Cup-cage construct provides options for large defect acetabular revisions

Cup-cage construct provides options for large defect acetabular revisions

http://www.healio.com/orthopedics/hip/news/print/orthopedics-today/%7B8aabf5d2-03b9-4ff1-8850-33497001dd0b%7D/cup-cage-construct-provides-options-for-large-defect-acetabular-revisions

• Orthopedics Today, April 2014
  Robert T. Trousdale, MD; David G. Lewallen, MD

Cup-cage construct provides options for large defect acetabular revisions
In most acetabular revisions, an uncemented hemispherical socket with screws can be used. However, in the past 15 years, we have learned that not all ingrowth surfaces are equal. Read more

Artículo completo, pincha aquí /cup-cage-construct-provides-options-for-large-defect-acetabular-revisions

Artroplastía Total de Cadera: alivio de dolor y recuperación de la función.

una publicación de Lesiones y Articulaciones.

Discusión entre pares / Any tricks to avoid drill bit breakage at neck level???

Indian-Orthopaedic Research-Group

Vijay Tubaki

18 de abril a la(s) 11:38 · Tumkur, India

Any tricks to avoid drill bit breakage at neck level???

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  Vijay Tubaki In this case,I had limited number of nail in my store.. I would have preferred longer nail..

  18 de abril a la(s) 11:43 · Me gusta
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  Vijay Tubaki Sorry,my question was how to avoid guide wire // drill bit breakage..in this case there was guide wire breakage!!!

  18 de abril a la(s) 11:45 · Me gusta
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  Vijayanand Addanki Is it a guide wire or drill bit ? Cos I've seen guide wires being cut so better not to send them beyond head...drill bits cannulated usually don't break...

  18 de abril a la(s) 11:47 · Me gusta · 2
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  Jassim M Alfailakawi Use new one

  18 de abril a la(s) 11:48 · Me gusta · 2
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  Sanjay Joseph Tough case. Good fixation. With PFN the proximal drill bits tend to get blunt rather quickly so it's always better to replace them every two or three operations.

  18 de abril a la(s) 12:00 · Me gusta · 3
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  Vijay Tubaki This breakage of guide wire/ drill bit is happening second time..manufacturing defect!!!!

  18 de abril a la(s) 12:00 · Me gusta
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  DrDilawar Khan Mahsud Excellent

  18 de abril a la(s) 12:27 · Me gusta · 1
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  Khin Zaw Hein Good

  18 de abril a la(s) 12:43 · Me gusta · 1
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  Viru Somashekaraiah follow the direction of the guide wire while drilling. even a slight change in direction of drillbit/reamer can damage the thin guide wire. btwn excellent job for this tough case.

  18 de abril a la(s) 12:44 · Me gusta · 2
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  Sachit Malhan Believe me or no but local 100rs drills are far better than 2k drills. Never saw a single breakage for last 5 years and prev when we using imported ao drill 4 or 5 incidents were there. And another benefit you can change the drill bit after 2 or 3 surgeries and won't affect pockets at all.

  18 de abril a la(s) 13:10 · Me gusta · 3
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  Viru Somashekaraiah sanchit , here its guide wire not the drill bit

  18 de abril a la(s) 13:21 · Me gusta · 1
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  Sachit Malhan It is okay but question specifically asks for broken drill bit scenario prevention not guide wire. Regards Dr Sachit.

  18 de abril a la(s) 13:55 · Editado · Me gusta · 1
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  Shyamlal Mukhi Excellent job ! Please be careful one may fail

  18 de abril a la(s) 13:39 · Me gusta · 2
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  Prasad Murugappa Gowda Good job...keep posting

  18 de abril a la(s) 13:44 · Me gusta · 1
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  Nadir Shah great job done

  18 de abril a la(s) 13:45 · Me gusta · 1
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  Drgirish Gupta Excellent delay wt bearing please

  18 de abril a la(s) 13:46 · Me gusta · 2
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  Ahmedknawyy Ortho Great job
  Diffecult fr.

