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A-1210 Intramedullary screws
Maurizio Calcagni, Switzerland
Thursday, June 14, 2018 · 9:15 a.m. · 08m 58s
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very much for invitation amber bock marketing michelle dear colleagues
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um i don't have any conflict of interest to
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declare regarding fixation and uh also synthesis
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um why we were looking for different fixation is but it's because we have been hearing already in the first talks
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that uh um complication can happen in terms of scaring of these same additions
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and um in some location mainly with a non so stable fixation delayed monthly station
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and we look at least um x-rays we might think but they are
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very uh nice but you see here wrinkles in the skin
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see here but you have actually um extension lack which is not obvious at the beginning and based means but
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these plates it's nice looking into x. rays that the ball is huge but is not a perfect result
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um if you look out in the literature a few very good quality papers this is
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of um um suisse group and if you look carefully you see that uh um
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in the in the file and g. congealed fractures you have a very high rate
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of uh um complications in the matter couple fracture and it's so high
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and um if you lock uh then at the uh overall result in motion and you see that
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in uh this poll in twenty three percent in fear in
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ten percent so i uh you have really um
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very high um percentage of bad results is a different study wave or more or less
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the same results a lot of uh stiffness and uh uh dijon due to what
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these edition and contractual so already very very long time ago in in the seventies
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and then again in the nineties people shape tried to produce a internal fixation
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and of course these me knees means we're technically not refined enough
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to be a every day uh applicable and um so
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we had to wait for uh some other reports but started
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to show what's the possibility to use these screws
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um the headless screws in uh in fractures of of
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an geo punches and to meet a couple bowls
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um we have been extensively uh using the screws
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and to hear our our indications so
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we don't do a good so it we can not using very oblique or spiral fractures
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but uh in most other side fractures it can be used we use these screws
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i'm in to that size depends a off on the uh on the night of them better america now
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um i like miscues because they have a very sharp um tape and
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so you don't have so much torsion into by but when
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you when you screw them in otherwise you have to cut right through high risk of this locating the the um the fracture
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um there's a big discussion on how to approach
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um the um uh those violent findings we like to to go
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from prague somehow uh to distill because in this way
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we can not we do not damage the much smaller so it phase of the of
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the p. i. p. child of course you can discuss whether business s. three
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we are now on on the way uh with our five years results to look at
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the amount of uh also try to swim produce bases uh uh not always possible
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to achieve these like this degree of dislocation this is in a cadaver so it's very
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easy to get this much dislocation sometimes you have to go from the side
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in some cases is a necessity to go through the uh head of
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a meta carpal pieces something uh everybody knows from a skateboard fixation
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i'm a doctor for second publish very nice paper just
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through uh the trapeze with fixation was covered so
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nobody has any kind of a fear to do that in the cart was so
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why not do it in the finger uh in some compresses i was um
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um attacked that's all you're doing a peek hole you are distracting the whole
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joined so we decide well let's go to the lab and look
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how big is the surveys the damage reproduce and uh
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uh actually actually and we found out that uh depending on
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the size of the of the screw what actually
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damage is a very small percentage far four to eight percent of the uh surveys and this is
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uh over exterminated because we didn't calculate the
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hollow of of surveys with with
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two just the flaps a face sort of projection after the operation
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uh i'm normally we can uh use are controlled immediate normalisation with about this paint
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and progressive load uh all the time yeah normally three weeks and in the night i want to
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explain to the p. l. p. joint in full extension and m. p. joint in flexion
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we could you can have complications in this case uh i would drop the school
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because it was a very and very uh fit uh assistant
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and he was just talk and then you hear it
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and to tighten just breaks you don't have any any as a warning
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uh it heal well we had to sorry we had to
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open a and put a a plate then um but um
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i think and you can see here it was okay you can see that i
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like very much a compression screws also in carpal surgery indication these up
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drawings taken from the paper uh of um doctor being out
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you can see here are a typical compression uh of the
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uh financial fractures or of a matter carpal bone
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but you can use also in in a community factors is i accept attracting
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uh we know exactly also from uh our topic surgery you
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can use and nail also in case of a
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of um a committed fractures the only very important thing it to not look for compression you're
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subtracting if you start compression of course all those pieces are going to fall apart
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um this is another case and you see the result is not so bad
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i'm in a in a we have also in that you can use it in opera fractures
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and uh despite these all still is license here the
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the the the factual he's perfectly and you
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see is the in insertion point was eccentric to spare the surveys uh the glide interface
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um this was a an on an unstable very unstable um base
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fracture of p. one out here you can use very often
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so conservative treatment actually is the first uh treatment of choice
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but in this case in some cases you cannot achieve
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a stable situation and this is a good solution again you see here you can also go from the side
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now that's a paper a shot from a spanish group showing that in some cases you
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can even use two screws if uh if the mid america now this week
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um this is not the logic fracture uh after a depriving
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the the happening in control we used a a scroll
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and uh the season with the cargo fracture and i don't use these for a
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sub capital fractures i'd i'd agree with a a doctor couldn't professor gibbons
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but um most of them can heal conservatively otherwise i like uh in
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the middle larry a wiring uh us it was a sean's before
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and uh the seas in particular fractures you have advantage right you can
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vary the head of the school day in the lower the cartilage
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and uh achieve a proper reduction and a stabilisation like you can see here
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limits their oblique fractures i told at the beginning into articulate coming notion or easier solution
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i mean we're speaking now about internal fixation bucks um the the um the other
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techniques like a k. wires or conservative should always be kept
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in mind these are for example is one fracture
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i don't know i don't if it was really a good the best solution it is a solution
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but you see how long is the way in the bone here so when the that's right
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uh believe infrared is trying to start into grasping to ball you
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have compression so one of the two threads has to rip
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