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Nick posted an update
a year ago (edited)
I have an upper Ao4 that has failed twice now. I feel like im beating my head against a wall with this case.
Only thing ot takes is synthroid. He also has a condition where he vomits multiple times. I did not when pt was seen 5/30 his tissue looked red, inflammed and there was plaque on tge MUA. Im not sure if that plays a part or not.
The top photo is pt revision surgery failure taken today and the second one is when i noted the 1st failed on 5/12/22.
Any suggestions of what can done to prevent this?
Ivan6 Comments-
Hey Nick, can you give some more background? Also can you share the patient’s pre-op x rays?
I share your frustration man. Some patients have such a hard time tolerating the implants that I screen more heavily. I’m more conservative than most. I’m looking forward to seeing the pictures.
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So here is the pre and post op radiographs. As far as medical hx pt doesn’t smoke, only thing he told me about after he didn’t show for his revision post-op appt is that he has some medical issue where he has vomits almost constantly. He apparently had to go to the hospital b/c the zofran wasn’t enough. I wouldn’t think this would have much bearing other than it being a source of initial tissue irritation while initial incision was healing.
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I would most definitely dig into that condition that causes vomiting. Often what patients find irrelevant, is actually more important in contributing to overall health including bone health.
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You are probably doing a ton of arches over there huh? How many would you say you do per month?
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More removable than fixed. I’ve only done 2 arches of fixed this year. Inflation killing my fixed game.
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