  18 de abril a la(s) 14:03 · Me gusta · 2
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  Mohamed Ayman Great job

  18 de abril a la(s) 14:56 · Me gusta · 1
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  Bipin Solanki Drillbits breaks when there is track mismatch in guide wire and cannulated Drillbits, then actually Drillbit cuts the guide wire. This happens when we use low quality very flexible threaded guidewires which doesn't go straight in bone but rigid Drillbit go straight so they cut it on there way.. Moreover threaded wires r very weak.. I use k wires in place..

  18 de abril a la(s) 15:28 · Me gusta · 3
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  Sachit Malhan I agree with Dr Bipin Solanki but not with the fact low quality guide wires. If you do drilling on mismatch tracks guide writes break. These wires have to be inserted by cannulated drill s ,if done by normal battery non cannulated drill track miss match will result. I have seen people doing that too.

  18 de abril a la(s) 20:33 · Me gusta · 1
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  Javed Shaikh 1 option- i always drill without guide wire (so never encountered guide wire breakage !)
  2nd (v helpful)- wen u get little resistance or getting stuck, do 4wd backward, dnt drill 4wd only.
  Belive me it works 

  18 de abril a la(s) 20:45 · Me gusta · 1
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  Dipak Vadodaria Great.... Why not two screws proximally?

  18 de abril a la(s) 22:48 · Me gusta · 1
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  Kulvinder Gill Done close or open. How was traction applied. Problem in manipulating guide wire.

  18 de abril a la(s) 22:49 · Me gusta · 1
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  P.s. Balaji Did u open anywhere along the shaft?

  19 de abril a la(s) 0:40 · Me gusta
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  Doc Umair Rana Great job

  19 de abril a la(s) 0:59 · Me gusta · 1
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  Gopal Goel There is only one tric-- dont cause any angulation while drilling

  19 de abril a la(s) 1:47 · Me gusta · 1
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  Vijay Tubaki It was pure close reduction and internal fixation.i did not open at any site...ya,I had tough time in manupulating guide wire..but we were successfull!!!

  19 de abril a la(s) 2:05 · Me gusta
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  Akhilesh Vanam Poor at metallurgy.....but do not push hard if any resistance and avoid drilling for long at one go

  19 de abril a la(s) 2:32 · Me gusta · 1
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  Akhilesh Vanam Do not overuse old drill bits,avoid angulation

  19 de abril a la(s) 2:35 · Me gusta · 2
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  Shrikrishna Dhone USE new1/8TH size dril bit available at hardware stores costs Rs 20

  19 de abril a la(s) 2:57 · Me gusta · 2
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  Sunil Gupta dr Vijay Tubaki how did u obtain closed reduction in such a difficult case?

  19 de abril a la(s) 11:42 · Me gusta
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  Vijay Tubaki Hi,Sunil Gupta,,first I made sure that my entry point was perfect in both AP and lateral.I slightly bent my guide wire tip before I passed inside the medullary canal..So that each stage, I can rotate around to push into next medullary canal...then I passed guide wire reducing each fracture one by one..each stage I did not bother about distal fracture fragments..

  19 de abril a la(s) 11:49 · Me gusta · 2
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  Sunil Gupta grt sir!

  19 de abril a la(s) 11:51 · Me gusta · 1
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  Bhupendra Bharti good job dr vijay

  19 de abril a la(s) 13:14 · Me gusta · 1
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  DrHarpreet Singh Bhatia grt work sir

  19 de abril a la(s) 15:13 · Me gusta · 1
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  Sunil Gupta Dr Vijay Tubaki till what no. Did u ream and what is d nail size

  19 de abril a la(s) 21:29 · Me gusta · 1
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  Aung Kyi Win Nice job.

  20 de abril a la(s) 1:18 · Me gusta · 1
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  Vijay Tubaki 10.5 ream and 10mm nail

  20 de abril a la(s) 4:06 · Me gusta
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  Sunil Gupta Should not u take nail of1.5mm lesser than reamed

  20 de abril a la(s) 8:44 · Me gusta
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  Sunil Gupta Dr Vijay Tubaki Any option for unreamed nail in this case.also in unreamed nail is reaming not done at all?

  20 de abril a la(s) 8:46 · Me gusta
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  Vijay Tubaki May be unreamed nail is also option..but it is easier to pass nail in reamed canal than unreamed..in unreamed,we may have to really struggle intraop!!

  20 de abril a la(s) 10:08 · Me gusta