Cirugía de Columna y Articulaciones: Discusión entre pares / 30 yrs male. Injured while playing football.

miércoles, 17 de septiembre de 2014

Discusión entre pares / 30 yrs male. Injured while playing football.

Indian-Orthopaedic Research-Group

Shyamlal Mukhi

30 yrs male.
Injured while playing football.

30 yrs male.
Injured while playing football.

Bhavin Jadav Weber B with seemingly > 2 mm displacement. Must have ORIF.

13 de septiembre a la(s) 5:33 · Me gusta
Ujagar Singh If patient can't afford then CR/POP Cast...

13 de septiembre a la(s) 5:39 · Me gusta
Ramendra Narain Singh consevative

13 de septiembre a la(s) 5:54 · Me gusta · 1
Rahul Arora Orif compulsary

13 de septiembre a la(s) 5:56 · Me gusta · 2
Sherif Sarhan Does this small fragment of pos malleolus fracture need fixation with the lat malleplus ??

13 de septiembre a la(s) 6:01 · Me gusta
Arvind Jain tibio fibular need screw

13 de septiembre a la(s) 6:14 · Me gusta · 2
Bhavin Jadav The posterior mall fragment is less than 30% and doesn't need fixing.
I don't think this injury pattern is that of syndesmosis injury. This doesn't need a diastasis scree but a lag-screw and neutralization plate construct for accurate reduction and fixation of fibula and of secondarily talus in the joint.

13 de septiembre a la(s) 6:18 · Me gusta · 3
Mokhtar Al Sabre Need syndesmotic screw

13 de septiembre a la(s) 6:20 · Me gusta · 1
Bhavin Jadav The lines to show that the syndesmosis is contained but there is a talar shift. This is secondary to displacement of fibular fracture- not due to syndesmosis widening.

13 de septiembre a la(s) 6:25 · Me gusta · 7
Ka Saindane Fibula dcp with syndesmotic screw ,

13 de septiembre a la(s) 6:31 · Me gusta
Rehan Azmi Below knee cast.

13 de septiembre a la(s) 6:40 · Me gusta
Ahmed Elsawaf I would fix of course

13 de septiembre a la(s) 6:51 · Me gusta
Anuj Agrawal I agree with Bhavin Jadav. There is posterolateral shift of the talus in the mortice, due to displacement at the lateral malleolus fracture.
This requires an accurate reduction and plating. Syndesmotic injury cannot be ruled out, and it should be tested intra-operatively.

13 de septiembre a la(s) 6:55 · Me gusta · 7
Ceyhun Ferzulla Requieres Opi .plating

13 de septiembre a la(s) 7:01 · Me gusta
Farhan Syed LH Supination External rotation type injury. Fibular fixation can be done either by interfrag and neutralization plate or a posterior antiglide plate. Syndesmotic injury unlikely but a good practice to test it once you have fixed fibula. Post malleolus and deltoid lig injury doesn't require surgical intervention.

13 de septiembre a la(s) 7:11 · Me gusta · 2
Shyamlal Mukhi Post op X-ray... Comments plz

13 de septiembre a la(s) 7:17 · Me gusta · 8
Bhavin Jadav Looks good reduction and fixation. My choice of implant and placement would be slightly different but this is sure good.

13 de septiembre a la(s) 7:36 · Me gusta
Shahab Ud Din Anteglading plating vd syndemotic screw.

13 de septiembre a la(s) 8:14 · Me gusta · 1
Kamlesh Dutta Tiwari coservative.

13 de septiembre a la(s) 8:44 · Me gusta
Guevara Hamo conservative

13 de septiembre a la(s) 8:54 · Me gusta
Ka Saindane Sir it is going to unite.but ideally interfrag screw should be there ,and syndesmotic screw inserted, if u mobilise pt immediately ,it is likely to increase the medial joint space ,latter on joint arthritis enevitable,why not to do ideal fixation .

