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Rahul B Tanga Indian Orthopaedic Research Group
32yrs male presented with closed comminuted intrarticular fracture distal end of radius extending into lower 1/3rd of radius. Plan A was orif with 3.5 mm distal radius lcp but maximum available length was 8hole and where 3 screws in shaft was not possible. so crif with 3.5mm interfrag screw with ligamentotaxis radius done.
Rahul B Tanga Valuable inputs?
Vishal Kodgirkar Rahul B Tanga Sir when will you remove the fixator??
Rahul B Tanga Vishal after 1month
Faisal Siddiqui Well done salvaged very well I would like fixator for six weeks
Srinivas Daravathu Rahul ,nice try ,I Wud have thought of the same plate ,here u need fixator for 6 wks in my opinion
Mohanraj Sadasivam Excellent fixation sir.. could have used proper sized drill bit.. that would have avoided splintage of bone at the far cortex
Muzaffar Mushtaq Few things, on the volar aspect I see possible trouble for the flexor tendons, or even a carpal tunnel syndrome. Second, though the split looks well dealt, a lag screw should be used, or a cortical screw with overdrilled cis fragment. Third, conventionally we put the metacarpal pins in 2nd MC, you've chosen 3rd one?! Otherwise it's a good option.
Abhinav Bhardwaj why ve u put pins in 3rd mc
Alok Jain Have u ever tried Overlapping plating..????
Cheppalli Nspreddy Rahul- I think it wud have been fine just to use plate instead of ex fix. As it is long oblique few ( more than 1)interfrag screws with neutralization plate wud have been fine. I don't necessarily feel that we need to have 6 cortices if it is stabilize...Ver más
Chandra Mohan Rahul B Tanga nice reduction Rahul ji, as usual.. But a suggestion.. First distal Pin should be at the level of base of 2nd and 3rd metacarpals.. Here it is just over the shaft.. But end result is good..
Kir Pat Redo with plate ,You have opened ,reduced, same plate will have done the job and by stack plating as Alok has mentioned, ,another low profile plate.4 hole.with 2 holes combined better if locking now...Rupture of flexor tendon likely as Muzaffar Mushtaq,good observation note...that spike /beak is suggestive of rotation of frgs
Mansoor Jaleel Interfrag screw was percutaneous?
Rahul B Tanga Muzaffar Mushtaq thanks.this is what i could do best on table in a closed manner.as maximum length available lcp was 8holed and requirement was 10hole . That screw itself is a lag screw and near cortex was overdrilled to 3.2mm to achieve lag effect. At our center where i did dnb used to follow 1st pin 4cortices and 2nd pin 3 cortices in MC for better stability. .
Rahul B Tanga Alok jain sir never tried overlap plating nor seen one.
Rahul B Tanga Cheppali i agre with you. But this what i could achieve and ex fix results are equally good in such cases in comparison with plating as you are not handling soft tissues. Putting screw in distal end radius is quite challenging in comminution and have seen causing more damage than help in my series so i prefer ligamentotaxis.
Rahul B Tanga Indian Orthopaedic Research Group
32yrs male presented with closed comminuted intrarticular fracture distal end of radius extending into lower 1/3rd of radius. Plan A was orif with 3.5 mm distal radius lcp but maximum available length was 8hole and where 3 screws in shaft was not possible. so crif with 3.5mm interfrag screw with ligamentotaxis radius done.
Rahul B Tanga Valuable inputs?
Vishal Kodgirkar Rahul B Tanga Sir when will you remove the fixator??
Rahul B Tanga Vishal after 1month
Faisal Siddiqui Well done salvaged very well I would like fixator for six weeks
Srinivas Daravathu Rahul ,nice try ,I Wud have thought of the same plate ,here u need fixator for 6 wks in my opinion
Mohanraj Sadasivam Excellent fixation sir.. could have used proper sized drill bit.. that would have avoided splintage of bone at the far cortex
Muzaffar Mushtaq Few things, on the volar aspect I see possible trouble for the flexor tendons, or even a carpal tunnel syndrome. Second, though the split looks well dealt, a lag screw should be used, or a cortical screw with overdrilled cis fragment. Third, conventionally we put the metacarpal pins in 2nd MC, you've chosen 3rd one?! Otherwise it's a good option.
Abhinav Bhardwaj why ve u put pins in 3rd mc
Alok Jain Have u ever tried Overlapping plating..????
Cheppalli Nspreddy Rahul- I think it wud have been fine just to use plate instead of ex fix. As it is long oblique few ( more than 1)interfrag screws with neutralization plate wud have been fine. I don't necessarily feel that we need to have 6 cortices if it is stabilize...Ver más
Chandra Mohan Rahul B Tanga nice reduction Rahul ji, as usual.. But a suggestion.. First distal Pin should be at the level of base of 2nd and 3rd metacarpals.. Here it is just over the shaft.. But end result is good..
Kir Pat Redo with plate ,You have opened ,reduced, same plate will have done the job and by stack plating as Alok has mentioned, ,another low profile plate.4 hole.with 2 holes combined better if locking now...Rupture of flexor tendon likely as Muzaffar Mushtaq,good observation note...that spike /beak is suggestive of rotation of frgs
Mansoor Jaleel Interfrag screw was percutaneous?
Rahul B Tanga Muzaffar Mushtaq thanks.this is what i could do best on table in a closed manner.as maximum length available lcp was 8holed and requirement was 10hole . That screw itself is a lag screw and near cortex was overdrilled to 3.2mm to achieve lag effect. At our center where i did dnb used to follow 1st pin 4cortices and 2nd pin 3 cortices in MC for better stability. .
Rahul B Tanga Alok jain sir never tried overlap plating nor seen one.
Rahul B Tanga Cheppali i agre with you. But this what i could achieve and ex fix results are equally good in such cases in comparison with plating as you are not handling soft tissues. Putting screw in distal end radius is quite challenging in comminution and have seen causing more damage than help in my series so i prefer ligamentotaxis.
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