8yr m fall on ground before 1 day having # shaft femer
Before 10 month he was fall & Having #on jn of u/3rd&m/3rd femer& put enders nail than aftrer 6 month removed nail again refracture on #site
Put Dcp before 4 month than again # on shaft
May be osteopetrosis? ???
What is the best T / t of choice
opinion plz
Before 10 month he was fall & Having #on jn of u/3rd&m/3rd femer& put enders nail than aftrer 6 month removed nail again refracture on #site
Put Dcp before 4 month than again # on shaft
May be osteopetrosis? ???
What is the best T / t of choice
opinion plz
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Girish Vimal Wt exactly Nial sign means? S u hv 2 remove d implant opn is must, dn take a long im lock femur nail keep it just above d physial plate n lock it. Dr. Is chance o further fracturing d plated part so needs gentle hand reaming through # site retro n antigrade.Girish do it n dn tell d further story.
Jayant Sharma Girish why did you label it as osteopetrosis. Why was index surgery enders nailing in a 7 year old why not hip spica. Why did enders fail. Was plating and bone grafting done
Ashutosh Chaudhari X-rays don’t seem to suggest osteopetrosis , osteogenesis imperfect a is what I would think of , send it to a paediatric orthopod ,
Drgirish Gupta @dr Jayant Sharma sir I prefer enders nail at the age of 7yr union achieved but after nail removal pt fall again &refracture occur
Than 2nd surgery done Dcp with out BG Union achieved but pt again fall on ground &now new#below plate
Navin Singh non union femur in paediateic age group is a rarity. kindly post previous X rays . This DCP and screws are clearly oversized for this age. The stress riser at the end of plate made this fracture inevitable- Jayant Sharma Just to discuss out here how many of us operate a 7 yr old fracture shaft femur. I treat it in spica or a tobrruck. What is the logic for operating.
- Navin Singh Sir , for children older than 6 or heavier than 49 lbs AAOS recommends TENS, so I do likewise. I do hip spicy for younger
- Drgirish Gupta @dr Navin Singh at present I am not having old xrays
I used narrow DCP with 4.5mm cortical screw b/c
Bone is osteoporotic thatswhy 3.5 screws purchase is doubtful 
- Nisarg Raninga Bhuro I think removal of plate and long sized 4.5 mm dcp probably locking is the best option, at least 3 screw below 2 inbettwen #siteand 2 above # site
Nishikant Kumar It may be OI; LOOK FOR CAUSE, and now treatment plan is implant removal followed by longer plate;; LOCKING PLATE.; As it may be difficult to negotiate enders / TENS through earlier fracture site,Maintain working length.- Nishikant Kumar Look for cause ; If OI, you will find severe osteoporosis so DCP may not hold so you shd use LOCKING PLATE.Anyway locking plate is not contraindicated in pediatric patients.
Sanjay Joseph If this is, as I suspect, osteogenesis imperfecta, then in an ideal world the treatment would be telescopic nailing. Failing this then enders nails are not a bad option.
