Enes.Kanlic at ttuhsc
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Jan 17, 2008, 1:14 PM
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[Orthopod] Re: post-nailing fracture: CHANCES... TKA... yes
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Dear Alex,
"About get_image3 case - the elderly lady admitted with acute
osteoporotic fracture above the knee with stiffness in extension after
previous injury and treatment. Preoperative images of the patients are
attached - would you really perform TKR in this pattern?"
EMK: On the x-rays we see severe arthritis, lateral tibial plateau
defect and probable knee instability.
If patient is in good medical health (able to walk and leave
fes more years, and the only limitation is bad knee pain and
instability), with decent soft tissues (no risk of flap necrosis), than
with one procedure we would solve her fracture, pain and probably
improve the range of motion...
Enes M. Kanlic, MD, FACS
Professor
http://www.ttuhsc.edu/elpaso/som/Orthopaedics/
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-----Original Message-----
From: orthopod@googlegroups.com [mailto:orthopod@googlegroups.com] On
Behalf Of Alexander Chelnokov
Sent: Thursday, January 17, 2008 1:09 PM
To: orthopod@googlegroups.com
Subject: [Orthopod] Re: post-nailing fracture: CHANCES
Dear Enes
Kanlic, Enes wrote:
> Your fixations look "possible working" (although "get-image 3" patient
> would have much more benefit with total knee replacement rather than
> with nail)....
With experience of more than 70 distal femur cases treated by antegrade
nailing we feel that it is working not possible but definitely ;-)
About get_image3 case - the elderly lady admitted with acute
osteoporotic fracture above the knee with stiffness in extension after
previous injury and treatment. Preoperative images of the patients are
attached - would you really perform TKR in this pattern?
> *We should be recommending the methods which will work in about 90% of
> cases in average orthopaedic surgeon hands*, not just what one
> exceptionally skilful person could do in very few cases (especially if
I certainly agree that one shouldn't use a technique which he is not
enough familiar with. Actually the technique i mentioned is now
performed after short learning curve by surgeons with less than average
experience.
> we do not have "proof" -good study published in peer reviewed paper
The technique has been presented at recent Kuntscher society meeting.
The paper is in plans...
___
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia
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