ВХОД ДЛЯ ПАЦИЕНТОВ
вверх
поиск
админ
главная
исходное
|
Re: Acetabular Fx Surgical Approach
послал Bruce Ziran 17 Июль 2006, 14:51
|
Some of this discussion does not make sense. The sciatic notch is no different anatomically whether prone or lateral. The imaging is not difficult in the lateral positoin. The traction used is not sustained either. It suspends the leg and is only used when needed. The literature on traction for femoral nailing emphasized the use of wider and well padded posts, and unsustained use. The operative times for most KL approaches are well below 2 hours and traction is used for the brief moments to help with reduction and to look into the joint. The patient is well positioned, gravity actually helps with exposure and is overcome by equipment. I used to be younger and learned both methods from the same experts. They both work and the surgeon just needs to pick what they feel most comfortable using. Now I am older and I use and teach the lateral approach successfully. I respect Chip's opinion and expertise but either I am one of the three 0.01% of ortho trauma surgeons who use the lateral, or that 99.99%
figure may be a bit skewed! My previous partners both used lateral without any traction and did a nice job as well.
I dont think it makes sense to espouse one technique too strongly. Just as in femoral nailing (supine or lateral) and in total joints (posterior, lateral, or anterior), there are several ways and many opinions. What is the best for the patient, is what the surgeon does best. I began with the prone positoin but felt it was too restrictive and developed a way to make the lateral position work although there are times I use the prone as well. Others feel differently and I would never chastise another acceptable way of doing these cases. Lets face it in the pool of orthopedists, very few are willing, or able to do this type of surgery, The bottom line is that whatever approach or method used, if it is done properly and with attention to the principles, it will work.
BZ
Bruce H. Ziran, M.D.
Director of Orthopaedic Trauma
St. Elizabeth Health Center
Associate Professor of Orthopaedic Surgery
Northeast Ohio Universities College of Medicine
|
Послать ответ |
Обратите внимание: Поля с жирными названиями обязательны.
Старайтесь отвечать в рамках обсуждаемой темы, а не начинать новые обсуждения.
Указывайте адекватную тему сообщения, чтобы было ясно, о чем оно.
Не послайте сообщений не по теме (оффтопик), раздраженных, грубых или обидных комментариев. Здесь это неуместно.
|