Case # 140Y MaleSupracondylar Femoral Fracture & ORIF

After 11 months of pain an no bone healing, He had Deeop venous thrombosis and Pulmonary Embolysm. Due to a possible complication he was sent to us for ESWT treatment. I performed ESWT. He did well for almost ayear an the X ray were preetty good,. When he started muscle rehab, he had pain again and the xrays were not as good. There is a gap again on the X rays.

Question:

WOULD YOU TRY ESWT AGAINOR

WOULD YOU GO FOR SURGICAL TREATMENTFOR THE PSEUDOARTHROSIS ?????

Carlos Leal MDFenway Medical

Bogota

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April 201011 months after ESWT

Pain during Physical Therapy

X rays show fracture site again

Jun 200910 Months after surgery

Complicated with DVT and Pulmonary embolismESTW Treatment for

delayed union

Dec 20096 months after ESWT

No pain, stable knee no crutches.

Starts physiscal activity

Male 40yrHorse traimer

Horse backriding accidentAP X-RAYS

Carlos Leal MDFenway Medical

Bogota

April 201011 months after ESWT

Pain during Physical Therapy

X rays show fracture site again

Jun 200910 Months after surgery

Complicated with DVT and Pulmonary embolismESTW Treatment for

delayed union

Dec 20096 months after ESWT

No pain, stable knee no crutches.

Starts physiscal activity

Male 40yrHorse traimer

Horse backriding accidentLATERAL X-RAYS

Carlos Leal MDFenway Medical

Bogota

Case # 235Y Male – Orthopedic SurgeonParachute Accident 16 months ago

This colleague was treated with ORIF and did not heal. The tyibia healed well, and the metaphyseal region looks good. Hoverer, the last x-rays show a n oblique fracture line onb the distal diaphysis. No infection found, He was treated for the delayed union with open surgery, allografts – Autografts, growth factors and osteoconductors. He is in crutches at the moment.

Question:

WOULD YOU TRY ESWT IN THIS CASE, AFTER SURGICAL TREATMENT AND GRAFTING ????

Carlos Leal MDFenway Medical

Bogota

Aug 20097 Months after surgery

Tibial Hardware removed.Part of femoral hardware

removed.Grafted and augmented

with Growth Factors

Carlos Leal MDFenway Medical

Bogota

Carlos Leal MDFenway Medical

Bogota

Apr 20108Months after

Grafting Surgery

StablePain with loads

Apr 20108Months after

Grafting Surgery

StablePain with loads

Carlos Leal MDFenway Medical

Bogota