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A-1218 Complications
Jin Cheng
Thursday, June 14, 2018 · 11:20 a.m. · 14m 41s
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than for imitation think prefers the simple time for imitation to says
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complications actually prevents a present has already talking about some complications
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uh i've it gives to some general uh prince a
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postal from cases and my paternal experience on this
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and the complication occur really hand and a couple factors are traded whether surgically all non surgically
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so someone missing hannah couple fractures is a simple factor when compared
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to the larger bombs was last complications that is it
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is not always so simple like these how many paintings here
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and also a scum occasions are not uncommon actually
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so uh type of communications it could be infection and also my my life use
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hardware related complications no unions no unions
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was the stiffness of the joint and bone occurrences in the post traumatic arthritis
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some knowledge of the causes indication for treatment and the surgical techniques for
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such complications should be a part of every hand surgeons or marie
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so this is a po box fracture wasn't trench fees change reuse you
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can use that played in school has a very nicely fixed fracture
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i have a few overlooks that possibly rubber contamination we humans are liable kind of a human fight
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this is the perfect looking at three the progress to some skiing problem the balloon problem
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and then you can progress tucson 'cause our some of us tomorrow night
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is you have to remove the income and you can use electronic
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later sometime you you mean you some facts system for control that
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infection that in that program is it's okay she's rubber approval
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and it also for this on the uh open fracture crossed injury
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be very cautious about the type of the hardware you choose sump stopped
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issue problem because the uh uh not you know the ball and
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and this is the the so filer felons fracture where tiny fragment
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but that means think nissan simple procedures you really need more difficult to to fix
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this patient as surgeon use science teacher anchor however is approach to show of the oversize we shrink if you're
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just say that user souvenir route and the overlying screen infection progress and remove
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all the point yeah but inevitable and the patients deformity of the native
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this again this tiny if fragments is is that you can that is
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that's a double sized wise which is broken that is of phantoms
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it's kind of an tiny fragment actually it's not so easy to fix is afraid of the fixation
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you have to a page and as everybody is surgery to proper fix this kind of fragments
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no unions could be actually articulate antarctic or is this kind of uh actual article or uh
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maybe union can lead to straight looking of the hannah was across him that fingers
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but generally is over twenty to thirty degrees of the
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corner plan may union syndicate corrective of shortening
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so on like the crown or playing the sector playing
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a mail you knew actually has is more tolerable
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you should you should uh exam the patient happy to see whether such regulation cause function impairment
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purse hadn't the shock factor of fees for the next couple we all
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know that can tolerate such blank elation up to fifty degrees
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and that horrible that herbert degree was such a triangulation decrease by five
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to ten degrees moving from the little finger to index finger
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some of shortening this patient has some short any of that deformity which could be
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tolerate you all met a couple fractures like this force met a couple here
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the patient had only had very my loss of of prominence of the m. c. p.
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joining 'cause feast but has no function to fix it and we had tolerated
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this patient has a looks has a better hitting there's no obvious anger
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elation at a fad and proctor famines and and met a couple
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however if you are willing to the location of the buttons is that this is
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a common error for taking the experiments it's a surgeon's present present has
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as speed forced a brief reached it shows that you cannot take the tar like this
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and the rotation or start missing amateur because it also intended that too in that daily activities
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it's patience looks s. s. successful conservative treatment again rotational and relations
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which are cloud rotation or certainly
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so you can look at the table so they actually the apex also
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angle a shana shortening use it generally is it's a tolerable
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how were the rotational deformities s. node tolerable inmate
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the treatment we usually you can use the closing gradual struck me because it is technically simplicity
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however when there is a significantly short any of the ball opening
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wedge of struck me we say punk what is recommended
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articulate my i'm a union generally speaking if that's step of is
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uh more than two mini meeting you don't need that correction
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uh well if that's that step loss not have the middle portion of the article or service
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some sometimes that it could can function where an an operation to voice surgical intervention so the surgeon need to
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a carefree weight in the location was that most the patients
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jeez i and activity levels the age of the patient
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this is is a million have a particular with a service at a meet at
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the top portion you're young active patient and the ulcers it's divided very rapidly
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so now you're near source again the simple factual don't on the undead meeting
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it is kind of a stable single king fixation is not enough
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again this is a lot in office not honesty is is on stable construction we
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need some more stable like a screw that's paid for this kind of haitians
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and uh this is a 'cause you good surgeon uses played
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unscrew for the fans fractures and use it okay
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over the top the case last bit for demonstrate the user longer plate which can
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tolerate but much stress because that's really so much stress you
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this is because the simple spiral fracture s. s. a. k. is stable construction
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okay it's just not stable enough unable to control the rotational court court here
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so this is patient had a filter fact m. c. p. j.
