Doc, thanks for this and your other videos. I just had a case identical to your 10 day delayed presentation SH fracture of the wrist and treated it in-situ with a below elbow cast. Your tip helped me make the right decision in real time.
Sir your every video is excellent and very informative.i use to watch your videos before doing any difficult surgery. you give valuable tricks&clues to orthopaedician so that we are able to provide better result to our patients , Thanks alot Sir🙏🙏
It’s only the good and experienced doctors that know when to leave things alone. Sometimes the body can heal itself without intervention. This good advice is of as much importance than your surgery video’s. Thanks for sharing your experience.
First , the dont touch ,yes It work if the fracture is delayed salter 1 or 2 , but when the fracture is intrarticular like salter 3 or 4 , the remodelling will not offer that accepted healing and the risk of later persistant deformity and the premature physeal closure is high . Intra articular # is intra articular even in children Second , why we dont accept the displaced salter harris fracture in distal femur if presented late ??!
Thanks doc for your advice it’s really helpful,we had a lot of patients with delayed presentation and it’s a management dilemma … but if the age of the patient above 10 will you expect the remodeling like ur case ?
Thank you sir for this advice Today a 14 yrs boy came with transient 1 month same fracture without reduction.. Callus formed dorsally so i had opinions about remanipulate or leave it alone ! After i saw this video i prefer leave it alone for the nature .. And if the last xray you viewed after 3 months ,,it should be a great resault,, thank you sur
Sir just a small query.. even in such displaced fracture .... have you given any traction and applied back slab..... Or have u applied a simple back slab without any traction
Hi sir,i would appreciate if you could elaborate and upload video about forearm both bone fractures in children conservative treatment.We shall be thankful to you in this context.
Dr.Vinay,thanks for all your videos..It is very good work,but I want to know if there will be any incidence or chance of malunion or non union in any of these cases ?
Hello sir nicely explained, i have one question similar kind of patient presenting at 3 weeks with median nerve compression symptoms what would be the further line of management, would you manipulate it or operate and if operate would you fix the fracture or only adress compression ?
Hello doctor I have 38y male pt with history of bullet injury at right thigh since 2007 now present with full strength dorsiflexion of rt foot eversion also functioning but no planter flexition and no inversion what your opinion what I can do only arthrodesis of ankle
My mom(age-56) has severe frozen shoulder .. she is suffering from this disease 6months ... It's very painful for her.. pls sir tell the treatment and what to do !!!🙏🙏🙏
Explain that doing anything will do more harm. You can also show them this video
2 ปีที่แล้ว +2
And as always..keep a fluent communication with the parents..explain them what is this about in a clear language avoiding medical terminology ,which might be pretty confusing for the non medical people..stay away from problems..and medicolegal issues..👍👍
Sir my son is patient of osteogenisis imperfecta his age is 15 years he have 15 fractures , please sir suggest best biphosphonate medicine, i am very poor i can't afford any orthopaedic surgeon
Sir My age is 17 & i am patient of osteogenisis imperfecta type 1, i am in good condition , only my right leg have been broke for 10 time, i can walk with braces & lift weight, please suggest me a good medicine thanks .
You are amazing sir.. we watch your videos before deciding on any treatment.. thanku sir
My pleasure
Vinay everytime I see your video , a wave of happiness pass through my body.Blessings. to you
Thank you for your love and affection 💝
Dr.vinay, thanks for putting forth your findings .I myself have observed this in many pediatric patients ...keep up the good work ..GOD BLESS YOU .
Thank you
Doc, thanks for this and your other videos. I just had a case identical to your 10 day delayed presentation SH fracture of the wrist and treated it in-situ with a below elbow cast. Your tip helped me make the right decision in real time.
Glad it was helpful!
Sir your every video is excellent and very informative.i use to watch your videos before doing any difficult surgery. you give valuable tricks&clues to orthopaedician so that we are able to provide better result to our patients , Thanks alot Sir🙏🙏
Thank you Ragvendra
Very useful sir. Normally we can't understand medical terms. But in your explanation every one will understand sir. It was very helpfull to all Sir.
Thank you
The end result is very surprising 👍👍
thank you for sharing this case with us 🌹
It's not surprising at all. This will happen every time
It’s only the good and experienced doctors that know when to leave things alone. Sometimes the body can heal itself without intervention. This good advice is of as much importance than your surgery video’s. Thanks for sharing your experience.
Thank you for your kind input
Very nicely put Dr Vinay, these are std guidelines which is not known to many practicing colleagues. 👏👏
Piyush Setia
RMCH Manchester
Thank you Piyush
First , the dont touch ,yes It work if the fracture is delayed salter 1 or 2 , but when the fracture is intrarticular like salter 3 or 4 , the remodelling will not offer that accepted healing and the risk of later persistant deformity and the premature physeal closure is high
. Intra articular # is intra articular
even in children
Second , why we dont accept the displaced salter harris fracture in distal femur if presented late ??!
Any surgery of any kind will do more harm in any Slater Harris Physeal Injury.
Femur is a weight bearing bone radius is not
I shall be very thankful to you,
Replies
Thanks doc for your advice it’s really helpful,we had a lot of patients with delayed presentation and it’s a management dilemma … but if the age of the patient above 10 will you expect the remodeling like ur case ?
Any age let nature take over and see the magic
Dr. Vinay
Very good and practical point is explained by u
Thank you
You are amazing sir...Plz continue Sharing your knowledge...
Thank you Tanvir
Thank you sir for this advice
Today a 14 yrs boy came with transient 1 month same fracture without reduction..
Callus formed dorsally so i had opinions about remanipulate or leave it alone !
