вверх  отправить  поиск  админ  главная  Предыдущее	Re: несросшаяся шейка бедра Dr Abdelsalam EID 30 Май 2007, 08:55 Hello Anton I do not see why you need to perform the operation the way that you mention. The X ray that you provided does not show 8 cm of shortening. Perhaps you could send one showing the whole pelvis and proximal femurs. If you are concerned about intraoperative reduction of the prosthetic head, a few useful hints could be: 1- use a lateral approach (Hardinge) as it will give you access to the anterior structures if you need to perform a release. 2-perform your cut flush with the lesser trochanter 3-Psoas and adductor tenotomy may help reduction if difficult 4- use a modular prosthesis with different neck lengths and choose the short one. I hope this helps. Dr Abdelsalam EID M.D., AFSA (Paris V) AO Fellow Lecturer of Orthopedic Surgery Faculty of Medicine, Zagazig University, Egypt.	Сообщения о Ортопедия и травматология Также Dr Abdelsalam EID Связаться с автором
	Ответить Re: несросшаяся шейка бедра Myles Clough 30 Май 2007, 21:04 I  agree with Dr Eid's comments. The origin of the 8 cm leg length difference is a  puzzle. Is this a clinical measurement? In that case contracture of the joint  might affect the measurement. Can we see an AP pelvis to include both hip joints  (including a calibration object with a known length) so that the difference in  leg lengths that can be ascribed to the hip deformity and bony reabsorption can  be measured. This sort of xray will help with templating for the TJR also. I  would be very tempted to do a one stage procedure and accept some shortening.  Shoe lifts should take care of a 3-4 cm difference. Myles Clough MD FRCSC DPhil  Orthopaedic Surgeon  Kamloops, British Columbia  Clinical Instructor, University of  British Columbia, Dept of Orthopaedics [ Ответить ] ( Ответить )

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