Saturday 30 April 2016

MIO Tibial Plating

A 24 year old male had a RTA and sustained a Femur fracture with a Comminuted Tibia Fracture and Compound Foot injury.

Tibia Fracture was Comminuted in the Mid shaft for about 2/3 rd of the tibial length. There was segmental fracture of the fibula

Pre Op Xray :

Considering the Comminution MIO/MIPPO plating was planned.

The length of the Plate could have been a problem and hence X rays were taken with the longest plate available.


PLATE XRAY


OPERATIVE PEARLS :

·         MIO Plating was performed spanning the Comminuted Shaft fragment.
·         Segmental Fibula fracture was fixed with One proximal and one distal Rush nail.


 10 WEEKS                                                                            10 WEEKS 


 Fianl 10 WEEKS                                                                   Final 10 WEEKS 

   

After 24 Weeks                                                                       After 24 Weeks                                                                 

Fracture united at 5 months and patient has excellent Functional Range of movements.


Post OP Xray



Post OP Xray

Monday 25 April 2016

Hip Replacement in Acetabular Fracture

A 78 year old Patient had an RTA and sustained a Hip injury. He was diagnosed as having a Central fracture dislocation (Bicolumnar Fracture). He was not operated by the treating Orthopedic Surgeon considering the Risks involved at the Age. He presented to us after 7 months with ProtrusioAcetabuli with AVN of Femoral head.

His major Complaints were:
  •             Severe restriction of daily activities
  •       Night pain and Rest Pain
  •        Difficulty in Sitting and Getting up


















Pre Op Xray

Discussing the risks involved, the Patient was asked to undergo a hip replacement to alleviate his symptoms.

CT Pelvis was done to get a better understanding of the defects.

CT 1

CT 2

CT 3

CT findings :
·         Defect in anterosuperior wall
·         Posterior wall was intact
·         Defect in anterosuperior part of head

Challenges of Surgery :
·         Defect Reconstitution
·         To get the Perfect Rim fit
·         Early mobilization considering the advanced age
·         Restoring near normal Hip Centre

Operative Pearls:
·     It was decided to use a Trabecular Metal cup and Uncemented Stem on the Femoral side Head and neck
·       The graft was Fixed with the Screws through the cup

·       Rim fit Gription Cup was placed and sufficient lateralization was achieved



Post Op Xray