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Re: Peri-prosthetic femoral fracture
Myles Clough 21 Ноябрь 2006, 13:47
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The implication from Mr Asumu's original message is that if a retrograde nail was possible he would do it. If it is truly impossible then I would agree with Alex' suggestion; perhaps use a hacksaw to shorten the nail a little. If it's just "difficult" to do a retrograde nail and you have proved (on the bench) that you can get nail up past the implant, then I would try that and revert to antegrade if on the day it is "impossible".
Another thought - spanning external fixator holding the fracture reduced until healing then whatever procedures are necessary to recover range and acceptable function once the fracture has healed. This might mean a revision TKR but one with a reasonable chance of success and you might get away with no major procedures.
Myles Clough
Consultant Orthopaedic Surgeon (Retired), Kamloops, BC, Canada
Clinical Instructor, University of British Columbia
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Re: Peri-prosthetic femoral fracture
george therthanath 21 Ноябрь 2006, 14:19
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Myles,
The external fixator very close to the knee prosthesis till such time that we get good union!
Isn't there a high risk of infection to the prosthesis in this procedure?
Or, are there any tricks to minimise infection from a pin tract that will be very close to the prosthesis?
Dr. T. I. George,
Senior Orthopaedic Surgeon
And Head of Orthopaedics Unit-III,
Little Flower Hospital and research Centre,
Angamaly, Kerala State,
India.
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