Discusión entre pares / 15 yr old boy,4 days old injury,sweling ++, my plan is medial T plating,avoding physis, or plz vote for expert tibia nailing

Indian-Orthopaedic Research-Group

Ashish Khandelwal

15 yr old boy,4 days old injury,sweling ++, my plan is medial T plating,avoding physis, or plz vote for
expert tibia nailing in 15 yr boy.?

Me gusta

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  Balakannan Jayabalan Try k-wires

  18 de noviembre a la(s) 11:50 · Me gusta
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  Ashish Khandelwal why not closed medial mipo plating/

  18 de noviembre a la(s) 11:58 · Me gusta · 1
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  Banesh Gaikwad Closed reduction n ak cast as per protocol for this age group.

  18 de noviembre a la(s) 12:11 · Me gusta · 3
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  Ahmad Ayaz Retrograde rushpin could be dobe

  18 de noviembre a la(s) 12:17 · Me gusta
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  Srinivas Daravathu Mipo lateral ptlcp sparing physis

  18 de noviembre a la(s) 12:24 · Editado · Me gusta · 3
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  Mostafa Mahmoud Why medial plate?
  What about lateral plate with MIPO technique??

  18 de noviembre a la(s) 12:26 · Me gusta · 4
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  Sagar Hansalia Cross k wire

  18 de noviembre a la(s) 13:46 · Me gusta · 1
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  Drnitin Patel Cr n cross k wire

  18 de noviembre a la(s) 18:30 · Me gusta · 1
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  Ananda Regmi For discussion, IS it possible physeal sparing I/L nailing ?

  18 de noviembre a la(s) 19:36 · Me gusta
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  Ganesh Yeotiwad as fibula is also fracture then it wil reduced by close reduction fix it with up Kwire nd cast.

  18 de noviembre a la(s) 19:54 · Me gusta · 2
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  Ganesh Yeotiwad if its # tibia without fibula thn plan would be different

  18 de noviembre a la(s) 19:56 · Me gusta
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  Kamruzzaman Manik CRIF by cross k wire & cast

  18 de noviembre a la(s) 23:57 · Me gusta
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  Sharma Pervaind conservative,plaster

  Ayer a las 0:03 · Me gusta · 1
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  Amit Sharma In this particular # pattern, patellar tendon has the tendency to keep proximal # hyperexteded. We have enough space distal to epiphysis for plate fixn.so in my opinion, either absolutely conservative with serial xrays (k wires cannot negate ap pull of patellar tendon) or minimally invasive plating.

  Ayer a las 0:46 · Me gusta · 2
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  Alind Kishore Singh Ananda Regmi Sir problem in this case with nailing is that its recomended to have an enry point as high as possible for better reduction in proximal fractures which is not possible in this case, bt yes its a possibility with lower entry point with open reduction.i would prefer a latral plate with mippo .

  Ayer a las 1:55 · Editado · Me gusta
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  Mufazzal Bohra But its seems like physis is fused . treat him like an adult

  Ayer a las 2:46 · Me gusta
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  Dr-Ahmed El Dreny I have tried Elastic nail for such a case with excellent result

  Ayer a las 3:45 · Me gusta · 1
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  Yemin Htut # pattern is a little bit more proximal
  Reduction under c arm with cast or mipo is my choice

  Ayer a las 5:10 · Me gusta · 1
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  Bhavin Jadav Seems a very unstable fracture pattern. I would lateral plate this sparing the physis.

  Ayer a las 7:30 · Me gusta
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  Ananda Regmi Thank u, Alind

  Ayer a las 8:10 · Me gusta · 1
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  Ananda Regmi The boy is already 15, can't u treat as an adult?

  Ayer a las 8:12 · Me gusta · 2
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  Kamalakannan Giridharan nailing besywith poller screw

  Ayer a las 10:30 · Me gusta
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  Ashish Khandelwal Done closed medial mipo...one proximal screw crosing physis in distal part, had tried to avoid it ,but plate directed it there.. but in 15-16 yr old boy, i think should not create problem.. also will remove this screw early.

  

  Ayer a las 11:04 · Me gusta
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  Ashish Khandelwal

  

  Ayer a las 11:05 · Me gusta
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  Mufazzal Bohra Y u have not locked the proximal screws in plate

  Ayer a las 11:23 · Me gusta
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  Drsiraj Butt you can bent plate at level of proximal screw side to avoid physi

  Ayer a las 11:34 · Me gusta
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  Drsiraj Butt physis

  Ayer a las 11:34 · Me gusta
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  Srinivas Daravathu Not looking good,Wud hav tried same by lateral Mipo

  Ayer a las 11:38 · Me gusta
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  Srinivas Daravathu U crossed physis too

  Ayer a las 11:38 · Me gusta
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  Srinivas Daravathu Atleast remove plate by 6 months

  Ayer a las 11:39 · Me gusta
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  Dr-Ahmed El Dreny

  

  Ayer a las 13:57 · Me gusta · 1
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  Suman NV You should have thought in preop planning force of injury is directed laterally , so you should have supported the fracture from lateral plating

  Ayer a las 14:07 · Me gusta · 2
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  Ashish Khandelwal Patient is 15 yr old. Plate is applied to hold fracture only,its not tibial condyle fracture, i think it should unite well,will remove one proximal screw crosis physis at one month.

  Ayer a las 20:15 · Me gusta · 1
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  Kapil Dev Garg It's going to unite but the thing is your proximal screw is crossing physis n plate should be lit bit distal

  Ayer a las 20:51 · Me gusta
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  Yogendra Nehete Go for plate avoiding physis will give good result. I will not prefer wires as explained by Dr. Amit already

  17 horas · Me gusta · 1
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  Rakesh Agarwal Have you put plate over the patellar tendon

  16 horas · Me gusta
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  Bhavuk Garg why not a try for plaster?

  13 horas · Me gusta · 2