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A-1287 Q&A followed by A-1288 Case discussion
Panel
Wednesday, June 13, 2018 · 3:40 p.m. · 12m 20s
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give or much stay on the full uh at out any questions from the floor all
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so i yeah i won i won for you uh do you think it's
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always necessary to uh when you do a a prosecution did were
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a position of the lewd made to the radius always also possible to
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do or a position of the moon it to the capital it
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and then of course according to the radios we have to bring it up in a
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good position without any doubt but into possibly always argued we have to bring out
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it's illuminated to complicate in one line because this
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straight or increases the tenth anniversary to copy the commands and improve tension
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but the problem however is when you bring it up in one line increasing
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pressure to on macabre trying in some patients also complain and complain
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pay a a pain it's or it's on at and of course when
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a incomplete eighty one line is not on the committee position
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and now will be a little bit more restrictive that maybe you see you like him at all michael position
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but at least number one is to restore it neutral position but we
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don't always a push it eluded computing one line to goodwill
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okay and you use always said bow graph for a parcel of fraud total wrist used because
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it several applications they all use but we're off i think there is a must eh
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the only question is can you go only with local bone graft was really go to your breast
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he is the majority views probably bone graft like my i said absolutely e.
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to use polygraph because we have significant uh a number of unions they want to avoid end
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for informal times people sort just we re meat and then we put
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on your plate circular plate whatever type of uh use but
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the failure rate was to write to you have my eyes orders
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to go okay another question so could you use the microphone
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there is one and behind and also an information so the next session
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will be at four o'clock in the program there is a mistake
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it said two thirty in the program but it's four o'clock so we
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have so little time for a break up the weights yeah
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like your final from and the very beautiful overview um i always
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feel we should trying keep mobility as long as we can
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and what you see a supposition before see revision or pierce you with c.
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s. um i recording and from with the r. c. r. a.
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or would you offer people a total wrists ceases
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this first and all sorry could yeah actually once again because even if if forms uh
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oh it would be hard to understand it not from the language part from
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the okay to repeated once world lit visually their communications which
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you would see for revision of a pure c.
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going to we are recording implants office okay part i got
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it sorry no i'd rather recently i got the
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i think what you are asking is can only call for revision or no paying full or failed
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proximal wrote compared to me and makes it stands for example to reconstruct
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ahead of the completed for example if i recall the internet
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but that was quick truck so that when i read about this technique i
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was very encouraged and that's what it should be a good idea
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there's also a some people from it and they will need to pick is furious
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but in our hands or in our hands the the results
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repeated it in seven cases will mixed that meets
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often half control we decided to give it up because how uh uh
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experiences a full of when not in that way that we expected
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and for example you don't use it anymore anyway it's a good idea if it works too
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partially make a reserve visiting off to completed our experience did not get are expected
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okay so thank you very much now at the end we have a case
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discussion i've prepared twenty cases but i think a two will be enough
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for the next that five to ten minutes uh and i will
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add all the all the audience here they are uh
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and and you and the audience and also the the speakers
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uh my uh disclosure this is the first case
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this is a twenty five year old professional i saw people yeah and to
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ice okay in a in a switch and is a very famous
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and get an accident during a qualifying match one week uh before and pain
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over the regular raced and he was sent from the team doctor
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with those those uh that those m. or i look and see if there is a uh
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yeah that's a factor on the proximal a hole here
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and also a a you can see the very well and he told me yeah you have to look that
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he is in two weeks back on i sell now what's to do what would you do marks
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if that's covered no that is okay player not so uh
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the question is versus the non union it was a risk and then you know can put a screw
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in new and interesting actually but i think uh i would go for something like a nice okay
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okay and the others and here it really had tenderness at at the proximal board yep
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you only what happened it yeah i would go for surgery was i mean you know but screw
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yeah and it was a bit later would the the to play after two weeks and andreas
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i won't let him go play he's very important kane and done taken back and put a screen of
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covers because of i want don't want to risk that screws freaking out tunes important yeah if
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uh so so you know so you know uh that that uh we did we did this crew
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fixation dalton approaches when i don't have found that that's something you didn't want any k.
