Discusión entre pares del grupo: "Indian Orthopaedic Research Group"

Kir Pat ha añadido fotos al álbum "July 17, 2013" en el grupo "Indian Orthopaedic Research Group".

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  Rajiv Baral what about reduction

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  Kir Pat Joint salvaging procedure in hallux/valgus rigidus on one side.in75 yrs aged one

  

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  Aud Hussain Dr Kir pat@ very nice case you do the correction of the hallux valgus closely,,and you use a K wire for fixation,,my question to you dear,,can you do a miniexternal fixation to fix the correction well ?

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  Kir Pat Not done...exfix.

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  Mario Tangari at this time with the dr. Alberto Battle of the 'San Giovanni Hospital of Rome abbuiamo developed a percutaneous technique with Miros and would also involve her dr. Kiran Patel

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  Kir Pat Sure, sir we will be pleased to learn newer dynamic early mobilsing path

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  Aud Hussain Dr Kiran Patel@ sorry but i dont understand,,what do you mean by NOT done...exfix? do you mean you just put that k wire ?

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  Bansal Ajay ?

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  Kir Pat I have not tried exfix...

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  Mario Tangari the primary issue in engineering Bosch is not the governability of the metatarsal head I'm sure you can do and act on the corner intermetatarsal and a proponent of a proximal metatarsal osteotomy technique and a percutaneous osteotomy of the base of the phalanx

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  Aud Hussain Dr Kir Pat@ have you make any small incision to make your owen osteotomy by naked eye?

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  Kir Pat IITV GUIDED

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  Kir Pat not owen it,s transverse

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  Aud Hussain Dr Kir Pat@ do you always do this for every case with hallux valgus? realy it is very simple and nice

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  Aud Hussain Do you put the patient on cast or any splintage? and for how long you would allow the patient for weight bearing?

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  Kir Pat BK slab ,6wks PWB remove k wire along with xray surveillance....done only two case result awaited,

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  Alberto Padilla I use the traditional aproach to hallux, Chevron technique in my favorite, i don`t belive in percutaneus surgery

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  Rajasekhar Rao P In hallux valgus interpositional arthroplasty is best and I never osteotomy of metatarsar in a 75 year old this can be done in a young girl in this case only palliative

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  Kir Pat This is not in 75yrs, i did arthrodesis in 75yrs posted

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  Rajasekhar Rao P even arthrodesis is not required in that age u can easily do interpositional arthroplasty and give painfree functional first metatarsophalangeal joint

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  Rajasekhar Rao P what I miss in India is my hallux valgus which I used to do atleast two cases per day in Russia

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  Aud Hussain Dear Dr Rajasekhar Rao P@ are you talking about the hallux valgus in the top above pictures? or you are talking about the hallux rigidus which is also posted by Dr Kir pat under the comment?

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  Aud Hussain Dear Dr Rajasekhar Rao P@ what do you mean by interpositional arthroplasty,,can you please clarify?

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  Rajasekhar Rao P any hallux valgus

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  Rajasekhar Rao P u do interpositinal arthroplasty in a severely damaged joint.

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  Aud Hussain Dr Rajasekhar Rao P@ please if you can post any picture in regard to your comments for the benifit of all group members

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  Rajasekhar Rao P I dont think I can find will try to find it

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  Alberto Padilla ok

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  Rajasekhar Rao P http://www.healio.com/orthopedics/foot-ankle/news/print/orthopedics-today/%7B62F8A330-EE7B-4128-B8B3-BB0937B2E63C%7D/Capsular-interposition-arthroplasty-offers-an-option-over-fusion-for-hallux-rigidus

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  Rajasekhar Rao P u need to take capsule as a tougue with the base attached to the proximal phalanx of the firt toe and remove the base of first phalanx and remove all the osteophytes from the head of MT and just put that togue of capsule between the head of MT and phalanx and it is better to fix that toungue with one suture to the medial capsule so that it wont slide away and I allow weight bearing walking after third or fourth post op so that movements can be initiated.

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  Rajasekhar Rao P U need to close only skin dont get capsular closure.

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  Rajasekhar Rao P in a very old patient u dont need to correct valgus angle as they are least bothered than the pain due to secondary oa

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  Rajasekhar Rao P u need to be very careful while elivating the toungue as u might land up with tongue in your hand and u need to do arthrodesis.

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  Rajasekhar Rao P spend some time and use 11 no blade where the tip is sharp

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  Aud Hussain Dr Rajasekhar Rao P@ thanks alot,,do you mean to put the tongue of the capsule in the metatarsophalangeal joint?does this cause fibrous arthrodesis?

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  Rajasekhar Rao P skin Incision, I never take straight incision over a joint

  

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  Rajasekhar Rao P tongue shaped capsule elevatin

  

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  Rajasekhar Rao P base osteotomy

  

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  Aud Hussain Dr Rajasekhar Rao P@ the article said to put the extensor hallucis brevis beside the capsule

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  Rajasekhar Rao P I dont do that I have uploaded my technique and patients are quite happy and this is easy one for me everything done through same incision

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  Kir Pat Michael Dujela do you preffer keller,s procedure with capsular as stated above?disadv as per book (not experienced) shortening and dorsal callosity in shoes

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  Michael Dujela In patients With somewhat diminished bone quality over age 60 I perform arthrodesis of the first metatarsophalangeal joint. We have over 50 cases of this and our AOFAS scores are substantially improved. I abandoned Keller arthroplasty particularly in...Ver más

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  Kir Pat Thks

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  Chirag Prajapati when do u remove k wires ? what shoe support do u give postop to th patient ?