Discusión entre pares / 22 years old male ... sustained that patellar fracture 3 m0nths ago

Ayman Sabour‎Orthopaedic consultation room - Present your case here FB

3 horas · 

22 years old male ... sustained that patellar fracture 3 m0nths ago , treated as shown in a supposed respected specialized trauma center(?????)... the now clinical picture is ; well healed longtudinal incision , quadriceps wasting , extension lag about 5 degrees , active flexion 70 degrees with marked pain in attempt to make more flexion passively ... is there any intervention to do now to save that knee ?! the last 2 radiographs were done 2 days ago

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  د.عبدالمجيد أبوالعباس أبوالبراء

  وده عبارة عن إيه اللي اتعمل بالضبط

  2 horas · Me gusta · 3
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  Mohamed Farouk Zaky

  اتعمل معاه الجوﻻشة
  Needs revision with augmentation of the quad tendon, removal of the small fragments

  2 horas · Me gusta · 2
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  Mohamed Baz

  الحلزونه ياأمه الحلزونه

  2 horas · Me gusta
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  Mohamed Baz What about excision of the patella??

  2 horas · Me gusta · 2
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  Ahmed Saber El Refaiy Urgent physio then deal with complications

  2 horas · Me gusta
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  Mohamed Farouk Zaky Patellectomy will decrease the moment force of quad which is already weak

  2 horas · Me gusta · 1
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  Ayman Sabour dear dr. Mohamed Baz . i think the age of the pt guides us to make every effort to preserve the patella

  2 horas · Me gusta · 1
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  Ayman Sabour dear dr.Ahmed Saber El Refaiy , the pt already underwent an extensive course of physiotherapy for 3 months

  2 horas · Me gusta
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  Mohamed El Ragaby Revision

  2 horas · Me gusta
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  Mohammad Saleh Soliman Decisions are more important than Incisions.

  2 horas · Me gusta · 1
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  Mohamed Baz Do you think that you can restore the articular surface ?

  2 horas · Me gusta
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  Mohamed Farouk Zaky You can regain the force of quad tendon as much as you can +you try to make congruent articular surafce as you can, then after complete healing and regained power if you fear of patelofemoral you can do patellar resurfacing or artificial patella

  2 horas · Me gusta · 1
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  Eslam Khalaf Tension band after releasing under anaesthesia , then early rehabilitation

  1 hora · Me gusta
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  Mohamed Kamal The patella now is double its normal height witch explains extensor lag.so according to patient life style and activity your plane will be held,either continue with physiotherapy or revision