Discusión entre pares / ortopedistas

Rahul B Tanga ha añadido fotos al álbum "October 26, 2013" en el grupo "Indian Orthopaedic Research Group".

Rahul B Tanga ha añadido fotos al álbum "October 26, 2013" en el grupo "Indian Orthopaedic Research Group".

Rahul B Tanga criticism and suggestions?



Hatim Elgazzar Very good
But the fr dislocation can be treated also bypinning&a/e cast



Rahul B Tanga thanks dr hatim deformity was gross and it was difficult to maintain reduction so went ahead with ligamentotaxis.



Rohit Damor There is still somevl dorsal tilt at # d/e radius...
Femur is very good but for primary BG no need to be so much agressive otherwise exellent.



Mavv Prasad I agree wth dr rohit lat view not much comfortable I feel kwire was agood option n femur good decision of or bg does encirclage wire really needed



Brajesh Tyagi Personally I would not have opened the # femur.bg in2 nd sitting if the need be. More cmmunited the # more callus is formed provided the periosteum is intact. Now the chances of inf.have also increased.



Amit Varshney i agree tyagi sir



Rahul Verma Will prefer to do closed nailing. ....
Indication for open reduction and encirclage??????



Rahul B Tanga Thats not true lateral view , i had asked radiographer to take bit oblique as fixator would had overlapped.



Rahul B Tanga dr brajesh tyagi do you think in this particular case the periosteum is intact? by seeing preop xrays amount of internal compounding or degloving is severe.



Amit Varshney tanga sir is this open fracture



Rahul B Tanga open reduction was done as closed reduction was not possible even tried to do joystick technique. secondly when i opened it there was lot of lot of soft tissue interposition.it was a big fragment and once i opened it i felt encirclage was better with bg.



Rahul B Tanga dr varshney it was closed fracture.



Amit Varshney than sir i m wid dr tyagi opinion



Rahul B Tanga thanks dr rohit the patients dont believe and agree in second stage bg or any kind of procedure and there was bone loss on medial side .



Rahul B Tanga dr varsyhney i dont mind on whose side you are ,as a operating surgeon i tried my level best for closed reduction and failed after repeated attempts. so was opened. at the same time just go through the preop xray distal femur has gone and split the proximal femur.with this even soft tissues get interposed.



Rohit Damor Agreed dr Rahul B Tanga as pt is not willing for 2nd procedure and bone loss then 1ry BG ok. My concern is that in such high velocity multifragmented # there is so much internal soft tissue injury and blood loss , so chances of infection are high.... femur has profuse blood supply from all around so chances of nonunion are less in such stable and acurate fixation that you have already achieved.



Rahul B Tanga I have quite good number of cases which were even type3a open fractures treated with circlage+bg and got good results .such cases I have previously posted with results in iorg.



Rohit Damor Ultimate goal for every surgeon is to get solid union in normal anatomy without complications by any means.



Brajesh Tyagi Dr.Tanga with due regards ,you asked for criticism in your post , I always maintain (along with Amit)
that on table surgeon is the best judge. We respect your decision.



Umesh Meena Sir I think if it is possible, closed iln is best but if it require open reduction dn encircalage wd primary bg is better.....so u hv dn gd job sir
Hace 2 horas a través de móvil · Me gusta · 1


Raj Sekar nice one. only risk is infection.



Habeba Wael Very good excellant work



Gopal Goel Rahul B Tanga I would go for CR+ ILN - Nail entering from Tip of GT. No OR+ Circlage wires+ BG. Wrist -- I would Go For CR+ Pinning + Distractor through 2nd MC



Rahul B Tanga dr goel every orthopaedic surgeon would love to do close nailing rather than taking so much of extra efforts and do open nailing and bone grafting.so if close is not possible then only open nailing is done.as far as wrist is concerned distractor was necessary on table so was put.



Gopal Goel Rahul B Tanga I have not criticized you since i know that every ortho surgeon would do his best. I have hust stated my views. For wrist i would have added pinning also



Rahul B Tanga I know dr goel you have not criticised but I just expressed why open nailing was done. ya pinning can be added . but usually what I have seen is fixator maintains reduction.