[Pediculated bone grafts as vascularization aids. At the wrist level].
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Biomedical subjects
Publications and source records attributed to S Baux.
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The authors describe 68 articular fractures of the lower end of the radius in which a postero-medial accessory fragment was displaced. They have made a study of the anatomy and fibrous connections of the fragment and conclude that this fragment is best maintained reduced by a transverse pin passed from the ulna towards the radius. They attach great importance in such fractures to injury to the triangular radio-ulnar ligament and to inferior radio-ulnar dislocation.
The authors report a case of traumatic rupture of the tendon of the adductor magnus. It was operated on one month after the injury when it had formed a painful contractile tumour in the perineal region. The tendon was re-attached to the femur. The result was satisfactory. The authors have made a review of the literature.
Plasma phenylalanine concentrations were measured on the seventh postburn day in patients with burn surface areas ranging from 1 to 39%. Hepatic function (glutamate-pyruvate transaminase, prothrombin time) and protein breakdown (nitrogen balance, urine 3-methylhistidine/creatinine ratio) were evaluated in parallel. Plasma phenylalanine concentrations in patients with normal hepatic function and those with hepatic failure were similar. A correlation was shown between phenylalaninemia and nitrogen balance for all patients but phenylalaninemia only correlated with the urine 3-methyl-histidine/creatinine ratio in patients with burn surface areas under 20%. Taken as a whole, the data suggest that the determination of plasma phenylalanine concentration is a valuable test to assess the nitrogen balance in burn patients. This test, when performed on day 7, is particularly relevant in patients with normal hepatic function and either slight or moderate burn injury.
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In fractures of the lower end of the radius, the presence of a posteromedial fragment should be recognized if present. This fragment with two articular surfaces, if not reduced, will damage the radiocarpal and inferior radioulnar articulations. The diagnosis needs to be made on 3/4 X-ray views, as the fracture is often mistaken for a Colles' fracture. The author advises reduction and fixation by a method of double pinning. By comparing two sets of statistics, the overall results are shown to be improved without more complications.
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The authors report a case of posterior sternoclavicular dislocation, and discuss the diagnosis and treatment based on the relatively rare cases reported in the published literature. Therapy is described, which appears to be logical, even though a homogenous group of patients treated for this condition does not exist.
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