[ORT-L] fem head fracture - Orthopedics Forum


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[ORT-L] fem head fracture

danschlatterer at yahoo
New User

Aug 16, 2006, 9:19 AM

Post #1 of 4 (545 views)
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[ORT-L] fem head fracture	Can't Post

hello,
I am seeking input on management of this pt. the challenge is his body habitus. I am considering
using a modified ilioinguinal approach as reported by kloen/siebenbrock/ganz for low AC, AW
acetabular fractures (se JOT 2202). the approach includes an ASIS osteotomy and rectus
detachment. does anyone have any further thoughts/recommendations? thank you for your input.
dan schlatterer
atlanta, ga

--- Jeffrey Brooks <jjbrooksmd@hotmail.com> wrote:

> My vote would be for a łlateral column˛ procedure as described by OšDriscoll
> et.al. (Lat approach below BR), ant and posterior ostectomies, postop
> suppression (indocin or rads), BUT I donšt know if it is OK to do so in a
> (very) skeletally immature patient.
>
> Are there any pediatric ortho traumatologists on this list?
>
> Thanks,
> Jeff Brooks MD
> Stamford, CT
>
>
> On 8/13/06 5:16 AM, "hselhi@gmail.com" <hselhi@gmail.com> wrote:
>
> > Dear All,
> >
> > 10 yr old male child suffered a supracondylar fracture elbow one year back and
> > was managed with closed reduction and POP. History of massage is doubtful?
> >
> > Post op no active physiotherapy.
> >
> > Now has presented to us with ROM at elbow 80 degree to 90 degree. No further
> > flexion or extension apart from this jog of movement.
> >
> > X-rays are attached for your perusal. One of the films is with max possible
> > flexion and extension.
> >
> > I shall wish to know your opinion regarding the approach, results, does it
> > need Hinged apparatus post release etc.
> >
> > Regards
> >
> > Harpal
> >
> >
> > Dr Harpal Singh Selhi
> > Associate Professor
> > Dept of Ortho Surgery
> > D.M.C. & Hospital.
> > (Adult Joint Reconstruction, Hand, Shoulder & Sports Medicine)
> >
> > Resi: 527-L, Model Town,
> > Ludhiana-141002
> >
> > Phone: 0161-2433002
> > Fax: 0161-5013004
> >> -
> >
>
>
>

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(This post was edited by christian on Jan 24, 2007, 3:12 PM)

Attachments:

fem head aug06.ppt (5.14 MB)

mlroutt at u
New User

Aug 16, 2006, 12:20 PM

Post #2 of 4 (545 views)
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Re: [ORT-L] X-IMail-SPAM-Connection fem head fracture [In reply to]	Can't Post

Obese adult male patient with a 10 day old displaced femoral head fracture
after closed reduction. In addition to being 10 days old, he has the
complicating factor of panniculus fungus according to your photo.

Correct?

Unless there are other details on other images not shown, I recommend an
anterior surgical exposure (as we've discussed several times on this list
for femoral head fractures).

He's a deep dissection regardless of the avenue in.

The 10 day delay will be more frustrating than the abdominal obesity.

Abdominal obesity rarely complicates this exposure.

You are lucky that his injury pattern allowed closed manipulation to reduce
the fracture-dislocation.

