Data Trace Editor – Discussion: – IM nailing of Intertrochanteric fractures – Synthes Trauma Menu / Proximal Femoral Products – nails designed for trochanteric entry and rigid fixation into the femoral head are optimally used; – indications: – interlocking nails have been used for subtroch frx when lesser trochanter remains attached to the proximal … Read more
Co-authored by Dr. Mangal Parihar – Fixator Characteristics: – ring characteristics: – wire insertion technique: – half pin insertion techniques: – Specific Uses: – circular wire fixators for tibial frx: (foot inclusion); – circular wire fixators for knee fusion: – limb … Read more
Dr. Mangal Parihar – Discussion: The early post operative period extends from the time the patient comes out of surgery till the beginning of distraction. Even before the patient comes out of the OT one needs to confirm that the operative plan has been carried out correctly by proper ‘final’ x-rays of the part. Relying … Read more
Dr. Mangal Parihar – Discussion: It is during the distraction phase that most of the complications of the treatment will occur, and consequently the surgeon has to be constantly on the lookout for the known complications. Follow-up Frequency: During the distraction phase, the patient should be seen at least every two weeks. At these visits … Read more
Dr. Mangal Parihar – Discussion: Like all mechanical components, the Ilizarov frame is liable to loosen. Therefore at every visit a check is made to ensure that the various bolts and nuts are adequately tight. Though is does not happen often, wires may loosen. The patient with loose wires complains of pain at the pin … Read more
Dr. Mangal Parihar – Discussion: A month too late is better than a day too early. This is a useful thing to remember at a time when even the most cooperative patient is usually becoming impatient for the frame to be removed. The ability of the regenerate for unprotected weight bearing must be ensured prior … Read more
Dr. Mangal Parihar – Discussion: The rhythm and more so the rate of distraction are not fixed numbers. 1 mm per day in four equal fractions is only the recommended average. There are frequently cases that require a slower rate, or occasionally a faster rate. This can only be adjusted if one is looking closely … Read more
Dr. Mangal Parihar – Discussion: Pinsites should be cleaned with sterile saline (boiled & cooled water would do as well) and cotton swabs on a daily basis. Use of antiseptic lotions to cover the pinsites is favored by many surgeons, but is not necessary. In fact the only area where any gauze dressings are required … Read more
Dr. Mangal Parihar – Discussion: Much is spoken about physiotherapy and it’s importance in the Ilizarov method. Unfortunately, this is infrequently translated into practice. One just has to look at many cases with iatrogenic problems to realize that lack of physiotherapy lies at the root of the majority of these. The patient has to participate … Read more
Dr. Mangal Parihar – Discussion: Pain relief is very often not given due importance in our (Indian) circumstances. The importance of keeping the patient free of pain, during the entire length of treatment cannot be overemphasized. This is even more vital in the early post-op period, because the patient with pain is not going to … Read more