After i saw this video i prefer leave it alone for the nature ..
And if the last xray you viewed after 3 months ,,it should be a great resault,, thank you sur
Thank you for your feedback
Nicely said.....but you didn't tell us the exact age of the patient.... what to do if the same case come to us in age of 10 years or above... thanks
Leave it
Very common saying which should always be followed in ortho "one should always know when not to operate..."
Correct
very valuable point of view ,thanks
Thank you
Thank u
My pleasure
Legend as usual 🤩🤩
Thank you
Thank u for sharing the valuable work
My pleasure
ONLINE EDUCATION IS FUTURE EDUCATION
Yes
Good information sir
Can you please put a video on basics of shoulder arthroscopy
Ok
Very wise words ,
thanks 👍
Thank you
Thank you sir for your inspiration
My pleasure
Sir just a small query.. even in such displaced fracture .... have you given any traction and applied back slab.....
Or have u applied a simple back slab without any traction
You don't make any effort to reduce it.
Hi sir,i would appreciate if you could elaborate and upload video about forearm both bone fractures in children conservative treatment.We shall be thankful to you in this context.
Ok
For how long should I follow up the child for remodeling, and when should I decide to do osteotomy?
You will never require osteotomy. Follow for sixth months
Great piece of information sir 🙏🙏
Thank you
Dr.Vinay,thanks for all your videos..It is very good work,but I want to know if there will be any incidence or chance of malunion or non union in any of these cases ?
Results would still be better than when you operate
Very much informative. Thanks alot sir
Thank you
You are amazing sir , thank you for the great content.
Thank you
All waiting for your video sir
🙏
Hello sir nicely explained, i have one question similar kind of patient presenting at 3 weeks with median nerve compression symptoms what would be the further line of management, would you manipulate it or operate and if operate would you fix the fracture or only adress compression ?
I would just decompress median nerve
@@DrVinayKumarSingh thank you sir for your response
Thank you sir
My pleasure
How old was he?
Does age make different? Especially if he's near skeletal maturity?
Age is mentioned. Age does make a difference. I tend to leave it at all ages if presenting late
Sir kindly do on calcaneum fracture fixation with plating 🙏
Thank you sir
Ok
Sir is this common to any physeal injuries..what about a 10 yr old with tibia proximal epiphysis type 2 injury with thursten Holland fragment..
Weight bearing bones are different
Hello doctor I have 38y male pt with history of bullet injury at right thigh since 2007 now present with full strength dorsiflexion of rt foot eversion also functioning but no planter flexition and no inversion what your opinion what I can do only arthrodesis of ankle
I wait your opinion for this case
Can't advice without consulting you
Sir a basic doubt which is confusing.... ideally what drill bit should we use for 3.5 locking cortical screw
2.7mm
1st xray of Dorsal displacement. 10 days old injury. sir you apply as in situ cast or CR under Anesthesia?
Cast only
Sir i am practising in rural area here also it's common to come late ..... i will also do the same thanks for the video
Thank you Sandeep
Sir can biphosphonates help me in osteogenisis imperfecta, means pamidronate injection or BMD test to calculate bone density
Yes but you need drug holiday in between so that you don't end up iatrogenic fracture.
What if in case of acute presentation
MUA and plaster
@@DrVinayKumarSingh ❤️❤️❤️Thanku
My mom(age-56) has severe frozen shoulder .. she is suffering from this disease 6months ... It's very painful for her.. pls sir tell the treatment and what to do !!!🙏🙏🙏
Go for ultrasound or Xray guided arthrodialatation.
@@DrVinayKumarSingh thank you sir for your kind information... Pls make a video about frozen shoulder
Sir, the standard text books are saying the same protocol if the patient is presenting after 7 days?
Just to know to defend in medico legal cases .
Yes after week leave it alone
@@DrVinayKumarSingh 🙏Thankyou
Salam sir please kindly upload a video of proximal tibia closed fracture fixation..
Sure
thanku so much sir
My pleasure
I got the similar case sir type 2 salter harris in 13 yrs old child should i leave it as it is?
Yes if it's come late
good advice.. its wise not to treat the x ray flim
Absolutely
How to counsel such patient sir that leaving alone will do the job .
Explain that doing anything will do more harm. You can also show them this video
And as always..keep a fluent communication with the parents..explain them what is this about in a clear language avoiding medical terminology ,which might be pretty confusing for the non medical people..stay away from problems..and medicolegal issues..👍👍
Wise words
Sir my son is patient of osteogenisis imperfecta his age is 15 years he have 15 fractures , please sir suggest best biphosphonate medicine, i am very poor i can't afford any orthopaedic surgeon
Osteophos 70mg once a week
Sir plz a video on hip spica
Sure
Is pt not in need of cast
U need to keep in case for four to six weeks depending on the age
No slab immobilization sir
You give plaster for four to six weeks
Sir what is the upper limit for you to attempt reduction in physeal injury presenting late ?. How many days ?
7 days. You've that in the video. Thanks.
A week
Immobilise ?for how long
Four to six weeks
Sir My age is 17 & i am patient of osteogenisis imperfecta type 1, i am in good condition , only my right leg have been broke for 10 time, i can walk with braces & lift weight, please suggest me a good medicine thanks .
There is no magic drug for osteogenesis imperfecta unfortunately
@@DrVinayKumarSingh
Sir can biphosphonates are helpful in osteogenisis imperfecta
@@DrVinayKumarSingh
Still i am using no any medicine
Sir is it bad to do a open reduction
Its criminal
Thank you sir
✌️✌️
Thank you
❤️
🙏
Sir , May I know the age of this patient?
I think he was a 8or 9years