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A-1212 External fixation
Frédéric Schuind, Belgium
Thursday, June 14, 2018 · 9:45 a.m. · 07m 58s
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stuff like she fixation yes so the mushy other the acrylics how to get the better result
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when treating a hand fracture well uh i don't produce a fracture especially in different images
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intended like been cleans up either be able belies the fracture
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like the speech and non and then the contradiction impairment of the
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like the planes and launching a blue they should catastrophic results
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this is a patient created by a boxing loath twenty four weeks one year after catastrophe
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immobile decision is bad for the hands look at these all
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statistics of over six eight hundred to cases from canada
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if you enable us astray able fracture for four weeks only
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one quarter of the patients will regain full motion
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and so if it is an unstable fracture only ten percent
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how to get the good results i sink if it is a stable number
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space close factor like we have hurt into chewed immediate protective mobility station
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if it is an unstable fracture converted to a stable situation ways anatomical reduction
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preserve the gliding planes uh is it should immediate remember decision and the morse either
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the fracture in the us is it that legions the more important this attitude
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lacking this patient ways a scan distraction bond effect uh this location then the
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lesions make immediate remote decision possible avoid plus the cost by all means
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so how to achieve the stables didn't is is we can do it
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by the plates and screws like we have just heard it
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imposes however fracture approach for open what direction and implant the position
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it may impair the gliding planes especially in the fingers
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it is related to control indicated in open court in mediated factors also you can do some uh flaps
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and uh it is specially indicated for particular fractures and most of them it's
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like this case of in trotted to the us to to me of a d. had offered to make a couple both
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examine a fixation is another option you do minimal opening set distance of
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the fact aside to insert the pins you preserve the gliding planes
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you will have a stable fixation other will immediate active my bills each
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and and it's partly indicated of course in open contaminated fractures
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but you can use as well enclosed by fizzle fractures and you can use it in particular fractures uh
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by bridging the uh joins so d. understood indication icing
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case open with a couple of financial fractures
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especially in association with other uh a soft tissue lesions let's come back to this case
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so uh we have uh use the forty hours isn't this is examining fixation we have inserted in
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the bond effect to jen debate and fortunately we had not spa gentle beats we have reduce
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the couple but the cobble dislocation of the index with the a. p. wire and
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uh it the coverage was done by your personal interest was flat we have
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also inserted a route for the this board extensive tendons this is the motion
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after two months replace the beat why cancel who's been autographed and that
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these are the results in these patients i actually had a patsy of the distal
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part of uh the uh the uh in the branch of the on
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on uh which needed some tendon transfers and this is uh he's a result
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that is uh quite a acceptable sorry i wanted to show the video
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but cannot
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what we do is not working anyway yeah as normal motion of the hand
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another case i don't discuss the micro surgical reconstruction assistant is by
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many fixation assertion of small beads in the distraught i
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project of the thumb replacement by counsellors blunt autographed and a
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t. c. c. d. x. non functional resulting this patient
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they are all the indications you can use examining fixation close but a
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couple of financial fractures also you had the choices of all
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the techniques like in these patients close with action insertion of the
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pin immediate motion and to the healing of the fracture
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you can use a a it meant examine
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fixation to the reduce commuted particular fractures
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it works well for but it factor doesn't work so well for uh
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uh the uh p. i. p. a joint uh so you can see that
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this is not bad at all the result in this patient uh
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during certain time we could use the prototype of a moving external mini
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fix it uh which is not to my knowledge available anymore
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rare indications pediatrics fractures then you preserve with the fixated easily that was
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played corrective posted to ms is very easy to uh uh
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pretty uh it calculate the angle between the planes and then you just put the pins
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power that and i do have the correction of the us to to me
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i think the lengthening it's of course a good indication of examine the fixation like
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these congenital shortening the force but a couple and uh do resulting this patient
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uh and they are numbers of indication see the chapter of the book
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so we published long time ago a prospective study
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of over five hundred cases of examining fixation
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um and uh uh with the mean duration of external fixation was forty days
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uh we had been hating in ninety five percent of course this is including all cases including
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nonunion antiseptic non units uh and to rehabilitation and see a p. s. in six percent
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and the results were quite good and uh we later on uh uh isolated in this air races
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sixty three close by phase and met a couple fractures uh we had the me generation
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of fixation of twenty nine days or fractures healed and that to make a reduction in eighty
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six percent knows here p. s. an excellent or good function results in ninety seven percent
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and also the way isolated differential the close the fractures
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uh we had the mean to read made me generation of
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fixation of thirty days or fracture healed anatomical reduction in
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the ninety one percent c. appears in four percent and
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accidental good function results in ninety four percent so
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and many fixation is a simple you can adapt it to all situation it respectable biology
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you have good stability still you can institute e. meter to motion you preserve that
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like than planes you maintain the skeletal things you can use in children
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uh you can if the reductions not perfect you can re manipulative needed to adhere to fracture
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uh there is a no surgery to remove the hardware drawbacks it's expensive also
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now they are a low cost uh uh many fixation the feel about
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uh they are the bone and skin reactions to the pace which is minimal
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in the hand is not the case everywhere in the the by the
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and then uh the the main criticism is that uh uh
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you do some at some location tenderness trends fiction it's
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actually a problem only at the base of the first uh a french otherwise it doesn't like pizza motion
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two and another case open fracture at the time we did
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a mcgregor england flap and uh we use external
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fixation for the uh uh synthesis and uh later on
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there was a a a a rotational uh
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a million enough for the force me to cut also we corrected by examine fixation and also
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a short sound that a wilting sense as you can see later on we did to pursue and
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in in dresses flapped open the first what and the functional was that was quite a good
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just to attract attention to our symposium next here on after placid and
Conference Program
A-1205 Welcome and Introduction
June 14, 2018 · 8 a.m.
A-1206 Epidemiology
Kevin Chung, USA
June 14, 2018 · 8:04 a.m.
A-1206 Epidemiology Q&A
Kevin Chung, USA
June 14, 2018 · 8:16 a.m.
A-1207 Evidence
Janos Rupnik, Hungary
June 14, 2018 · 8:19 a.m.
A-1208 Conservative
Grey Giddins , UK
June 14, 2018 · 8:31 a.m.
142 views
A-1209 K-wire & cerclage
Anuj Mishra, UK
June 14, 2018 · 8:57 a.m.
119 views
A-1209 K-wire & cerclage - Q&A
Anuj Mishra, UK
June 14, 2018 · 9:08 a.m.
A-1210 Intramedullary screws
Maurizio Calcagni, Switzerland
June 14, 2018 · 9:15 a.m.
156 views
A-1210 Intramedullary screws - Q&A
Maurizio Calcagni, Switzerland
June 14, 2018 · 9:24 a.m.
A-1211 Plates & screws
Philippe Cuenod, Switzerland
June 14, 2018 · 9:29 a.m.
154 views
A-1211 Plates & screws - Q&A
Philippe Cuenod, Switzerland
June 14, 2018 · 9:42 a.m.
A-1212 External fixation
Frédéric Schuind, Belgium
June 14, 2018 · 9:45 a.m.
126 views
A-1213 Compound fractures
Thomas Giesen, Switzerland
June 14, 2018 · 9:54 a.m.
364 views
A-1213 Compound fractures - Q&A
Thomas Giesen, Switzerland
June 14, 2018 · 10:08 a.m.
238 views