Date: Sat, 15 Oct 2005 00:35:12 +0600
From: Alexander Chelnokov
Subject: Neglected femoral neck fx
A male 31 years old treated elsewhere after not severe pelvic fracture 2 months ago, was managed non operatively. So the injury looked as a reason of his inability to elevate the leg. However at the recent x-rays the neck fractire was found. The patient already has been walking with partial weight-bearing.
Looking at the x-rays and the time since the injury, what is the optimal treatment for now? We discussed 1)leave as is, 2)2 cancellows screws as is, 3)valgus osteotomy. Total hip replacement looks unnecessary yet.
What is your opinion? Which option from the listed or something else should be preferred and why?
THX in advance.
Alexander N. Chelnokov
Ural Scientific Institute of Traumatology and Orthopaedics
str. Bankovsky, 7. Ekaterinburg 620014 Russia
Date: Sat, 15 Oct 2005 10:44:22 +0300
From: Erden Kilic
I would leave it as it is. Because surgical intervention will not be able to prevent osteonecrosis if it is going to be. MRI may be helpful to determine union if there is any and also gives an idea about the viability of the head.
Erden Kilic, MD
Gulhane Military Medical Academy
Date: Sun, 16 Oct 2005 13:31:50 +0800
If I were u , a DHS will be used to fix it . And I will tell the patient not to weight bearing from now on. It will accelerate the aseptic necrosis of the femoral head.
Best wish to U
Dr. Sam. Shen
Dept. of Othropaedic and Trauma
Shanghai, P.R. China
Date: Sun, 16 Oct 2005 21:42:17 -0400
dhs will not correct improper improper biomechanical environment