13 de septiembre a la(s) 9:35 · Me gusta
Bhavin Jadav The number of people who definitely want syndesmosis screw here is worrying.

13 de septiembre a la(s) 9:37 · Me gusta · 2
Shyamlal Mukhi Have u friends observed the anchor sutures for deltoid ligament? See stress X-rays on CARM adduction

13 de septiembre a la(s) 9:53 · Me gusta · 5
Shyamlal Mukhi Abduction

13 de septiembre a la(s) 9:54 · Me gusta · 3
Shyamlal Mukhi Thanks to all my friend for good comments and discussion

13 de septiembre a la(s) 9:55 · Me gusta · 2
Sudhir Chandel Agree with Bhavin Jadavin

13 de septiembre a la(s) 10:07 · Me gusta
Navin Singh Syndesmostic injury becomes evident only after stressing under C Arm after fixing fibula. I had made this point in a much debated post long time back

13 de septiembre a la(s) 21:26 · Editado · Me gusta · 2
Srinivas Daravathu Lateral malleolus fracture and syndesmosis injury and ? Talus neck undisplaced fracture

13 de septiembre a la(s) 12:10 · Me gusta · 1
Srinivas Daravathu This needs a longer 1/3 tubular plate contoured along lateral malleolus dis tally and syndesmotic screws thru the plate

13 de septiembre a la(s) 12:12 · Me gusta
Drgirish Gupta Fibula platting with syndesmosis screw

13 de septiembre a la(s) 13:52 · Me gusta · 1
Freddy F Galvis Gomez fibular platting with tubular 1/3 PLUS SCREW ONLY PROXIMAL IN POSTEROLATERAL EGDE.

13 de septiembre a la(s) 14:48 · Me gusta · 1
Farhan Syed http://www.ncbi.nlm.nih.gov/pubmed/22767333
There's no evidence to suggest deltoid ligament repair in ankle fractures. Only indication for exploration will be ligament interposition preventing reduction of ankle joint.

The diagnosis and treatment ... [Strategies Trauma Limb Reconstr. 2012] - PubMed - NCBI

www.ncbi.nlm.nih.gov

PubMed comprises more than 23 million citations for biomedical literature from M...Ver más

13 de septiembre a la(s) 16:35 · Editado · Me gusta · 4
Suneet Rajshekhar since there is med jt space widening , plating the fibula is essential. fracture is distal to syndesmosis so no screw needed

14 de septiembre a la(s) 1:43 · Me gusta
V V Prasad Ortho how many of u have seen fracture of fibula below the syndesmosis WITH SYNDESMOTIC DIASTASIS??????

14 de septiembre a la(s) 5:49 · Me gusta · 1
Drgirish Gupta Space increase bn mm&talus ??

14 de septiembre a la(s) 5:58 · Me gusta
Bhavin Jadav Girish, the talus also shifts as a result of deltoid ligament injury, not just syndesmosis.
Deltoid injuries don't necessarily need repair- accurate reduction of lateral strut is adequate to allow deltoid lig to heal.

14 de septiembre a la(s) 6:23 · Me gusta · 4
Pradeep Moonot weber B fracture of the fibula with deltoid lig injury. Fibula needs plating

14 de septiembre a la(s) 12:47 · Me gusta · 1
Saadi Alkaragoli It's DJanis weber type 2 with devoid ligament injury so best treatment by plate fixation of fibula after exposure of medical maleolus exclude tibialis posterior tendon interposition between medical maleolus and talks then future of devoid ligament

14 de septiembre a la(s) 16:51 · Me gusta · 1
Subhash Mohite Fibula plating , third mal small un displaced # can be left alone

Ayer a las 2:09 · Me gusta
Srinivas Daravathu it seems deltoid repaired,great sir

Ayer a las 2:17 · Me gusta
Sunil Mehrotra conservative can be tried non wt bearing for one month change of cast after 15 days and check x,,,,,ray

Ayer a las 11:47 · Me gusta

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