Tuesday 14 November 2023
10 yrs post latarjet asymptomatic and played badminton
the bonegraft broke off while sleeping after 10 yrs post op. Did the grqft ever incorporate or did it break off being avascular.
increasing attempts at latarjet and its modifications will definitely raise similar complications and osteoarthritic even after ? healing. we migth reduce dislocation rates at best , rest time will tell.
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Intraop fracture in a prior fixed and healed distal femoral fracture
salvage of a porotic intraop fracture ina RA pt thru the cyst poorly stabilised by the plate, revised by the rotating hinge link knee with distal femoral replacement
Periprosthetic fracture in a Octagenerian
afe and aortic stenosis
narrow canal 10.5. bowed femur absence of curved 10 inch 10.5 mm dia porocqt stem made us use this cemented long wxeter stem z10 mm dia and 240 mm and wired proxmily without cement. in the past a porocoat stem was cemented distally after removing the porocoat i trqop with a burr only distally to cemebt the proximal uncemented stem was witd to the periprosthetic fracture to facilqta e ingrowth or fracture heqling . It make for a quick surgwry in these unfit pts and can mobikise full wt bearing stwt.
Patella dislocation with osteochondral fracture of medial facet
14 yr old male with genu valgum open physis and grade 3 b troclea and osteochondral fracture patella underwent medial epiphysidesis by paeds team, fixqtion on oc peice with suture tape and biopins and teochleplasty and mpfl repqir rather than recon.
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Saturday 16 September 2023
Hypointense ACL
we still do not have a a clear cut correlation between clinical and radialogical data to make an informed decision for return to sport like in fracture union
Tuesday 12 September 2023
Ulnar plus with TFCC tear
ulnocarpal impingement with triquetrql wear and large central tear of TFCC treated arthroscopic wafer procedure
Intraop fracture in a porotic RA pt with 2 yr okd fracture treated by interfragmentary screws only
stem and wedge back up done but unfortnately during trial reduction the femoral
condyle fractures and screw hold for fixation was poor and therefore a distal
femur replacement with Link Rhk was done a few days later. Having a distal
femoral replacement inplant on table is advisable as a policy
Sunday 30 July 2023
Distal femoral fracture in a 80 CRF patient on dialysis and major cardiac issues
Rising incidence of Periprosthetic fractures and the need for aggresive managemwnt of osteoporosis
Rising numbers of elderly parents living alone need an aggreesive metabolic management of osteoporosis. we are seeing an epidemic of insufficiency and periprosthetic fractures thsi fortnight. Better methods other than BMD measurements are needed to control bone and muscle loss. Do we need to routinely use bone resorption markers as the BMDs dont match the porosis when do the Bone cuts in TKR.
Quick stable fixations as seen above are needed in these patients to get them back on there feet soon
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Thursday 20 July 2023
Dislocation in a post stroke patient one montg postop
Wednesday 31 May 2023
Dislocation in Thr post fracture neck of femur
Dislocation post THR in elderly is an issue which can be avoided by using larger head diameter, Tighter soft tissue with correct verical and horizontal offset. Good soft tissue repair is possible and may be avoid southern approaches
The case below had stem sinkage causing lax soft tissue and retroverted acetabulum. A cemented stem to correct the vertical and horizontal offset and constriained liner was used as the posterior soft tissue were deficienct and patient was elderly.
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