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A-1280 Case discussion
Wolfgang Hintringer, Austria
Wednesday, June 13, 2018 · 1:57 p.m. · 19m 38s
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okay so i have collected some cases so our our um we have some problems
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so they're also microphones between the auditory on and if you have
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questions or if you want to discuss with the art
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to eat yeah you see here a case so uh
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right we have um so called probably some sigmoid notch
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which was healed model position and says surgeon
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did some scene which is not very good he shortened the
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on the on the new ball of cystic what knowledge
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so what to do now
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shall we
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lance and again they all uh
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and corrected radios
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or walk to to my to
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it was somehow on the audience
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uh_huh
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okay obviously the rights well the question is does action have pain
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the patient had pain because in radial and all not auction always you see here to
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skiff wouldn't low energy had some t. association here was popping around that ream
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okay how does the patient where information on that petition
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was relatively long about fifty use old fifty
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larry fairly on very on and things i'm very old he's
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fifty years uh yeah yeah the c. t. scan
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huh do you have a c. t. scan all it is a very outward case ahead no c. d. at that time
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but the question is uh should be lengthened again they are not
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and correct that c. can we watch fragment or something else
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the question is where he has is eh if the pain is already has to paint
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your in the area ready element all not auction yeah slanting it can full snapping
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we can have pain in both directions you can have pain in the a ready a couple
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joined as well in the history or not or did not first of all i had
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no brain form rotation net pro helen was sold his alma short in first of all
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i would to a restaurant was copy and to look for the radio couple joint
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uh_huh uh and see how the collection is the cartilage is still
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got it would be probably an option for an interrupt circular
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um correctional the just radius to bring up the uh learned
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facts that again there is already yeah but if
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you bring up to limit for say it again you have to or lance and they'll also again
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not necessarily
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why the two male maybe tender short because he shortened the on off
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on the needle of cystic whatnot
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yeah but uh it s. exactly yes no problem in the d. r. u. j. has problems in the ready couple joint
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but now is perfect and reveal like joint and if you then call wreck the games is
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seeking with knowledge maybe you'll have sen laughed or to some troubles i don't think so
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i went to the risk up first or cities can and then decide okay
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so i can show you what i did that i
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i corrected the rest that means i uh
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made a into article they're all still up to me and
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lifted up now the uh radios on the new ball
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and you can see here on on on on that uh next case and you can see here uh uh well aligned uh oh
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uh to caller surface and the um the patient the beige and was pain free so that's
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you can do it so all was all i did it in that way to another case
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you see here mel alignment of c. radios and uh
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this patient has no parole and so be nation it was talk between berlin
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soupy nation and the question is and you had to if you had
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uh the alignment of such a all nor style would roddick what would you do
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it well um first i would do the x. ray of the opposite side
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and uh then the money on a well uh the distillate
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is just a fragment and the style it are connected
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it's a it's a one piece so because the radius a small positions
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that's why the style it does not heal and we know from the corrective first outcomes of the radius that if you're correct
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precisely radius the style it heals in these situations but
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i would be because i think it goes into the d. r. u. g. sigmoid knowledge i would be
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interested in in c. t. scan handling of course i would go for the procedure on the radius
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you see here what i did i did a correction or still to me
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from the wall aside i lifted up to radios uh and uh
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late ted the correction open it's not very much
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and you'd feel to it well i'm in a car wreck
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they even and a willingness pilot sometimes he'll receive subtraction
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from the mel aligned uh to stall radios is released
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and you had perfect cruel and stupid nation yeah
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next case you see here uh those uh
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fifty six year old maiden who had the bicycle x. intent and roll
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he's a computer room what are the radio head and the uh
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eh radio hit he'd part you head and all our lands in in a
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pout in kong perry's and to the other side from fourteen millimetres
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so the question is
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how can we
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shorten the on off fourteen millimetres because you know all
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all one centimetre uh it's always a problem
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yeah but hammond okay miking showed us very nicely his technique
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and this allows thought that about two short need
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eight millimetres eight millimetres yes and at all it's very nice we have eight million yeah that's
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yeah answer is very easy to have to repeat the same procedure one more how
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okay it it was never done before is that device we did this yeah the old technique is the same way
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okay so let me that a case from martin lecturing indiana
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he he gave missus case because he was very proud
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between all poet interoperate t. v. he put out that first seven millimetre
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and you know all you close to get and then you
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have to to train again to the proxy model um
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a screw into long hole into the other position and to the same procedure
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again so you can do it up three times if you want
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but that one he's made two times
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ah
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and you see here which amount of porn he pulled we
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sick in two steps they picked up to uh well
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so this could result to is free motion and that seeks
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really of course it's perfectly down but we also have
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to discuss because if you really go for all pretty nasty or to me in such a long distance
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and martin asked and discuss perfectly but i know p. cost you to me in georgia new
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fourteen the media makes it very difficult it's not completely precise saying you have a problem
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and i personally in such cases code for just four or something posted
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horizontal which makes it much easier okay roddick we're using them
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are there any questions from the audience build it does does does the wiles what do the way
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okay i show you another case here we have that
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that's a very special case yeah uh because uh
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that was a very old woman eighty seven you all
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out and you got the conservative treatment uh
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of this re use fracture and human or in the beginning it look not so bad
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but anyway it heat in that way uh but
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speak shortening of c. radios will name tag jen and
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you see here on the right side uh
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the mel alignment of the who couples and uh
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you see here the c. t. scan
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well it it looks not really he thought it was typed uh and the uh
