Case sent by C . mahajan
67 year old with 2 year old malunited acetabular fracture planned for thr
problems.
1. Is the fracture united - if not in situ posterior column plating single or double.
2. Cavitatory defect with posteriosuperior migration. peripheral reaming to widen the acetabular mouth to fix a peropheral fitting cup and particulate grafting of the cavity. The union to could be assesd from the floor.
Implants. - keep larger cups as well as pinnacle revision cup back up in case.
Gages may not be needed.
Dr mahajan felt that the acetabulum was united and did an uncemented cup without screws. He was confident of the stabiilty. I would have been comfotable with screw at least 2 of them as well as posterior plates if there was any doubtof column union. I need to get his permission to upload the post op pics
jacob
1.Fix the posterior column fracture.
ReplyDelete2. Graft the medial wall.
3.Use a Primary large peripheral fitting cup or pinnacle revision cup.
4.USe an uncemented stem.