mlroutt at u
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Jul 25, 2006, 6:53 AM
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Re: [ORT-L] fracture floor of acetabulum-more CT
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Ilioinguinal.
>
> some more CT pictures,
>
> Thanks very much
>
> rajesh
>
> Dr.K.R.Rajesh, MS,DipNB,FRCS,FRCS(Orth)
> Consultant Upper Limb Surgeon
> Division of Upper Limb , Arthroscopy & Joint Replacement Surgery.
> Cosmopolitan Hospital
> Trivandrum,Kerala,India.
>
> Mobile-9447191205
>
>
>
> -----Original Message-----
> From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org]On
> Behalf Of Chip Routt
> Sent: 24 July 2006 22:45
> To: ORT-L@www2.aaos.org
> Subject: Re: [ORT-L] fracture floor of acetabulum
>
>
> She has an associated both column displaced acetabular fracture.
>
> An ilioinguinal surgical exposure allows excellent open reduction and
> internal fixation for her particular pattern...unless I've missed some
> details in the images as shown.
>
> Locked pelvic reconstruction plates have essentially no indication in
> routine acetabular/pelvic surgery. This is an expensive and un-needed
> fad...the "bell-bottom pants of pelvic surgery". The locked implants control
> where you are allowed (by implant design and contour) to insert a screw
> rather than where you the surgeon choose to direct it based on structural
> need and osseus anatomy.
>
> Your patient's fracture pattern details do not warrant a posterior exposure
> for successful operative management..you'll be sad with the result if you go
> posteriorly.
>
> Chip
>
>
>
>
>
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>
>
>
>
>>
>> 55 yr old lady (cleaning lady at our hospital) hit by a car (merc C
> class,no
>> less !) 4 days ago. I think she has a comminuted floor of right acetabulum
>> with a transverse # and involvement of both anterior and posterior
> columns.
>> Only other injury is a # of neck of scapula on the left side. I am
> planning
>> to operate on wednesday.After following all the discussions,I was thinking
>> of a prone kocher-langenbck exposure ( have only done a few lateral ones
>> before,but I can see the advantages), and use recon plates posteriorly. I
>> will then have to do an anterior approach as well and fix the superior
> ramus
>> using plates as I have been unable to get any ramus screws. Is there any
>> advantage in using locking recon plates as opposed to ordinary recon
> plates
>> (so that i dont have to use very long screws?)
>>
>> Thanks for any suggestions and any other options. Some more CT films are
>> available and i will send them across as soon as possible.
>>
>> rajesh
>>
>> Dr.K.R.Rajesh, MS,DipNB,FRCS,FRCS(Orth)
>> Consultant Upper Limb Surgeon
>> Division of Upper Limb , Arthroscopy & Joint Replacement Surgery.
>> Cosmopolitan Hospital
>> Trivandrum,Kerala,India.
>>
>> Mobile-9447191205
>>
>> --------------------------------------------
>> My mailbox is spam-free with ChoiceMail, the leader in personal and
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>
> 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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> --------------------------------------------
> My mailbox is spam-free with ChoiceMail, the leader in personal and corporate
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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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