.com/1471-2474/15/189

Received:	1 November 2013
Accepted:	14 May 2014
Published:	30 May 2014

© 2014 Regling et al.; licensee BioMed Central Ltd. 

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

Background

The importance of the tip-apex distance (TAD) to predict the cut-out risk of fixed angle hip implants has been widely discussed in the scientific literature. Intra-operative determination of TAD is difficult and can be hampered by image quality, body habitus, and image projection. The purpose of this paper is to evaluate, through a cadaveric study, a novel computer assisted surgery system (ADAPT), which is intended for intraoperative optimisation of lag screw positioning during antegrade femoral nailing. A 3D measure for optimal lag screw position, the tip-to-head-surface distance (TSD), is introduced.

La importancia de la distancia de la punta del ápice (TAD) para predecir el riesgo de desconexión de los implantes de cadera ángulo fijo ha sido ampliamente discutido en la literatura científica. Determinación intraoperatoria de TAD es difícil y puede verse obstaculizada por la calidad de imagen, hábito corporal, y la proyección de imagen. El propósito de este trabajo es evaluar, a través de un estudio de cadáver, un nuevo sistema de cirugía asistida por ordenador (ADAPT), que está diseñado para la optimización del posicionamiento intraoperatorio tornillo de tracción durante el enclavado femoral anterógrado. Una medida para la posición 3D tirafondo óptima, la distancia de punta a la cabeza en la superficie (TSD), se introduce.

¿Que es una osteosintesis con tornillo de esponjosa?

¿Que es una osteosintesis con tornillo de esponjosa?

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  Osteosíntesis es la reconstrucción ósea tras una fractura. El tornillo de esponjosa es un tipo de tornillo que llega hasta la médula esponjosa del hueso y tiene la particularidad de tener un espiral más grande en el extremo. A fines prácticos, parece uno de esos tornillos tirafondos que se usan en las paredes de yeso.

Glucosamina, el compuesto que nos hará vivir más

 http://www.abc.es/salud/noticias/20140408/abci-glucosamida-longevidad-201404081322.html
una publicación de Victor Ravens.