Thoughts and Innovations for Southern Philippines Medical Center

Posted by on Aug 16, 2017 | Comments Off on Thoughts and Innovations for Southern Philippines Medical Center

Last week I went into 2 SIGN cases.

The first was a proximal femur fracture involving the basicervial and intertrochanteric area.  I indicated this for fixation with the SIGN hip construct nail.  Unfortunately the residents of the service involved had lapses in their preparation and were not able to autoclave the SIGN hip nails– for this lapses they were given sanctions .  We modified and fixed the fracture with a standard nail and was only able to place a single screw going to the neck and 2 proximal locking screws and a side plate.

What we learned here was that exposure and insertion of the nail was easier done with the patient on lateral decubitus position, which what was done to the patient.  BUT it is ver important to put a bolster in between the thighs so as to prevent fixation in varus, which happened in this patient when we forgot to do just that, we had to revise the fixation and was able to correct the varus.

The second case was a rotationplasty procedure in an 8 year old boy for an osteosarcoma of the distal femur.  We innovated and fixed the femur and tibia with a fin nail and got a stable fixation, procedure was shortened. Because we did not need to lock distally, and I think this fixation provided less trauma to the rotated limb by avoiding the need of distal locking screws.

Image below are those of the proximal femur and the other image is the first SIGN fin nail in a rotationplasty.

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