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Re: Многооскольчатый перелом плеча
GOBINDER SINGH 25 Сентябрь 2003, 08:58
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This IS a terrible fracture, are the neuro-vascular bundles OK? With respect, Dr Salvi's approach is "classical AO thinking", from a country where the Ilizarov technique was first used outside Siberia! Cattani, Cataneo, etc, must be most upset that their teaching is being forgotten already...Even the AO giants would not do the classical approach here, I think.
With an open, comminuted fracture of the humerus, the option chosen must respect the soft tissues, or an infected non-union will be the result. I would chose either a hybrid Ilizarov-type fixation, with half-pins proximally and wires distally, or a locked IM nail.
Gobinder
___________________________
GOBINDER SINGH, FRCS
Consultant Orthopaedic Surgeon
Pantai Medical Centre
59100 Kuala Lumpur
Malaysia
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Re:Многооскольчатый перелом плеча
Andrea Salvi 27 Сентябрь 2003, 01:33
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Dear Dr Gobinder,
of course this is a terrible fracture (we both said the same).
Because our colleague (who proposed the case) didn't told anything about neurovascular bundle, focusing our attention to the kind of fracture I
thought it was OK. Of course Ilizarov is a very good and reliable device, but in the proposed case, in my opinion, is of the utmost importance to investigate all the bone fragments, and, so on, to investigate also the neurovascular bundle if it is damaged.
A locked nail would be a hazardous choice, because of the multifragmentary fracture.
And, don't be afraid: Catagni (not Catani) and Cattaneo (not Cataneo) Ilizarov teaching will never be forgotten: the results using Ilizarov
devices are successfully. Suggesting an extensive approach, I have just given my opinion.
Sincerely,
Andrea Salvi - MD
Spedali Civili di Brescia
UniversitЮ degli Studi di Brescia
Clinica Ortopedica dell'UniveristЮ (Direttore : Prof. U.E. Pazzaglia)
2' Divisione di Ortopedia e Traumatologia
Address : P.le Spedali Civili , 1
25100 BRESCIA - ITALY
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