Treating Severe Infected Hip Replacement and Neglected Tibial Fracture
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here sharing with you complicated cases that we encountered in our hospital & how we treated. all advices are always welcome
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Treating Severe Infected Hip Replacement and Neglected Tibial Fracture
- 1. CASE NO. 1 63 YR OLD MALE ,H/O OLD MALUNITED ACETABULAR # OPERATED FOR THR ELSEWHERE WITH SIGNIFICANT INFECTION,PAIN.
- 3. .. STAGE 1 ; • REMOVAL OF EXISTING IMPLANTS, ANTIBIOTIC MIX CEMENT WITH CONTOURED K NAIL FEMUR AS A SPACER • PT. IN BED FOR 3 MONTHS WITH SPECIFIC ANTIBIOTIC COVER. • AFTER HEMATOLOGICAL PARAMETERS LIKE ESR,CRP,TOTAL COUNT WERE CONSTANT FOR 2 WEEKS, DECIDED TO OPERATE. • WE HAD NOTICED LARGE ACETABULUM WHICH WOULD NEED • AUGMENTATION
- 4. OPTIONS CONSIDERED • ACETABULAR MESH,PLATE WITH BONE GRAFTS • EXTRA LARGE ACETABULAR CUP WITH WEDGES • ALLOGRAFT AUGMENTATION. • FIRST 2 OPTIONS WERE EXPENSIVE SO DECIDED ON THE 3RD • ALLOGRAFTS,PROCURED FROM TATA MEMORIAL HOSPITAL WERE USED.
- 5. POSTOPX-RAY
- 6. CASE NO. 2 55 YR OLD NEGLECTED CONDYLAR # TIBIA PRESENTED AFTER NEARLY 1 YEAR SHE WAS NOT WALKING WITH SEVERE PAIN & DEFORMITY.
- 7. ..
- 8. ..
- 9. .. • PT. LOST FOR FOLLOWUP 3 MONTH POST OPERATIVELY . • CAME WITH FIXED FLEXION DEFORMITY,70 DEGREES, POSTERIOR SUBLUXATION & PAIN.
- 10. .. X- RAY S/O UNITED OSTEOTOMY POSTERIOR SUBLUXATION.
- 11. PROBLEMSFACED • FIXED FLEXION DEFORMITY • POSTERIOR SUBLUXATION • SEVERE PAIN sOLUTION • SKELETAL TRACTION ABOVE THE ANKLE • TO OUR SURPRISE DEFORMITY WAS CORRECTED OVER 3 WEEKS PERIOD
- 13. OURTAKEONTHISCASE • NEGLECTED CONDYLAR FRACTURES ESPECIALLY WITH SUBLUXATION SUGGESTING SIGNIFICANT INTERNAL DERANGEMENT COULD HAVE BEEN PRIMARILY SUBJECTED TO TKR. • MERE CORRECTION OF DEFORMITY BY THE 1ST PROCEDURE WAS INADEQUATE YET MADE OUR SUBSEQUENT TKR EASY.
- 14. THANK YOU