Chip

> hello,
> I am seeking input on management of this pt. the challenge is his body
> habitus. I am considering
> using a modified ilioinguinal approach as reported by kloen/siebenbrock/ganz
> for low AC, AW
> acetabular fractures (se JOT 2202). the approach includes an ASIS osteotomy
> and rectus
> detachment. does anyone have any further thoughts/recommendations? thank you
> for your input.
> dan schlatterer
> atlanta, ga
>
>
> --- Jeffrey Brooks <jjbrooksmd@hotmail.com> wrote:
>
>> My vote would be for a łlateral column˛ procedure as described by OšDriscoll
>> et.al. (Lat approach below BR), ant and posterior ostectomies, postop
>> suppression (indocin or rads), BUT I donšt know if it is OK to do so in a
>> (very) skeletally immature patient.
>>
>> Are there any pediatric ortho traumatologists on this list?
>>
>> Thanks,
>> Jeff Brooks MD
>> Stamford, CT
>>
>>
>> On 8/13/06 5:16 AM, "hselhi@gmail.com" <hselhi@gmail.com> wrote:
>>
>>> Dear All,
>>>
>>> 10 yr old male child suffered a supracondylar fracture elbow one year back
>>> and
>>> was managed with closed reduction and POP. History of massage is doubtful?
>>>
>>> Post op no active physiotherapy.
>>>
>>> Now has presented to us with ROM at elbow 80 degree to 90 degree. No further
>>> flexion or extension apart from this jog of movement.
>>>
>>> X-rays are attached for your perusal. One of the films is with max possible
>>> flexion and extension.
>>>
>>> I shall wish to know your opinion regarding the approach, results, does it
>>> need Hinged apparatus post release etc.
>>>
>>> Regards
>>>
>>> Harpal
>>>
>>>
>>> Dr Harpal Singh Selhi
>>> Associate Professor
>>> Dept of Ortho Surgery
>>> D.M.C. & Hospital.
>>> (Adult Joint Reconstruction, Hand, Shoulder & Sports Medicine)
>>>
>>> Resi: 527-L, Model Town,
>>> Ludhiana-141002
>>>
>>> Phone: 0161-2433002
>>> Fax: 0161-5013004
>>>> -
>>>
>>
>>
>>
>
>
> __________________________________________________
> Do You Yahoo!?
> Tired of spam? Yahoo! Mail has the best spam protection around
> http://mail.yahoo.com

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
--

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dr-chinoy at cyber
New User

Aug 17, 2006, 10:10 AM

Post #3 of 4 (543 views)
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Re: [ORT-L] X-IMail-SPAM-Connection fem head fracture [In reply to]	Can't Post

This message of 7251 KB has come THREE TIMES. Please do not send messages
multiple times. It took 45 minutes to download each time. Lots of Precious
time wasted, plus unnecessary financial burden, as dial up connection
charges are per minute.

Thanks

Muhammad Amin Chinoy FRCS
----- Original Message -----
From: "dan schlatterer" <danschlatterer@yahoo.com>
To: <ORT-L@www2.aaos.org>
Sent: Wednesday, August 16, 2006 9:19 PM
Subject: [ORT-L] X-IMail-SPAM-Connection fem head fracture

> hello,
> I am seeking input on management of this pt. the challenge is his body
habitus. I am considering
> using a modified ilioinguinal approach as reported by
kloen/siebenbrock/ganz for low AC, AW
> acetabular fractures (se JOT 2202). the approach includes an ASIS
osteotomy and rectus
> detachment. does anyone have any further thoughts/recommendations? thank
you for your input.
> dan schlatterer
> atlanta, ga
>
>
> --- Jeffrey Brooks <jjbrooksmd@hotmail.com> wrote:
>
> > My vote would be for a łlateral column˛ procedure as described by
OšDriscoll
> > et.al. (Lat approach below BR), ant and posterior ostectomies, postop
> > suppression (indocin or rads), BUT I donšt know if it is OK to do so in
a
> > (very) skeletally immature patient.
> >
> > Are there any pediatric ortho traumatologists on this list?
> >
> > Thanks,
> > Jeff Brooks MD
> > Stamford, CT
> >
> >
> > On 8/13/06 5:16 AM, "hselhi@gmail.com" <hselhi@gmail.com> wrote:
> >
> > > Dear All,
> > >
> > > 10 yr old male child suffered a supracondylar fracture elbow one year
back and
> > > was managed with closed reduction and POP. History of massage is
doubtful?
> > >
> > > Post op no active physiotherapy.
> > >
> > > Now has presented to us with ROM at elbow 80 degree to 90 degree. No
further
> > > flexion or extension apart from this jog of movement.
> > >
> > > X-rays are attached for your perusal. One of the films is with max
possible
> > > flexion and extension.
> > >
> > > I shall wish to know your opinion regarding the approach, results,
does it
> > > need Hinged apparatus post release etc.
> > >
> > > Regards
> > >
> > > Harpal
> > >
> > >
> > > Dr Harpal Singh Selhi
> > > Associate Professor
> > > Dept of Ortho Surgery
> > > D.M.C. & Hospital.
> > > (Adult Joint Reconstruction, Hand, Shoulder & Sports Medicine)
> > >
> > > Resi: 527-L, Model Town,
> > > Ludhiana-141002
> > >
> > > Phone: 0161-2433002
> > > Fax: 0161-5013004
> > >> -
> > >
> >
> >
> >
>
>
> __________________________________________________
> Do You Yahoo!?
> Tired of spam? Yahoo! Mail has the best spam protection around
> http://mail.yahoo.com
>

