Discusión entre pares / male 55 ys old was in cast for 45 days in somewhere what to do now please

Shehata Albanouby‎Orthopaedic consultation room - Present your case here

male 55 ys old was in cast for 45 days in somewhere
what to do now
please

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  Mohamed Ibrahim Elbaqary ORIF with k wires and AEC for # ulna

  3 horas · Me gusta
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  Shehata Albanouby why k-wires in adult dr Mohamed Ibrahim Elbaqary and what about wrist???

  3 horas · Me gusta
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  Dr-Ahmed El Dreny the volar approach is preferred to decompress the carpul tunnel.

  3 horas · Me gusta
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  Mohamed Ibrahim Elbaqary i mean ORIF for lunate and repair ligaments then fix with k-wires and AEC for # ulna

  3 horas · Me gusta · 1
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  Shehata Albanouby do u think LUNATE reduction is easy after this period and which approach and technique prefered for such situation???

  2 horas · Me gusta
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  Shehata Albanouby Professor-Abdelsalam Eid

  1 hora · Me gusta
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  Shehata Albanouby professor Ashraf Ahmad Khanfour

  59 min · Me gusta
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  Shehata Albanouby professor Mahmoud El-rosasy

  59 min · Me gusta
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  Shehata Albanouby professor Mahmoud Mahran

  58 min · Me gusta
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  د.عبدالمجيد أبوالعباس أبوالبراء Follow

  55 min · Me gusta
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  Mahmoud El-rosasy after 45 days reduction of that lunate and fixation would result in a stiff and painful wrist. i think that excision and limited intercarpal fusion to avoid proximal collapse of the capitate would be a good solution. but i like to invite my friend Dr. Muhammad A Quolquela, to comment as a hand surgery expert.

  53 min · Me gusta · 3
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  Muhammad A Quolquela Dear Dr Rosasy , I appreciate your invitationso much. First, Lateral view is not an ideal lateral in which the outline of the pisiform should lie midway between that of the capitate and the sacphoid tuberosity,. It is volar luante dislocation meaning all the ligaments holding the lunate in position are disrubted i.e. the scapholunate and the less importantly the lunotriquetral lig.

  32 min · Me gusta · 2
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  Muhammad A Quolquela If it is a recent case I would go with open reduction through first dorsal approach and if it is difficult to retrieve the luante we combine it with volar approach too and fix the lunate with the scaphoid as if it is a scapholunate dissociation with K wires for 6 weeks

  30 min · Me gusta · 3
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  Shehata Albanouby first much thanks to both professors Mahmoud El-rosasy and Muhammad A Quolquela for great support

  25 min · Me gusta
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  Shehata Albanouby then now to reduce and fix or to excise please

  24 min · Me gusta
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  Muhammad A Quolquela If it is neglected like this one two points 1, reduction of the lunate is very difficult 2, even if the luante can be reduced the healing of the supporting ligament would be isufficient .also there is no limited fusion suitable for this injury as also...Ver más

  24 min · Me gusta · 3
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  Muhammad A Quolquela Now we are left with one option that is to excise the luante. we CAN NOT excise it alone it will invite collapse of the carpal bone the same as sacpholuante dissocaiation, So teh ideal would be PRC removing the whole proximal row . This allows early mobilization as teh wrist is already stiff due to no movements foe 45 days with the marked oedema usually associated with neglected dislocation.

  20 min · Me gusta · 4
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  Shehata Albanouby many thanks our helpful professors

  17 min · Me gusta
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  Mahmoud El-rosasy Dr. Muhammad A Quolquela, is there a place for lunate only excision and intercarpal fusion to avoid collapse. then the wrist movement occurs at the radioscaphoid articulation?

  1 min · Me gusta