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A-1230 Phalanx extraarticular - Q&A
David Shewring, UK
Friday, June 15, 2018 · 11:42 a.m. · 04m 51s
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00:00:01
thank you i think if there are any questions even if you stay here for the next talk to
00:00:10
uh from the audience question to this uh uh field i think the first fattening sissy really
00:00:17
problem most problematic fracture of hand fracture record due to the tendons and the
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gliding structure very close to the bone and if you show some cases
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yeah in the beginning when you did some put two tennis fixation and make
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commuted factor um how long you leave the k. wires in the situation
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um if if it's a spiral fracture uh i think screen half weeks is is enough
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if i views differ transverse in in the mid die offices i think you probably need a bit more because that
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healing takes a bit longer so i probably would maybe five half weeks for those two because usually if you
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and insert the k. wires from proximal they usually um
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fix a bit a bit ten uh extended put those little it's not probably
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you go to the side of the tens and uh obviously will
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go through the essential by hand but that doesn't seem to matter you have to go slightly actual to avoid fixing the coach ligaments
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that that was quite easy to just around the side of it hit the when the circular been that the
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base the portal products and then just fire and and and one more quest when you remove the wires
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you usually need look to the x. rays or you say i'm
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not interested so when in the x. ray control i uh
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decide in advance this is a fracture and after a depends on the stability i
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remove k. y. us off the five we after four weeks of five weeks
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i think you can predict fairly well uh how long it takes which
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distractions to heal if if they start you can leave the wiring
00:01:51
for a bit longer but uh i don't think there's any real need to reaction in which you shouldn't really change your decision
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um i think it's very often that to in these financial
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fracture after three or four weeks you see almost nothing
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uh one bone healing in the x. ray so there's a just a line in the
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but you know that solution is a you don't union will be occurring but
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it just hasn't consolidated yeah but at that stage it is then
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it then stable enough to effectively stay problem for fun hearing isn't anything to this very
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very important that the the the haitian starts moving early enough so i i yeah
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i pointed out in another session and i saw some some people's which we get
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anywhere and the the soldiers waiting for bone healing in financial factors menu kate
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made for three months and you you have to pass the still on on for years and then then the thing is the complete peace they fear
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okay are there any and there's so much or perhaps i'm not scared now
00:02:51
it is difficult for me to play sick a wire from the base of the facts
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show i normally introduce them by the t. i.
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p. jar and retrieve them box into ah
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they take a cross uh athletic uh a couple that or not
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for me it's much easier to that in a reverse way i think
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making them like the putting them in the base of the fellas is for scalar hats
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uh probably shoes easy i conclude i can teach my training to do it after one case
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yeah i think it's easy it's not so difficult to to meet the correct point on the base
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it depends a bit of fractures so i usually try to grow through the phalanx and
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go out on the other side and what the u. t. y. s. artistically
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love is done by a appreciation with special manners and and feel
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you have to you you you get to the skin you you hold the
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finger in one hand you the bandage into the rest of the lifted up off the operating table slightly and then you can just
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feel the base of the the the problem franks it's just if you if if you if you can do office could be you can do that easily
00:04:23
triangulation if so there at any other questions
00:04:30
so if not i think the new catch me get it with the next one yeah sorry
00:04:41
so uh the next to talk is uh about intro articulate fractures
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