Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...drashraf369
femoral head fractures are very complex fractures that need immediate and prompt surgical intervention.conventional surgical appproaches to hip may lead to short and long term complications.dr mohamed ashraf ,dr rahul thampi et al are presenting their experience with gantz safe surgical dislocation approach to surgical management of femoral head fractures
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...drashraf369
femoral head fractures are very complex fractures that need immediate and prompt surgical intervention.conventional surgical appproaches to hip may lead to short and long term complications.dr mohamed ashraf ,dr rahul thampi et al are presenting their experience with gantz safe surgical dislocation approach to surgical management of femoral head fractures
The effect of intact fibula on functional outcome of reamed intramedullary in...Love2jaipal
detailed journal club presentation on The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures
DR yasser baskoor orthopedic amputations.pptxybaskoor
Detialed orthopedics amputation and essential information needed to know by orthopedics resident doctors
Introduction
Defination
Types of amputations
Antomical requirment for every amputations
Fractures after Knee replacement can be challenging. An algorithmic approach would help manage them better. The presentation defines correct approach towards the same.
5. Broad, congruous & bleeding articular
surfaces in apposition
Well stabilized & compressed of articulating
surfaces with utmost care of skin and soft
tissues
Painless & stable fusion of ankle & subtalar
joints in functional position
Foot at 90 degree angle to long axis of tibia
with 5-7 degree of hindfoot valgus
6. Hindfoot nail
Nail + screws
Blade plate
External fixator
Ring(Ilizarov) fixator
Taylor spatial frame
Combinations
7. Valgus deformity – Supine position
Varus position – Lateral position
Severe varus – additional medial approach
Transfibular osteotomy
2.5 cm above lateral malleolus
Fibula is cut in bevelled fashion
8. Preserve fibula in young patients for later
date possibility ofTAR
Preparation of ankle & subtalar joints
Fixation – nail, blade plate, ex-fix or ring
fixator
Blade plate : Anterior, posterior or lateral
approach
9.
10.
11.
12. Compression at both joints-15mm
Two plane locking-40% increase in stability
Lock all holes
10mm nail, 150-180 mm length
Countersink nail up to 5mm
Grafting if needed
Use of end cap
• Prevention of medullary bleeding
• Preservation of threads for extraction
• limiting the heterotopic ossification
13. Stress fracture at tip of nail
(Controlled with longer nail)
Non union
(exchange nailing+ bone
grafting)
(ring fixator +bone grafts)
14. Pre-assembled, embedded distal locking
mechanism in the nail
7 mm of in-board compression
Ability to compress the subtalar and ankle
joints separately
Screws can still be removed without having
to disengage compression and/or
locking mechanisms
15. Blade plate – adoloscent/ humerus with
blade length of 40mm with plate holes up
to 5-8
Provisional fixation of joints with guide
wires/k wires/ST pin/ Schanz screws before
blade insertion
16. Guide wire:5-10mm of
calcaneus bone shall
remain plantar to the
blade plate
Push flush to lateral
cortex
Do contour to prevents
valgus malunion
4.5 screw proximally &
6.5 screws distally
17. Guide wire in
proximal screw hole
to prevent rotation of
blade plate while
hammering it in
Cut a notch in lower
end of tibia for sitting
of blsde plate
Use AO tension device
for giving compression
18.
19. Prone position
Midline longitudinal approach -
14-16cms
Skin+ paratenon in one incision
Z plasty of achilles
FHL with NV retracted medially