---
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lgzjr at sign-post
New User

Aug 17, 2006, 4:33 PM

Post #4 of 4 (542 views)
Shortcut

RE: [ORT-L] X-IMail-SPAM-Connection fem head fracture [In reply to]	Can't Post

I would get ct depictions of the femoral head in internal and external
rotation to decide whether to approach anterior or posterior to reduce and
fix the femoral head fracture.

Lew Zirkle
SIGN

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On Behalf
Of dan schlatterer
Sent: Wednesday, August 16, 2006 8:20 AM
To: ORT-L@www2.aaos.org
Subject: [ORT-L] X-IMail-SPAM-Connection fem head fracture

hello,
I am seeking input on management of this pt. the challenge is his body
habitus. I am considering
using a modified ilioinguinal approach as reported by kloen/siebenbrock/ganz
for low AC, AW
acetabular fractures (se JOT 2202). the approach includes an ASIS osteotomy
and rectus
detachment. does anyone have any further thoughts/recommendations? thank
you for your input.
dan schlatterer
atlanta, ga

--- Jeffrey Brooks <jjbrooksmd@hotmail.com> wrote:

> My vote would be for a łlateral column˛ procedure as described by
OšDriscoll
> et.al. (Lat approach below BR), ant and posterior ostectomies, postop
> suppression (indocin or rads), BUT I donšt know if it is OK to do so in a
> (very) skeletally immature patient.
>
> Are there any pediatric ortho traumatologists on this list?
>
> Thanks,
> Jeff Brooks MD
> Stamford, CT
>
>
> On 8/13/06 5:16 AM, "hselhi@gmail.com" <hselhi@gmail.com> wrote:
>
> > Dear All,
> >
> > 10 yr old male child suffered a supracondylar fracture elbow one year
back and
> > was managed with closed reduction and POP. History of massage is
doubtful?
> >
> > Post op no active physiotherapy.
> >
> > Now has presented to us with ROM at elbow 80 degree to 90 degree. No
further
> > flexion or extension apart from this jog of movement.
> >
> > X-rays are attached for your perusal. One of the films is with max
possible
> > flexion and extension.
> >
> > I shall wish to know your opinion regarding the approach, results, does
it
> > need Hinged apparatus post release etc.
> >
> > Regards
> >
> > Harpal
> >
> >
> > Dr Harpal Singh Selhi
> > Associate Professor
> > Dept of Ortho Surgery
> > D.M.C. & Hospital.
> > (Adult Joint Reconstruction, Hand, Shoulder & Sports Medicine)
> >
> > Resi: 527-L, Model Town,
> > Ludhiana-141002
> >
> > Phone: 0161-2433002
> > Fax: 0161-5013004
> >> -
> >
>
>
>

__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
http://mail.yahoo.com

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