65 year old, 18 months post surface replacement in apatient for OA shoulder with cuff tear. She has a malunited shaft fracture 18 years old.

1.Was the choice coloured against a TSR due to the malunion

2. Was the cuff tear signifcant for TSR and Cap to fail....

3 Reverse shoulder would have been the option if the cuff was deficient?

The much hyped reverse shoulder has finally reached our shores. It took five years for depuy to consider bringing this implant to india. This is more difficult operation to do with a reported published complication rate as high as 25%. sHE IS 3 MONTHS NOW WITH 100 ABD,90DEGRESS FLEXION, 30 DEGREES EXT ROTATION.

Scapular notching, stress fractures, dislocation etc are reported. It is important to be tight unlike TSR where in 50% subuxation should be possible after closure for a well functioning TSR. TSR OR Shoulder capping is acceptable in the young active person as the reported rate of glenoid loosening is high at 10 years.

Sub troch nonunion for THR post shanz osteotomy

One year post subtrochanteric osteotomy and thr post shanz ostrotomy for DDH. Patient is 35 years old

jacob

The instability at the osteotomy site was posibly due to lack of stable fixation of the distal fragment,which was augmented by the plate. I feel this was insufficient and hence the non union.- ideally the stem should have been upsized. This was revised to a distal loading solution stem using an eto to remove the well ingrown Srom sleeve