[ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur


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[ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur

alex61mobile at mail
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May 6, 2007, 11:44 AM

Post #1 of 5 (2377 views)
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[ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur	Can't Post

Dear colleagues,

A case from russian ortho list.

THX in advance for your comments and opinions.

This is a forwarded message
From: Ruslan <orthoforum@weborto.net>
To: ortho@weborto.net
Date: Saturday, May 5, 2007, 1:41:47 AM
Subject: [Ortho] The patient with non-union of the distal femur

===8<==============Original message text===============
A female with femoral nonunion,
Trauma in 2005 - closed fracture of the distal femur, external
fixation with Ilizarov apparatus. Non-union. In 2006 open reduction
and external fixation with Ilizarov apparatus. In November 2006 the
fixator was removed, after that valgus deformation developed. There
is mobility at the site. The knee motion 0-40. We'd like to discuss
options of internal fixation.

Ruslan
===8<===========End of original message text===========

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

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P2140200-2.jpg (19.9 KB)

nswolfso at usc
New User

May 6, 2007, 2:24 PM

Post #2 of 5 (2377 views)
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Re: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur [In reply to]	Can't Post

Dear Alex:

Funny: I reply to you from OTA site.

1. Patient's Age?
2. Is there any evidence of infection?
If not and patient is otherwise well: locking distal femoral plate is my first choice.

Nikolaj

Nikolaj Wolfson, MD, FRCSC
Assistant Professor of Clinical Orthopaedics
Department of Orthopaedic Surgery
Keck School of Medicine
University of Southern California
nswolfso@usc.edu
(323) 226-7346 phone
http://www.usc.edu/medicine/orthopaedic_surgery

----- Original Message -----
From: Alexander Chelnokov <alex61mobile@mail.ru>
Date: Sunday, May 6, 2007 11:44 am
Subject: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur
To: orthopod@googlegroups.com
Cc: ORT-L@www2.aaos.org

> Dear colleagues,
>
> A case from russian ortho list.
>
> THX in advance for your comments and opinions.
>
> This is a forwarded message
> From: Ruslan <orthoforum@weborto.net>
> To: ortho@weborto.net
> Date: Saturday, May 5, 2007, 1:41:47 AM
> Subject: [Ortho] The patient with non-union of the distal femur
>
> ===8<==============Original message text===============
> A female with femoral nonunion,
> Trauma in 2005 - closed fracture of the distal femur, external
> fixation with Ilizarov apparatus. Non-union. In 2006 open reduction
> and external fixation with Ilizarov apparatus. In November 2006 the
> fixator was removed, after that valgus deformation developed. There
> is mobility at the site. The knee motion 0-40. We'd like to discuss
> options of internal fixation.
>
> Ruslan
> ===8<===========End of original message text===========
>
>
>
> --
> Best regards,
> Alexander N. Chelnokov
> Ural Scientific Research Institute
> of Traumatology and Orthopaedics
> 7, Bankovsky str. Ekaterinburg 620014 Russia
---
[This E-mail scanned for viruses by Declude Virus]

FCyran at mednet
New User

May 7, 2007, 10:08 AM

Post #3 of 5 (2373 views)
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RE: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur [In reply to]	Can't Post

I have seen several of these fail after multiple attempts to get them to
heal(hard sclerotic bone like this, periosteal stripping, poor
vascularity, etc), and have required distal femoral replacements. Just
something to consider after the third attempt, and the patient is
becomming tired of being operated on.

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org]On
Behalf Of Alexander Chelnokov
Sent: Sunday, May 06, 2007 11:44 AM
To: orthopod@googlegroups.com
Cc: ORT-L@www2.aaos.org
Subject: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal
femur

Dear colleagues,

A case from russian ortho list.

THX in advance for your comments and opinions.

This is a forwarded message
From: Ruslan <orthoforum@weborto.net>
To: ortho@weborto.net
Date: Saturday, May 5, 2007, 1:41:47 AM
Subject: [Ortho] The patient with non-union of the distal femur

===8<==============Original message text===============
A female with femoral nonunion,
Trauma in 2005 - closed fracture of the distal femur, external
fixation with Ilizarov apparatus. Non-union. In 2006 open reduction
and external fixation with Ilizarov apparatus. In November 2006 the
fixator was removed, after that valgus deformation developed. There
is mobility at the site. The knee motion 0-40. We'd like to discuss
options of internal fixation.