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the question is now what would you to an old lady it is seven years old
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roddick if it's symptomatic and uh she's got a good just just will just a fragment and good proximal fragment
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i would not be afraid of doing if she gets symptomatic sure spain
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functional module or not should you could do anything she could not turn around she had painted
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i have no problem to do the or still some of the radius
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even with this big big shortening because my experience is that
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uh what i have i have a group of patients which are over eighty and
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they heal quite fine yeah i would be uh yes but you have you
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you know if you uh lessens the radios you have a big distance just and
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you would to unity here chris from eighty julian yes yes yes yes
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yeah somebody from the audience given pretty soon mike
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nah procedure okay
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who else will show something other
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given given please the microphone i don't hear here
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i thought they can fill the gap of from o'hare demographics tonight to the radius stratum
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i didn't understand it
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alcohol can we we have a lot of colours in formation around this
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and we have a solid fragment just only yeah very
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stable place it's just to lengthen it not perfectly
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putting the colours in the cap but i would not go with really aggressive into two or three
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so i think some years before we would not help touch to reduce because our plate
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were not sufficient to hold help because a surface but nowadays we have anger stable
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plates from two rules and maybe we can do
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that and the weed eat you see here
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the lengthening of serious it's not perfect build on those a little bit too long
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but anyway the question is what did we do with a big gap
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look here people begin particles
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and that to the point of discussion can be to do it really to heel yes
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word making around the pockets uh_huh it may heal around the pockets
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and other you know he'll yeah you you should not
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put in the particles in the loop the distance but
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maybe on the radio side as a place holder
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two helps a plate within the time to q. uh
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uh the the the whole not a volcanic because there
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was a discussion to do the the dollar direct
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and uh so i think we might we might discuss whether to go for the
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direct in this situation or not it's eighty seventy eighty seven years or whale
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yes it's a solution sure it's is solution dollars maybe didn't
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not some t. v. called tend to listen to reduce and that would be enough for her
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yes peter from and custom but yes i think it's it would be a lot uh uh a high
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tension so maybe and i right or am on a short thing at the same time you would
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and avoid the problem also i had another question to the
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professor kramer i really operation appreciate your lecture eh
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and you get a lot of the good points but i am i wonder about the dollar eh marion yes
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because then it's not so easy to use the plate and as a reduction device
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yeah it probably normal unions you can't use it take me n. for t. v.
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usually use for the walmart union because shortening more normal human is usually not
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such a long distance is just so open pop technique but at that time you can re mounted like of course
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but you can heave to get open and that's it also difference what
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we did in the past because even if it open poke surgery
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just to lift up separate us from the palm aside and put on a play the
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field it up this a bone graft and now these your thirty it up
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i think there is a difference also between our school and your school tuple or
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still don't is because they always would use it over the t. stall part
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and uh for us is sometimes we tried it also
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very difficult if you have a eh and
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displacement into a into and use to mount the
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plate especially in the a. p. u.
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uh maybe be serve you forty degrees out of the longitudinal axes to get
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the right x. is in the and and so
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we to normally they relate to say reduction
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with k. while so we sums the others that so the and i mean
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a supplemental spray the and then uh put on the blade on the
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mm all ready reached used videos but anyway i think there are more ways which
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good will and i think that if you tweak risque whereas it makes it much more difficult
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and for that reason of course to mount precisely the plate we created to since the man
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because you are absolutely right it's not that easy to mount the plate in an angle for a forty degrees
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and this is instrument it's really very reliable makes it easy to so what i
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wanted to show you is that says vector he'd around the the the the
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the um on the colours yeah and uh she has a really good
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result uh she has fall cruel and stupid nation yes another question
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think of katrina from uh from lady apportion for a concert
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in this case uh it just have the two
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differences in in no other people like this how long
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you would wait until you do the the skeleton
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uh the second question is an older people what's the the gap that
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you use of you you you talk about a six eight millimetres
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actually use monograph so in in older people do you it's
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lower the your interval or you just use the same
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so and the the third question that because they have is
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do you still do uh the dorsal first alchemy
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in which case is this whole hammond will on the the question because i did not hear log will be here on the
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stage you don't hear anything what you're talking about if it can be
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also in order people to get open and you're absolutely right if you have a highly
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or singapore i think bone thing you must think to uh putting a bomb go
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you also can use sometimes the technique said you take a small piece
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of bone graft from the radio shaft belonging to the new way
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and turn it around and put it in to get that one possibility if you you want to avoid the
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phonograph part enlarge it effects you know the people you
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have to singapore and eh the next question wants
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i forgot that the uh itself approach we use normal him
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only in exceptional cases for example clear indication for us four thousand approach
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for correctional steer to me is if you
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have additionally inter articulate a mile position
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because the dos approach allows us to have a direct you into the chart
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how long do you wait like in this lady until you go for of corrective started
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huh well sister lady was coming to us after i think uh oh
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halfway yeah the green correct devoted to me you should do we seem to you
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how long do you wait i mean sometimes they they come to you with
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three months with horrible pain and then you know you just see them
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five six months again and they they do well so they tolerate better i just want to know how long do
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you a seven mount union or the rate is income to
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your practised with significant a limited range of motion
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i would do the uh corrections taught me as soon as possible if you don't do this in it they have another union and
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the motion gets worse they might uh develop us your p. s.
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and things like that and so i would do this as early as
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possible i mean just older people not even an order thank you
00:19:26
okay we have to close the session and come to the next one unlikely for ah
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A-1280 Case discussion
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