Discusión entre pares/14yr f fall from bike today What is the best treatment? ?

Indian-Orthopaedic Research-Group

Drgirish Gupta

14yr f fall from bike today
What is the best treatment? ?

Me gusta

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  Bhavin Patel If DNV normal than just perform CR and fix it with K wires

  Ayer a las 4:15 · Me gusta · 3
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  Drsachin Phadnis CR seems difficult in this case so ORIF with crossed K wires

  Ayer a las 4:21 · Editado · Me gusta · 2
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  Firas Hamaidah CR and 2 crossing k.wires

  Ayer a las 4:35 · Me gusta · 2
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  Budha Prakash CR n pinning

  Ayer a las 5:00 · Me gusta
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  Mohamed Ghazoly Try cr and cross wires under carm

  Ayer a las 5:04 · Me gusta
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  Jalal Ahmed Hady CR with crossed k wires

  Ayer a las 5:09 · Me gusta
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  Amit Sehgal CRIF with k wires a/k plaster......

  Ayer a las 5:14 · Me gusta
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  Dinesh Loganathan Had come across a similar case like this.mostly require open reduction and criss cross K wires augmented by a POP or exfix

  Ayer a las 5:15 · Me gusta · 1
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  Amr Yasser Hassan Salter harris l for CR trial and k.wire fixation under image, if CR failed OR and crossing k.wires fixation and long leg POP.

  Ayer a las 5:29 · Me gusta · 2
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  Raj Bahadur Singh CR and k wire fix. Under sedation and under c arm.

  Ayer a las 5:48 · Me gusta · 1
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  Sadique Ahmed Khan

  

  Ayer a las 5:49 · Me gusta
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  Sadique Ahmed Khan

  

  Ayer a las 5:50 · Me gusta · 4
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  Sadique Ahmed Khan

  

  Ayer a las 5:51 · Me gusta · 4
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  Devapriya Majumdar One cd also use rush nails after cr under carm

  Ayer a las 6:01 · Me gusta
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  Trembak Patel CR &cross pinning. Growth arrest is 100%

  Ayer a las 6:22 · Me gusta
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  DrAvinash Mahender CR with or without crossed k wires

  Ayer a las 6:23 · Me gusta
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  Drgirish Gupta

  

  Ayer a las 6:38 · Me gusta · 6
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  Drgirish Gupta

  

  Ayer a las 6:38 · Me gusta · 7
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  Drgirish Gupta CR done & threaded k wire fixation with Above knee slab

  

  Ayer a las 6:40 · Me gusta · 5
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  Mansour Salem Close reduction and pinning

  Ayer a las 7:13 · Me gusta · 1
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  Yogesh Gaikwad Threaded pin wire should be avoided across physis.

  Ayer a las 7:26 · Me gusta · 1
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  Remon Lotfy

  

  Ayer a las 7:28 · Me gusta · 1
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  Remon Lotfy

  

  Ayer a las 7:29 · Me gusta
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  Remon Lotfy Closed reduction and cast in flexion

  Ayer a las 7:29 · Me gusta · 2
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  Kir Pat Why threaded? What is remaining growth?calculate

  Ayer a las 7:41 · Me gusta · 1
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  Alberto Padilla D Close reduction and 2 cross pins and cast

  Ayer a las 8:10 · Me gusta · 1
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  Albaraa Altowijri Excellent job

  Ayer a las 8:11 · Me gusta · 1
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  Drgirish Gupta Only region to put threaded k wire fixation is purchase on apposite cortex
  Plane k wire loose early

  Ayer a las 8:33 · Me gusta
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  Kir Pat I agree but it has been proved that threaded pin damage growth plate while smooth pin least or non damaging , tender plate..other option is periosteal fixation...

  Ayer a las 8:49 · Me gusta · 4
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  Gopal Goel CR + Fixation with K wires and Post splintage

  Ayer a las 9:09 · Me gusta · 1
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  Drgirish Gupta Thanks@drkir pat

  Ayer a las 9:20 · Me gusta
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  Praganesh KV reduce and fix with 3 mm crossed k-wires 2 from each side.

  Ayer a las 9:22 · Me gusta
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  Lokesh Bhatia Well I have no comments on Fixation method as it is well covered by all other colleagues, I would fetch you attention on 2 issues (1) Keep a watch on Pre and Post op Vascularity. involve Vascular surgeon there is always a chance of intimal damage with such severe injury, which might get missed in initial assessments no harm in doing CT Angio. to confirm it.

  Ayer a las 11:12 · Me gusta · 4
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  Lokesh Bhatia (2) my second point is be cautious while taking consent in all Growth plate injuries. get all the possible complications documented, so that the parents are aware well in advance.

  Ayer a las 11:15 · Me gusta · 6
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  Drgirish Gupta Thanks Lokesh Bhatia sir

  Ayer a las 11:18 · Me gusta
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  Kir Pat I will add documentation by multiplier or paley growth apps documentation and survieelance, if you find lateralise or stunt growth and if < 2-3 cm lld , you can choose for contralateral guided epiphysiodesis

  Ayer a las 11:35 · Me gusta · 3
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  Arvind Jain funtastic closed reduction and plastered by slab for one week in full flexion same way as we treat supracondylar elbow.have 30 year follow up one patient,fine till date

  Ayer a las 11:56 · Me gusta · 1
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  Bhupesh Mahawar Good job, close reduction alone with slab/cast is other option. 
  Though if u involves less than 10 % of epiphysis thru k wire then prognosis is fairly good. But all possible complications must b explained to parents. Nice job done

  Ayer a las 12:03 · Me gusta · 1
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  Prem Choudhary

  

  hace 21 horas · Me gusta · 1
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  Prem Choudhary

  

  hace 21 horas · Me gusta · 2
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  Prem Choudhary

  

  hace 21 horas · Me gusta · 2
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  Giovannini Cesar Figueiredo Show!

  hace 19 horas · Me gusta · 1
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  Arvind Jain so stable is reduction .no need to fix

  hace 18 horas · Me gusta · 1
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  Sayed Farooq Jalal N/v and compartment status?

  hace 14 horas · Me gusta · 1
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  Dhiren Singh They must be followed fr two years and growth disturbance rate is very high.. Parents must be briefed about it... Best of luck

  hace 14 horas · Me gusta · 1
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  Modi Neerav pl dont take chance CR + k wire n cast

  hace 12 horas · Me gusta · 1
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  Hanume Gowda S N Gentle attempt at CR..if not amenable to CR..OR....once refuced its always stable....does not need fixation...and definetly not threaded ones.....

  10 horas · Me gusta · 2