Ruslan
===8<===========End of original message text===========

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

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DGoetz at ghs
New User

May 8, 2007, 5:49 AM

Post #4 of 5 (2373 views)
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RE: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur [In reply to]	Can't Post

First, knee needs to move so loosen up the gutters and surgically
recreate the suprapatellar pouch. A stiff knee putts too much stress on
your fixation.
Next, anatomic alignment [not necessarily anatomic reduction] and lots
of compression. I would use a locking plate with non locking screws
proximally to allow that extra compression watching to be sure not to
create excessive valgus. I would not worry about length.
Bone graft as needed.

D Goetz

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On
Behalf Of Alexander Chelnokov
Sent: Sunday, May 06, 2007 2:44 PM
To: orthopod@googlegroups.com
Cc: ORT-L@www2.aaos.org
Subject: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal
femur

Dear colleagues,

A case from russian ortho list.

THX in advance for your comments and opinions.

This is a forwarded message
From: Ruslan <orthoforum@weborto.net>
To: ortho@weborto.net
Date: Saturday, May 5, 2007, 1:41:47 AM
Subject: [Ortho] The patient with non-union of the distal femur

===8<==============Original message text===============
A female with femoral nonunion,
Trauma in 2005 - closed fracture of the distal femur, external
fixation with Ilizarov apparatus. Non-union. In 2006 open reduction
and external fixation with Ilizarov apparatus. In November 2006 the
fixator was removed, after that valgus deformation developed. There
is mobility at the site. The knee motion 0-40. We'd like to discuss
options of internal fixation.

Ruslan
===8<===========End of original message text===========

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia
---
[This E-mail scanned for viruses by Declude Virus]

mqsd25 at aol
New User

May 15, 2007, 3:14 PM

Post #5 of 5 (2323 views)
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Re: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur [In reply to]	Can't Post

HI
Can you send me the Xrays again please
thanks

MR Mohammad Maqsood
consultant orthopaedic surgeon
Lincoln county Hospital
Lincoln

-----Original Message-----
From: tanyaali2@yahoo.com
To: ORT-L@www2.aaos.org
Sent: Sun, 6 May 2007 11.32PM
Subject: Re: Re: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur

-----Original Mail-----
From: Nikolaj Wolfson
Sent: Monday, 07th May 2007 1:25 am
To: ORT-L@www2.aaos.org
Subject: Re: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur

Dear Alex:

Funny: I reply to you from OTA site.

1. Patient's Age?
2. Is there any evidence of infection?
If not and patient is otherwise well: locking distal femoral plate is my first
choice.

Nikolaj

Nikolaj Wolfson, MD, FRCSC
Assistant Professor of Clinical Orthopaedics
Department of Orthopaedic Surgery
Keck School of Medicine
University of Southern California
nswolfso@usc.edu
(323) 226-7346 phone
http://www.usc.edu/medicine/orthopaedic_surgery

----- Original Message -----
From: Alexander Chelnokov <alex61mobile@mail.ru>
Date: Sunday, May 6, 2007 11:44 am
Subject: [ORT-L] Fwd: [Ortho] The patient with non-union of the distal femur
To: orthopod@googlegroups.com
Cc: ORT-L@www2.aaos.org

> Dear colleagues,
>
> A case from russian ortho list.
>
> THX in advance for your comments and opinions.
>
> This is a forwarded message
> From: Ruslan <orthoforum@weborto.net>
> To: ortho@weborto.net
> Date: Saturday, May 5, 2007, 1:41:47 AM
> Subject: [Ortho] The patient with non-union of the distal femur
>
> ===8<==============Original message text===============
> A female with femoral nonunion,
> Trauma in 2005 - closed fracture of the distal femur, external
> fixation with Ilizarov apparatus. Non-union. In 2006 open reduction
> and external fixation with Ilizarov apparatus. In November 2006 the
> fixator was removed, after that valgus deformation developed. There
> is mobility at the site. The knee motion 0-40. We'd like to discuss
> options of internal fixation.
>
> Ruslan
> ===8<===========End of original message text===========
>
>
>
> --
> Best regards,
> Alexander N. Chelnokov
> Ural Scientific Research Institute
> of Traumatology and Orthopaedics
> 7, Bankovsky str. Ekaterinburg 620014 Russia
---
[This E-mail scanned for viruses by Declude Virus]

dear sirs we are facing a number of problems together 1st non union 2nd
dysuse osteoporosis which will make any type of fixation more difficult than
usuall 3rd the knee stiffness which will exert stress on fracture site ,
however , bone grafting & rigid fixation with an L-plate shaped for the femoral
condyles & when the # is sticky the patient should be placed in a caliber with a
knee hing & allow him to walk 1st partial then full wt bearing is my humble
openion Dr.Ali Faisal Erbil teaching hospital department
of orthopaedics & traumatology - Erbil / Iraq

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