bray at renoortho
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Aug 30, 2007, 10:14 PM
Post #7 of 9
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RE: [ORT-L] Capsulotomy after femoral neck fx
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Clearly with open reduction-however the question probably should be directed
to 'age group' specific fractures. If I do a closed reduction and fixation
on a 'senior' patient with a displaced femoral neck fracture, I never do a
capsulotomy. If it is a 'young' displaced femoral neck fracture that I can
reduce closed, never do a capsulotomy as I think the hematoma has already
been traumatically decompressed. I think the problem is the younger femoral
neck that is minimally displaced, I do an urgent closed reduction, if
possible, fix the fracture with percutaneous screws and then a mini lateral
incision to be able to slip a long handle knife with a large 20 blade over
the anterior neck next to the bone to try and open the capsule, never sure
if it works or not? It would take an enormous clinical series to support
the technique or the thinking. This topic has been debated at all levels and
there is little long term clinical science to support any definitive
treatment regimen. Bray, Althausen, O'Mara Reno
_____
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On Behalf
Of Jeff Brooks
Sent: Thursday, August 30, 2007 3:44 PM
To: ORT-L@www2.aaos.org
Subject: Re: [ORT-L] Capsulotomy after femoral neck fx
Sorry - to clarify: never done capsulotomy during CRIF, almost always is
part of exposure for formal ORIF via anterior approach, though.
On Aug 30, 2007, at 5:32 PM, Zamorano, David wrote:
Just wanted to take a poll. Was curious how many people perform capsulotomy
after closed reduction of femoral neck fractures. Would also appreciate
responses from people who don't do routine capsulotomies.
dpz
____________________________________________________________________________
________________________
David P. Zamorano, MD
Director, Orthopaedic Trauma Service
UCI Medical Center
(714) 456-7801 Office
(714) 456-7547 Fax
Jeffrey J Brooks, MD
Hand & Upper Extremity Surgery
Orthopaedic Trauma Surgery
Orthopaedic Surgery & Sports medicine center
1290 Summer Street, #4400
Stamford, CT 06905
(203) 323-7331
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