Consultant and Lecturer of orthopaedic and spine surgery at Zagazig university hospitals
Here is a 70 years old short obese porotic female with a supracondylar fracture femur. Fixation was done with bicolumnar plating. The medial plate was used to mitigate the varus stresss at the fracture site which is commonly the reason for failure of fixation in this fracture and also because of the porosis. Another strategy would have been using a retrograde nail with a lateral plate. #Orthopedic #Trauma #Distal_Femur #Bicolumnar_Fixation
Excellent result. Was the medial plate molded in surgery? or does it come prefabricated? I don't know of medial plates for distal femur, we normally use LCP plates and shape them in surgery
Looks great. But here’s a vote for a nail. Done in 30 minutes and less soft tissue dissection in an obese elderly patient.
Xrays look very good. Well done. Was there an I tercondylar split? Show us the films when it’s united please 🙏
What approach did you do?
In an obese patient, i would escape soft tissue dissection and prefer a nail. Excellent job though!! Small inquiry…did you need bone graft ?
A reversed tibial nail generally has more hole options than retrograde nail if not availible. But i personally only consider nail if fx is at metaphyseal diapheseal juntction. This on is a little low for me to nail. And the reduction is easierwith lateral plate if distal fragment islaterally displaced.
even with IM nail. the medial cortex is gone and very fragile, so, doble implnat in those cases is a good option to asure good recovery. Plate + bone Strut?. Nail + plate?. Plate + Plate?. ?
Excellently reduced fracture. Medial side I always prefer a recon plate because it moulds according to the surface and seats flush. If the lateral reduction and fixation is good, the fracture eventually unites.
Well done. Just maybe my 2nd plate will be shorter. Another arthroplasty surgeon may suggest replacement
Chirurgo ortopedico presso Casa di cura VILLA SALUS
8mowhich surgical access did you use?Double or single?