Femoral shaft fracture after hinge implantation
this week i attended a revision surgery.
patient was a 16 female
she had distal femur osteosarcoma.
https://www.box.com/s/ghf34bebkm6tyhzh2di1
and
https://www.box.com/s/kjd4clrh5v82v99egdoh
in previous surgery we've used GMRS implant, stryker, the tumor had been removed and 80 mm extension peaces and femoral condyle had been replaced with prosthesis.
we've used tibial stem (80mm) and femoral stem (125 mm).
https://www.box.com/s/36a592pf53h1lrdrgv3w
femoral shaft was fractured at the proximal site femoral stem.
https://www.box.com/s/3ogy74n324yg32hc1g5s
and
https://www.box.com/s/r4nlrncrwlg2mrctf1us
the initial plan was to remove the stem and re-cut the femur and use a longer extension peace and bigger stem to fit wider canal in proximal femur.
that plan changed according to stem length and risk of penetrating the hip joint
instead, a 9 hole plate was used anteriorly with 4 wire in the extension peace area and 4 screws in proximal femur and achieved a relatively good fixation
do you think this may be the best solution or you prefer other approaches.
patient was a 16 female
she had distal femur osteosarcoma.
https://www.box.com/s/ghf34bebkm6tyhzh2di1
and
https://www.box.com/s/kjd4clrh5v82v99egdoh
in previous surgery we've used GMRS implant, stryker, the tumor had been removed and 80 mm extension peaces and femoral condyle had been replaced with prosthesis.
we've used tibial stem (80mm) and femoral stem (125 mm).
https://www.box.com/s/36a592pf53h1lrdrgv3w
femoral shaft was fractured at the proximal site femoral stem.
https://www.box.com/s/3ogy74n324yg32hc1g5s
and
https://www.box.com/s/r4nlrncrwlg2mrctf1us
the initial plan was to remove the stem and re-cut the femur and use a longer extension peace and bigger stem to fit wider canal in proximal femur.
that plan changed according to stem length and risk of penetrating the hip joint
instead, a 9 hole plate was used anteriorly with 4 wire in the extension peace area and 4 screws in proximal femur and achieved a relatively good fixation
do you think this may be the best solution or you prefer other approaches.
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