Ortopedia Pediátrica. Traumatología y Reemplazos articulares: Discusión entre pares / 45yrs/male weighing 132kg polytrauma case presented with all ipsilateral fractures

lunes, 26 de mayo de 2014

Discusión entre pares / 45yrs/male weighing 132kg polytrauma case presented with all ipsilateral fractures

Indian-Orthopaedic Research-Group

Rahul B Tanga

45yrs/male weighing 132kg polytrauma case presented with all ipsilateral fractures was treated 5months back in a staged manner.present x rays show good consolidation at fracture site and patient walking fwb without support.

Rahul B Tanga critical comments?

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Rahul B Tanga valuable inputs?

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Ehab Ragab Nice work
ROM knee ???

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Rahul B Tanga Thanks 90degrees

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Syed Mohsin Plz tell d order of fixation u ve done

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Shivaprakash S Gowda Good work... n excellent results.. Dr tanga want to know order of fixation... Single sitting r staged procedure...?

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Lokesh Bhatia Well Done. Overall Good Job, I would appreciate if you give your own analysis first. As your analysis will be Clinico Radilogical and we are seeing only X-rays. What were the best things you did in this Polytrauma which we should do in every such case. What do you think you would do to improvise in next such case.

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Rahul B Tanga Thanks everyone.

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Rahul B Tanga Order of fiction was first femur nailing followed by tibia plating and address sing knee and third was hand and wrist.

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Yogesh Gaikwad Varus fixation of neck #.

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Rahul B Tanga Thanks Dr Lokesh Bhatia.this case was one of the most challenging case for me as patient was morbid obese and all lower limb fractures were on same side with extensive internal soft tissue injury with gross swelling of lower limb.patient was haemodynically unstable and was resuscitated first with couple of transfusions.there was difficulty getting better reduction of neck due traction was not sufficient due to tibia fracture on same side.so neck is in varus with single screw thr nail and cc screw was decided on table.saving patient life was first priority. Getting union at all fracture site was second priority and achieved.gettting functional rom knee is the third challenge and still working on that.and last but not least there is no LLD and patient comes to my consultation room walking without support which is the most happiest moment for any ortho pod. Thought closed fractures but still chances of infection is there but still could escape.only one thing I would like to improve in my case is to achieve better rom at knee in my next case.

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Syed Mohsin Did u put d pt on # table?

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Lokesh Bhatia No Doubt it was a very Challenging case not only for you, would have been for anybody in this world. What will you like to do to Improve Knee ROM.

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Rahul B Tanga Rom beyond 110 degrees and neck reduction at least 130degrees

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Karwan Ahmed Raouf well done ............great job

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Lokesh Bhatia Would you agree If i say If you were struggling so much, you could have addressed, Wrist and Middle MC injury in next session, as it is quite obvious you might have been quite tired by that time. In next 48 hrs you could have considered to do it. I think you could have attained a better Distal end Radius Reduction if you would have been doing it in second sitting. AS it became a herculean task to manage and fix all together in one sitting, you might have become Mentally and Physically tired by the time you were addressing the Wrist and Middle MC #.

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Rahul B Tanga Dr Lokesh Bhatia this case was done in 3 stages kindly go through my previous comments?

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Shivendra Sinha how much mm screw dia in patellar fixation?

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Siva Orthopaedician excellent job..

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Rahul B Tanga 4 mm cc screw

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Said Abdelhaleem Beutiful

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Raghuraj Kundangar u increased his wt to 133kgs... he he

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Golam Mahmud Suhash Great job

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Vinod Rajkumar great work..

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Stanley Ndakoro Kanyemba Post operative X-Rays?

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Freddy F Galvis Gomez 1)CONDYLAR 95 GRADES PLATING IN HIP AND ANOTHER IN SUPRACONDYLAR sPLIT. IS FAST AND IS GOOD PLUS_BUTRESS PLATING IN LATERAL PROXIMAL TIBIA.ROTULA CANULATED SCREW. BLOCKING IN THE SAME intramedular NAILING WITH TWO MORE SIZE. AND LDCP IN TIBIA. LOOK THAT IN PROXIMAL TIBIA THE ANATOMIC PLATE IS NOR BENDIND FOR ATACHMENT NEED BETTER TWO PLATES.

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Manoharan Muthulingam Nicely executed sir.

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Ahmed Abdulzahra Great job

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Drgirish Gupta Good job

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Doc Rahman great achievement sir...

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