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s. korean little finger offer comes of to be mobile edition
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so the issue very already bear in mind the say position here otherwise we need
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a surgical integration to release a contraction that also capture into the collateral ligament
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so no union the dawning curses actor is not so calmly in the
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fathoms and the metal coppers but like oh no that's a couple buttons particular skate for
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bones is more prone to have that the union problem and then it's it's it's
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so the the cans this patient has a young gentleman yeah so sixteen most circle has the least
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fractured initial so it uh x. three and you wrap staple no union
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ways uh come back to forty in a significant long lost
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the citation could be even worse the message it it's all in p. player
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has a proximal put annoy you know for one point five years fancy
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you can see it as a a nectar open it s. closes seeing an increase density is a possible a. b. and
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so what i what have you know i'm really as a hand surgeons so you actually you cancer history the the
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every d. case has a milestone technique uh pretty in the past that's ever check the
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case the week starting from some now watch the rights to go out to the
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a petticoat and a free one screw out on white and the art last point on court
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so we have so many choice i want to choose what could choose an
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so what is saw preferred strategy off the line from the patient
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and what are the key questions was good for non unions
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the question number one in sync is uh any significant compact it from t.
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o. d. c. deformity if that answers yes or choose the uh
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traditional noun was gonna rise splashed on why from that will approach
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which is simple we can do it within twenty minutes
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what is remarkable all the common to crap all these deformities handsets are probably getting rid
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of about eighty to ninety percent of the patients bill side way we and
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question on the two so let's clarity if the patient has a presence
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of a a we and all has a proximal code no union
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the traditional now was gonna rise congo off so i actually had right through
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all the calm when complete complete natures as approximate how occurs
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the new technique like oscar right can graphs require out this is a real the proximal po
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so want to i. c. s. i. which is popular worldwide in the past twenty years
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however this my failure my fellow cases so i was lucky
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because it's it's a anyone of my twenty two cases
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however if you really can't the literature it's a report in uh you know
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rate is only sixty percent yeah reach the best clarity of the petticoat
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is petticoat quiet has been added to be our reliable when it difficult to to credit compact deformity
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talk to go to still have told us that the ball is up on the way this routine the soft tissue in that
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but its master connection out than which it requires nazi party piece
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of the candidate maker buttock but the okay and the
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attention of the gardener and then place them has its point in and statement has been so
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clinically applicable then in the use of of what to write on route four no unions
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so our mayo clinic cardiac they use free medical
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far more common type on working for all stay for no unions i'm
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not so aggressive uh my uh indication reserved to the re
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the factory no union that means we began surgery re review and
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maybe in with a significant can last number prove bobbin comic
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use this kind of uh a flat a bomb for
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every set better quality and she's a reasonable functional
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the copy
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so what is that my treatment of choice in the last six years for almost every skate for my union
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top p. c. for taught me this technique house copy on crafting
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so it might be my handy for your into why but sixty cases all united
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now it's my first choice for almost every skate for now you know even with the patient with proximal po ab anymore
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why to moderate compact if on t. o. t. c. deformity looking back to the cases
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the patient you can actually you can check from the meat capo raise us for speech or check the stability of that
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of the uh no union actually you can find a some very very unstable
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we lose no union you can use upper to the private you provided
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like we do it in the open approach you divide all the scar tissue
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and here you can see the pleading you can check the vascular rightly this is a peaceful fragment
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actually you can see some fact eighteen beating from that the
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store fragment us speed posting from the resource or speed
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that means as as muscular a. t. is quite cute here in
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the pistol fragment but if you're looking at of proximal fragment
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there's no bleeding there is is a pale collared
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proximal fragment also confirmed ab and replace fragment
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so you could use ah so uh it's faster p. you can elegantly
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introduce some punk wafting from the uh the portal of the responses
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so the it factually here nicely and for the uh you go for the patient
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with prague simple no union bulky we in like this on n. p. player
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you can you can see that as a punk data plating from disco fairmont park no bleeding from the proximal fragment
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and with this approach the patient had a quick recovery and a reasonable all dude
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a comedy of the function and he she is now struggling for the coming winter olympic games
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so in some way to tiny bones to not mean simple procedures you really means more difficult to fix
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in a perfect read read a coffee does not correlate a perfect resort
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this off to your component of the injury should be carefully
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address all the outcome had improves things that institutional stable fixation masters
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complication mayor curry for fear to stick to basic principles some comfort computers have turner
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said you won't with walking up your party of no more than three
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there must be one who makes serve me as my teacher obvious exact they're worried
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enough follow them and then that's and from that ford and avoid them
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so likewise asserting who treat handed couple fracturing wrapped inevitably
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income that complications sets all my colleagues to
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show them painful parts to to us too so we can then from there are complications
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