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Re: Перелом бедра на фоне экзостозов
Carlo Bellabarba 12 Март 2002, 18:26
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Hi Alex,
You can use many of the standard nails through the retrograde approach if you want, particularly if the fracture isn't that distal. last i checked, this was a much cheaper way to nail femurs retrograde, even in this part of
the world, although that may have changed of late. the real advantage of nails designed specifically for retrograde use are the more distal interlocking screw holes and the anterior-to-posterior proximal locking screw orientation (especially easier in the obese).
Nails that don't do so well when turned around and placed retrograde are those with only oblique "proximal" interlocking screws (ie distal when retrograde), and those like the synthes universal nail where the "proximal"
end of the nail flares considerably.
Carlo Bellabarba
Seattle
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Re: Перелом бедра на фоне экзостозов
DR T I GEORGE 12 Март 2002, 18:29
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I have seen a surgeon use tibial nail as retrograde on femur. He was not keen on proximal interlocking since the proximal end of nail will be thru the isthmus of femur. What is the list members experience/opinion on leaving the proximal end unlocked?
DR.T.I.GEORGE,
CONSULTANT ORTHOPAEDIC SURGEON,
POLYTRAUMA,MICROVASCULAR SURGERY AND HAND SURGERY UNIT,
METROPOLITAN HOSPITAL,
TRICHUR, S.INDIA.
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Re: Перелом бедра на фоне экзостозов
Отправитель: James Carr 12 Март 2002, 18:37
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The concerns are the same as any femoral nailing: rotation and shortening in unstable fx patterns. Probably works fine in stable patterns in most cases.
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Re: Перелом бедра на фоне экзостозов
James Carr 12 Март 2002, 18:36
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I once looked at it, and many antegrade nails actually have more distal screws than their retrograde counterparts. The other advantages are as stated.
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