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or after off place after is good no no it was
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spewing a qualifying so it was during qualifying and uh
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about five or six days later we look to be off when
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you're every go for initial surgery without a conservative treatment before
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yeah we uh took no rafter three weeks in what lies asian
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when explained and then edition if i wouldn't have loaded stick
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handling on eyes so he wasn't training it's the canning during
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training but uh yeah not tonight so he was uh
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then he was a competed with consideration eight weeks post op
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and then was paid when we return in matt to the playoffs that's very important
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and then he was so on and the teen mothers which national i. circuit champion that
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this year once as a lot that yeah it was set it was a only
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get another rex it endured the playoff a broken finger that's why after uh
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a very hard and long seasons would slanted don't want to go to uh to uh to the national to yeah
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and that the second case this is an nineteen year old senate professional soccer player
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and yet accident human sports four months ago and dissenters
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to us with pain over the regular is
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and with those x. ray pictures and if you see this gave way
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there it looks a little bit but uh yeah uh yeah
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and common then that then i want to ah to have a l. c.
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t. scan and here and to see this guy and you see this
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yeah we have a c. v. a. d. fact uh in the mid portion of this cave which
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and the and the also if you have seen that on the coral
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plan also see the defect so it's a it's a nonunion cell
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what would you do marks or defects seems to me a little bit too
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big for just a a scope like uh what would go for a
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was chorus craft for me palmer on wrist growth rates craft and a script
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do you think it's enough for the poem about outside of the radius for this huge effect
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that why rascal rose because we have the i think the proximal part which is with
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what what i would do restful rose something which was alright are you but to be honest from the palm aspect
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to fix it like that but if you get to go for simple easy procedure it yet
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well if you want to read it um you know that's painful here you are you're ready so why don't you take a going from
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there were everywhere and the woodwork was to rise or not i don't think it makes a difference here we agree on this
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no nothing question what to limit of the side because you it's the size it is which
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is limited you are limited but generally in my experience this is a enough for disk
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but at the end you have to evaluate this when you every second fiscal records
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it once you have restricted then you see the real size of the basic
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so we have two opinions in crafting and andreas
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would you go for three dimensional uh reconstruction
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we always two three dimensional analysis you saw that uh this this case it was already
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yeah the seat information of about twenty five degrees and that's all that's already
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uh quite difficult to really put up two pieces together
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we saw this when we start to do d. c. t. analysis before we also pulled on the
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on the on the thumb and talk to the fragments go back into the into the
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dry position but they don't read you you you really need a a three d. orientation of
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these fragments to to put them back and usually um you make this country tool
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and uh if you just put on the on the phone and what we
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so that when we do a sweetie planning this these guides the
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end up with the essential to and this came from it and asked
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me to to before and that's the mixed operation easier um
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but you you can that's marks you do the same you usually to a
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rascal and we'll go from ratings because it's easier and faster and
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okay thank you so what did we have we done with the the reconstruction with the high
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court to draw from the the crest about eight millimetres perhaps a little bit too long
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and we fixed it with a such a screw and we put him in a
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forum cost uh for a eight weeks to that in drop give a result
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and uh you see that yeah that's uh the the c. t. scan after a eight weeks
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and they're happy i'm was not sure i also if you go for the
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coroner plane if there is a complete concentration because of the huge crowds
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and that's why he uh was allowed to play soccer with the praise for uh
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the next uh two months but all over the place and after two months
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we don't do a and uh another uh it's re control uh yeah
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uh with the with the the mixer controls for months post op and there i think we have a solid consideration
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and now we complete the completely return to the sport valparaiso you can see
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we have one cases we have several uh possibilities how to do that i think you
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have to uh to uh yeah men instead by yourself in your experience and
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discuss that in the team us i think there is not only one way also uh
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also a palm available are a craft uh could be there a possible what
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do what you can test okay that's very good so that's at the end thank
Conference Program
S77 Session introduction
Stephan Schindele, Switzerland
June 13, 2018 · 2:20 p.m.
140 views
A-1284 Review of imaging of the wrist
Andreas Schweizer, Switzerland
June 13, 2018 · 2:21 p.m.
181 views
A-1285 Acute scaphoid fractures when and how to fix
Hermann Krimmer, Germany
June 13, 2018 · 2:48 p.m.
245 views
A-1285 Q&A
Hermann Krimmer, Germany
June 13, 2018 · 3:02 p.m.
A-1286 Scaphoid non-union: vasularized or not
Max Haerle, Germany
June 13, 2018 · 3:05 p.m.
271 views
A-1286 Scaphoid non-union: vasularized or not - Q&A
June 13, 2018 · 3:18 p.m.
126 views
A-1287 Partial and total wrist fusion
Hermann Krimmer, Germany
June 13, 2018 · 3:22 p.m.
152 views
