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RISK ASSESSMENT
•Inflammatory arthritis
•Advanced osteoarthritis
•Advanced osteonecrosis
•Bleeding disorders
•Hypertension
•Diabetes
•Heart diseases
•Renal disorders
•Pulmonary insufficiency
•Old age
• Blood tests
• Urine tests
• X-ray chest
• ECG
• X-ray of
o Standing anteroposterior pelvis radiographs
o Cross-table lateral of the involved hip
o Standing bipedal 51-inch radiograph including the top iliac
crests to below ankle joints to assess deformity and leg
length
• Bone scanning
• CT scanning (Hip CT scan)
• MRI
• Aspirin was stopped
• Blood thinning medication was stopped before procedure
• Patient was on fasting for _____hrs before procedure
• Part was prepared and draped
ANESTHESIA:
•General anesthesia
THE PROCEDURE
INTERNAL FIXATION
•Skin incision was given on lateral side of ___ thigh and extended
the incision into subcutaneous tissue
•_______ muscles were retracted
•Blood vessels and nerves were protected form the injury
•A Steinman pin was placed into the proximal femur posteriorly, at
the level of the lesser trochanter.
•A second pin was placed into the distal femur at an angle
•Guide wire was placed for the blade plate into the femoral neck
and head in the ____ __location.
•The seating chisel was advanced over the wire with taking care to
enter the bone at the ideal angle in the sagittal plane.
•Flexion / extension was done
•The plate is then used to help obtain the correction.
•The osteotomy was done at the level of the lesser trochanter.
•Deformity was corrected
•The screws were inserted through the plate.
•Muscles were replaced
•Drain was placed
•Incision was closed in layers with _______
•Sterile dressing was applied
EXTERNAL FIXATION
FINDINGS:
AFTER PROCEDURE:
DURATION
_____hrs
POSTOPERATIVE CARE
COMPLICATIONS
•Infection
•Neurovascular injury
•Nonunion
•Inability to obtain or maintain a full correction
•Persistence of pain postoperatively
•Continued degeneration of hip articular cartilage
•Deep vein thrombosis
•Painful hardware
•Pin site infection
•Fracture above / below the frame
•Fracture through a screw hole after frame removal,
•Stiffness of adjacent joints
•Septic arthritis if pins communicate with the joint.