Re[4]: [ORT-L] Distal Femur Fx - to nail or?..


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Re[4]: [ORT-L] Distal Femur Fx - to nail or?..

alex61 at gmail
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Feb 6, 2007, 8:33 AM

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Re[4]: [ORT-L] Distal Femur Fx - to nail or?..	Can't Post

Dear Jeff, colleagues.

Jeff wrote 6 февраля 2007 г., 17:25:49:

> screws across the joint and look at it via a lateral arthrotomy to
> make sure the joint is congruent then slide up the LISS and position it.

The injury was more than 2 weeks ago i suppose fissures are "glued
up". Joint incongruity and steps, if any, are visible on image
intensifier. If the step is found the arthrotomy for reduction is
justified. In the case it must be unnecessary.

> I get plain x rays before leaving the OR after LISS plating b/c
> as Nik points out it's hard to 'trust' the c-arm images as parallax
> (sp?) can throw you off.

Yes, small round images can be misleading.

> Some authors have cited a high incidence of malreduction using the
> LISS, however, so one needs to be absolutely sure of the reduction

If you meet such publication pls drop me the reference.

> What will/did you do?

A small wire distractor was applied, with 3 frontal wires distally.
Antegrade nailing was performed, and two lag screws to fix condyles
in place of anterior and posterior wires. Images attached.

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

Attachments:

get_image.jpg (18.7 KB)

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