aftercare of nailed patients and dynamisation of fractures КЕМЕРОВО ГкБ №3 hospital @...
TRANSCRIPT
Aftercare of Nailed Patients and Dynamisation
of Fractures
КЕМЕРОВО
ГкБ №3ГкБ №3
hospital @ mail.kuzbass.nethospital @ mail.kuzbass.net
42A22
42A22
12 m
What is the cause of it?
The nail is too thinThe nail is too short Patient is a surgeonNo dynamisation
12 m
What shall we do?
Change UTN to plate
Change UTN to UN
Nothing
12 m
What shall we do?
Change UTN to plate
Change UTN to UN
Nothing
24 m
36 m
What shall we do?
Change UTN to plate
Change UTN to UN
Nothing
24 m
What does success of nailing depend on?
When?
Dynamisation Full weight bearing
What does success of nailing depend on?
Dynamisation
Distal locking Proximal locking
Static locking
Dynamic locking
What does success of nailing depend on?
Dynamisation
Distal locking Proximal locking
Static locking
Dynamic locking
What does success of nailing depend on?
Dynamisation
Distal locking Proximal locking
Static locking
Dynamic locking
What does success of nailing depend on?
Dynamisation
Distal locking Proximal locking
Static locking
Dynamic locking
is load transfer from nailto bone by removing proximal locking bolt from static hole
What does success of nailing depend on?
Static locking prevents:-rotational instability -shortening of the bone segment
Distal locking Proximal locking
Static locking
Dynamic locking
In case there is no danger of boneshortening
What does success of nailing depend on?
Dynamisation
What does success of nailing depend on?
When?
Dynamisation
What does success of nailing depend on?
When?
Dynamisation
What does success of nailing depend on?
When?
DynamisationPrimaryWith fractures - transverse fracture withlong proximal fragment, good qualityof the bone and anatomical reduction
What does success of nailing depend on?
When?
DynamisationPrimaryWith fractures - transverse fracture withlong proximal fragment, good qualityof the bone and anatomical reductionWith atrophic nonunion
What does success of nailing depend on?
When?
DynamisationPrimaryWith fractures - transverse fracture withlong proximal fragment, good qualityof the bone and anatomical reductionWith atrophic nonunion
Full weight bearing
In case of pain decreasedand soft tissue healed
What does success of nailing depend on?
When?
DynamisationPrimaryWith fractures - transverse fracture withlong proximal fragment, good qualityof the bone and anatomical reductionWith atrophic nonunion
Full weight bearing
In case of pain decreasedand soft tissue healed
Secondary
Dynamic locking Static locking
Transverse fracture
Spiral fracture
Small-stature patientObese patient
Long proximal fragment
Short proximal fragment
Good quality of the boneOsteoporotic bone
Clever surgeonStupid surgeon
What are timing factors of dynamisation
What does success of nailing depend on?
When?
DynamisationPrimaryWith fractures - transverse fracture withlong proximal fragment, good qualityof the bone and anatomical reductionWith atrophic nonunion
Full weight bearing
In case of pain decreasedand soft tissue healed
Secondary 6th through 8th week
3.9 locking screws – after dynamisation4.9 locking screws – in case ofpain decreased and soft tissue healed
No Dynamisation ?
No Dynamisation ?
Thank you
Спасибо