mlroutt at u
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May 29, 2008, 1:36 PM
Post #4 of 6
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Re: [ORT-L] 3 week-old posterior wall fracture
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Thanks.
The EUA with fluoroscopy is smart...and if unstable, I'd reduce and fix it.
But with no history of a dislocation and this pattern, it should be a stable
hip.
If it examines stable under anesthesia and fluoroscopy and it's 20 days
after injury, then I wouldn't operate on it.
chip
> Thanks for the reply, Chip. Do not have Judet's digitized right now
> but have included more CT cuts (see attached .ppt).
>
> In brief, 47 y.o. female with no prior history of hip/groin/knee pain
> in rollover MVA 19 days ago (5/10) c/o L hip pain in er but dc'd home
> when ap pelvis xr "negative". on crutches TDWB but hard to walk
> (obviously). saw my partner who got a CT scan showing the Fx then
> referred to me.
>
> Never was a dislocation by history or otherwise as far as I know.
>
> She is a healthy nonsmoker, non-drinker on cholesterol meds. Works as
> a cook at Kentucky Fried Chicken.
>
> Your input is appreciated. I have her on schedule tomorrow for at
> least an EUA under fluoro to test stability, proceeding as indicated.
> Thoughts & advice welcome.
>
> Thanks,
>
> Jeff
>
>
> Jeff Brooks
> Stamford, CT
>
>
>
> On Thu, May 29, 2008 at 2:31 AM, Chip Routt <mlroutt@u.washington.edu> wrote:
>> It'd be good to see more CT images and Judte obliques films.
>>
>> Did she dislocate and require relocation by history?
>>
>> If so, was there a dislocation film obtained before reduction?
>>
>> Are there other known details?
>>
>> chip
>>
>>
>>
>>
>>> QUESTION: would you fix this posterior wall or treat non-operatively??
>>>
>>> -----------------------------------------------
>>>
>>> 47 y.o. female in rollover MVA 3 weeks ago. initially missed this
>>> displaced posterior wall L acetab Fx. walked on it a bit so hip is
>>> proven-stable. but it's a big piece and it's displaced.
>>>
>>> in this lady with some mild pre-existing hip OA would you be inclined
>>> to ORIF at three weeks or leave it be?? i'm strongly leaning toward
>>> the latter but interested in your esteemed opinions.
>>>
>>> thanks in advance,
>>>
>>> Jeff Brooks
>>> Stamford, CT
>>>
>>>
>>>
>>>
>>
>> M.L. Chip Routt, Jr.,M.D.
>> Professor-Orthopedic Surgery
>> Harborview Medical Center
>> 325 Ninth Avenue
>> Box 359798
>> Seattle, WA 98104-2499
>> phone 206-731-3658
>> FAX 206-731-3227
>> --
>>
>>
>>
>> ---
>> [This E-mail scanned for viruses by Declude Virus]
>>
>>
>
>
M.L. Chip Routt, Jr.,M.D.
Professor-Orthopedic Surgery
Harborview Medical Center
325 Ninth Avenue
Box 359798
Seattle, WA 98104-2499
phone 206-731-3658
FAX 206-731-3227
--
---
[This E-mail scanned for viruses by Declude Virus]
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