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Re: Перелом бедра выше пластинки
послал Ajit Phadke 11 Март 2002, 01:00
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Till now in 16 years i have treated 3 cases of fractures beginning at the lower end of a DHS/Jewett nail, but all these were young patients. Older patients usually reduce their activity levels after a fracture neck femur,
especially in India, and so probably do not get fractures at the end of plates(this is only my opinion). Funnily enough, I have also treated five fractures beginning at the upper end of condylar plates and two at the proximal ends of radial plates but none in the humerus.
As literature and the general view of other orthopaedic surgeons around favours removal of implants, I always advise patients to get their plates removed SOON after fracture healing, more so because trying to remove plates after three- four years is always difficult and often impossible. I have had the misfortune of fracturing a patients ulna while trying to remove a plate put in four years earlier. Luckily for me the fracture healed in a cast.
I am not so convinced about removing Intramedullary nails as these rarely cause any problems.
Dr. Ajit Phadke
Consultant
Phadke Hospital
Tilakwadi, Yavatmal
India 445001
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