Artroscopia y ortopedia: Discusión entre pares / 25yr male ,h/o RTA almost 1 1/2 month old non treated , now come to me , suggestion

Drnitin Patel

25yr male ,h/o RTA almost 1 1/2 month old non treated , now come to me , suggestion

Sayed Elsibaey ILN femur
Anshul Garg ORIF with IMIL.. with BG..
Monirul Haque with bone graft
Baher Samy Open nailing
Waleed Elneggar Skeletal traction for release muscle spasm then iLN
Baher Samy No need for graft
Sayed Elsibaey reaming will act as graft ???!!!!!!
Baher Samy Gentle intraop traction will cause muscle fatigue which will overcome the muscle tension
Sayed Elsibaey traction hors then nailing
Surender Reddy Pendyala Skeletal traction, ILN&cancellous bg.
Baher Samy If u cannot overcome the contracture - which i doubt- u will have to go for shortening of no more than 2 cm
Drdinesh Gupta Traction to overcome shortening followed by IMN
Baher Samy I doubt traction prior to surgery will help, theres visible callus, u will have to release the calus before traction
Anshul Garg better to graft than not to! i would say.. at least the callus can used as a graft..
Baher Samy Anyway plan for open surgery and dont waste ur effort and time on trials of closed reduction
عبد المنعم جمعه Open iln femur...better if u have femoral distractor it will help you
Hassan Youssef Osteoclases plus LR S or ilizarove then change to internal fixation or continue with re adjstment with grafting to avoid stretch on neuro vascular on acute correction
Rashed Hasan Rony Skeletal traction to overcome shortening then I/L I/M nailing with bone graft.
Budha Prakash Prior to iln sk.traction is must
Siddhartha V Paluvadi Traction with utsp for 1 WK f/ b open iln.
Sandeep Bhat Kulamarva open and nail it
Lalith Mohan Straight away open. Deliver fragment nibbled the edges reduce! Lot of strength required.
Prabir Bala Open IM nail with BG
Ahmedknawyy Ortho Skeletal traction
Open reduction
ILN
Saleh Alfaisali skeketal traction then imn with bone graft and refrehment of the edges
Sadique Ahmed Khan Agree with Baher Samy.there is some visible callus .so open remove that small callus then give traction ontable yhen ILN.
Jayesh Parmar DFL Nail
Mero Gawargy Skin traction , ORIF By ILN
Binit Singh so much overriding.going to be really tough.skeletal traction followed by orif with ILN
Alhamwi Talal Traction then traction with opservation of the nurovasocular system then I L N
Pradeep Gupta Skeletal traction,ILN,open reduction,bone grafting
Hanume Gowda S N There is a lot of over lap...
If clinically frsnk mobility which I feel will be...ex-fx and distract it to get to length...then you can either nail it or continue with the exfix with realignment. ...
Single sitting may lead to neuro vascular compromise. ......
Not worth the risk....
Tejas Thakker Put a distractor,gradually achieve length and keep stretching soft tissue,once done change to nail and bone graft can b added as well.
Ananda Regmi Significant overlap of 1 1/2 mo duration.so plz do osteoclasis underGA then skeletal traction with good wt follow up xray in weakly interval .if u satisfied with traction then proceed for I/L nnailing.
Nirmal Chandra Mohapatra needs heavy skeletal traction for a week or two. do open reduction & nailing. wonder why our ignorant & negligent people put us & also themselves to this hardship to a simple problem
Drmahesh Dama agree with nirmal bhai
King Sudheer Traction.ILN+BG
Navin Singh ortho fix , distraction, locked nailing
Abdequahar Chimthanawala nailing bone grafting
Puttachar Niranjan Murthy Is it the latest X ray?
Drnitin Patel Yeah
Arun Jain Traction,followed by ILN & bg
Pradeep Gupta Thanks
Achyut Rajbhandari Two stag
e surgery. 1st. Soft tissue release followed by tibial skeletal traction for 3 weeks. 2nd. Intramedullary Interlocking nail with dynamlzation after 2--3 months.
Ramesh Kumar Gupta OR, imi nail n bg
Puttachar Niranjan Murthy Manipulate under GA to break early callus and to free the fracture ends. In this situation Ex Fix is ideal choice to slowly distract the overlapping of fragments and can be continued if aligned properly. Though this is lengthy procedure there is no risk of neuro vascular injury.