hselhi at gmail
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Jun 14, 2008, 11:42 PM
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[Orthopod] Re: non union #neck femur
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Dear,
Fracture neck femur is known to be problematic to judge the union from plain
radiographs. There have been instances in this part of the country where
patients have taken the surgeon to court for premature removal of screws.
I suggest though retrospectively, the screws should not have been removed,
CT scan to judge the union and if nonunion was observed, remove one screw,
vascularised or otherwise, fibular graft after enlarging the screw tract.
I would still suggest, reduce once again, fixation and grafting.
Regards
Harpal
-----Original Message-----
From: orthopod@googlegroups.com [mailto:orthopod@googlegroups.com] On Behalf
Of Emeka Johnson
Sent: Saturday, June 14, 2008 6:21 PM
To: orthopod@googlegroups.com
Subject: [Orthopod] Re: non union #neck femur
hi nitin,
I would offer her subtrochanteric valgoid osteotomy with a DHS and sidf
plate.
thanks
Dr johnson,E
Nigeria
--- On Tue, 5/27/08, mehta nitin <newholyfamily@hotmail.com> wrote:
> From: mehta nitin <newholyfamily@hotmail.com>
> Subject: [Orthopod] RE: non union #neck femur
> To: orthopod@googlegroups.com
> Date: Tuesday, May 27, 2008, 7:47 PM
> From: newholyfamily@hotmail.comTo:
> orthopod@googlegroups.comSubject: non union #neck
> femurDate: Tue, 27 May 2008 18:11:55 +0000
>
>
> Dear all,your esteemed opinion is solicited -A 35 years old
> lady sustained a #neck femur .she was operated 3 days later
> with 3 cannulated screws on 5.2.07 . post op xray appeared
> acceptable. physiotherpy was continued. however, pt. had
> persistant pain in the knee(xray normal) . At 3months
> although there was backing of screws but they were firmly
> fixed in the proximal head . pt. had continous pain in the
> knee and was not able to lie on the fractured side . she
> could lift the leg upto 60 degrees . at 6 months lying down
> and standing weight bearing Xray were same . Due to pain in
> knee -shortening 1.5cms and no pain in the hip the screws
> were removed on 2.5.08 . # stressed under II did not show
> any abnormality. however xrays done on 27.5 08 clearly
> showed non union . please suggest the line of action in
> such case 1 1/4th year after # and CR and IF. AVN is not
> there .Thanking youNitin Mehta M.Snew Holy Family
> HospitalKaithalHaryana , india
>
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