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
– See: Humeral Frx – Main Menu: / humeral shaft fractures – Discussion: – may be indicated for multi-trauma patients w/ humeral shaft frx, and patients w/ pathologic frx; – note that following humeral shaft frx, IM nailing provides torsional and bending stiffness of only 20-30% of normal; … Read more
– See: – Open Tibia Fractures – Infections of the Tibia – ” There have been major improvements in the surgical treatment of open tibial fractures during the past two decades. These improvements include aggressive treatment of soft tissue injury by means of immediate debridement and early coverage as well as … 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: 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: 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: 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: Proper limb positioning taught early on minimizes the chances of contractures developing later. The commonest cause of a flexion deformity is the tendency to keep a pillow lengthwise under a tibial frame. This causes flexion at the knee. This should be prevented by repeatedly correcting the tendency and keeping an … Read more
Dr. Mangal Parihar – Discussion: EMG monitoring of patients undergoing lengthening has shown that up to 80% of patients undergoing lengthening show electromyographic changes of neural injury, in spite of no clinical signs. This fact must be remembered especially when large lengthenings are being planned. The patient must have a proper evaluation of the motor … 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