Discusión entre pares / Done yesterday in a 55 years old lady Comments invited

Indian-Orthopaedic Research-Group

Javed Jameel

Done yesterday in a 55 years old lady
Comments invited

Me gusta

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  Mokhtar Al Sabre Where is. Rotational screw

  12 horas · Me gusta
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  Javed Jameel Used a guide wire to prevent rotation...was removed after the procedure done

  12 horas · Me gusta · 1
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  Rajiv Maharjan Usual case and usual post, there will be more scope of learning by posting unusual, difficult and challenging cases than routine work..........

  12 horas · Me gusta · 2
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  Drvikas Rathore Nice job..

  12 horas · Me gusta
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  Joseph Mathew Central screw placement has better purchase.

  12 horas · Me gusta
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  Javed Jameel Sorry for usual case...but unusual case came rarely

  12 horas · Me gusta · 1
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  Mohammad Tahir Good one but position of central scew is not proper.it shd b central central or slight post inferior.in this case screw is much inferior and posterior.

  12 horas · Me gusta · 2
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  Praneeth Revuri Nice

  12 horas · Me gusta
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  Srinivas Daravathu Good work,a derotation screw is wat u missed

  12 horas · Me gusta · 1
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  Shameem Ahmad Central placement of screw is desirable

  11 horas · Me gusta
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  Rajesh Vishwakarma Good job boss. I think a derotation Bar can do the job if derotation screw is not used

  11 horas · Me gusta
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  Naveen Sharma Javed Jameel I think screw is too inferior. And chances of cut out are high. It is better to put a derotation screw. I would also like to fix greater trochanter with a ethibond or TBW. I would prefer PFN.

  11 horas · Editado · Me gusta · 1
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  M Bukhsh Shahwani Lateral view bit more posterior

  11 horas · Me gusta · 1
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  Mukesh Agrawal Derot screw and medialisation of neck would have added to sure success...good fix

  11 horas · Me gusta · 1
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  Javed Jameel How to medialise the neck dr Mukesh

  11 horas · Me gusta · 1
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  D Mohamed Refat tip apex index????

  11 horas · Me gusta
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  Mohammed Faramawy Nice job man
  But I have 2 notification and a question as well:
  Will u allow this patient with unstable anatomically reduced trochanteric fracture to bear weight from day postop day1 , or you will postpone weight bearig till radiological union?
  The question is in such a case and u haven't the option of pfn and u are going to fix with DHS , to medialize the shaft intraop so allowing the patient to bear wt immediately postop or to anatomically reduce the fracture , which is better?

  10 horas · Me gusta · 1
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  Jagan Mohan Job well done , nicely corrected flexion,external rotation position of proximal fragment to anatomical position. A derotation screw would have added stability.

  10 horas · Me gusta · 2
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  Javed Jameel @ dr Mohammed Faramawy...thanks
  1) I will allow partial weight walk from 6 weeks onward
  2) I went with PFN also but since lateral wall is intact I prefer DHS 
  3) medialisation of shaft may lead to uncontrolled collapse and shortening. ..hence in stable construct like this I prefer anatomical reduction rather than medialisation

  10 horas · Me gusta · 2
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  Javed Jameel Yes derotation screw may be added ...

  10 horas · Me gusta · 3
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  Moayad Abu Qa'oud Isn't malreduced dear colleauge?

  9 horas · Me gusta · 1
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  Javed Jameel Yes...Some what you can say dear Dr

  9 horas · Me gusta · 1
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  Moayad Abu Qa'oud Difficult fracture though, I faced similar # today and I tried to reduce it by an open manner but it was very difficult as temporary k wires didnt hold my reduction.

  9 horas · Me gusta · 1
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  Javed Jameel I did it closed 

  9 horas · Me gusta · 1
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  Rajeev Jaiswal All good....Derotation screw should also b there....

  8 horas · Me gusta · 2
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  Saad Gaballah Need short parrel

  5 horas · Me gusta
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  Mohamed Kamal Nice i dont recommed derotational screw to it. it is purely inertrochanteric # moreover derorational screw disturb the biomechanics of DHS

  4 horas · Me gusta · 1
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  Jalal Achji excellent