DGoetz at ghs
New User
Apr 9, 2007, 2:33 PM
Post #2 of 2
(257 views)
Shortcut
|
|
RE: Re[2]: [ORT-L] Periprosthetic femoral shaft nonunion
[In reply to]
|
Can't Post
|
|
Stems you show are fine but removing a well fixed AML stem means an
extended trochanteric osteotomy, cutting the stem below its metaphyseal
flair, then over reaming the distal piece of prosthesis. Can be done
but is difficult, requires specialized equipment, and will create a lot
of proximal bone loss and proximal femoral instability. Also, with the
fracture, exposure of the hip joint is difficult because you can't
rotate the hip by moving the lower leg. This means clamps on the
proximal fragment further devascularizing the bone. You will be left
with a bag of bone proximally using less than ideal distal fixation to
encourage bone ingrowth to your revision prosthesis. Now you need
ingrowth AND union.
I would still prefer leaving the well functioning total joint out of the
procedure and making a better mechanical and biologic attempt on the
femur.
Dave
-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On
Behalf Of Alexander Chelnokov
Sent: Monday, April 09, 2007 2:03 PM
To: David Goetz, MD
Subject: Re[2]: [ORT-L] Periprosthetic femoral shaft nonunion
Hello Dave,
Monday, April 9, 2007, 11:24:26 PM, you wrote:
> Need stability and vascularized bone.
> Zimmer distal femoral periarticular plate will follow contour of the
THX for your opinion.
What do you think on advanced revision stem systems like the one at
http://www.opnews.com/profiles.php?index=35&total=36 ?
--
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]
---
[This E-mail scanned for viruses by Declude Virus]
|
MAIN
SEARCH
WHO'S 
LOG 
We subscribe to the HONcode principles.
Verify here