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[Distal radius fracture. Surgery or plaster cast?]].

Fractures of the distal radius are most commonly seen in women in the sixth and seventh decade of life. These fractures range in severity from simple, stable non-dislocated metaphyseal transverse fractures of the distal radius to complex, intra-articular fractures of the wrist with involvement of the carpus. This means that individual consideration of the appropriate therapeutic approach that needs to be adopted is required. A decisive role for surgical treatment is played by the anatomical angles at the radiocarpal articular surface, and the congruence of the distal radio-ulnar joint. If care is not taken to establish proper anatomical relationships, persistent problems must be expected.

Casts, Surgical↗

[Randomized comparison of CAM walker and light-weight plaster cast in the treatment of first-time Achilles tendon rupture].

INTRODUCTION: The aim of this study was to compare a CAM walker to a traditional cast. We expected the CAM walker to be comparable. MATERIAL AND METHODS: Fifty patients with a first time rupture of the Achilles tendon were randomised to either a cast or a CAM walker. Both groups were immobilised for eight weeks. All patients were examined four and 12 months after the injury. RESULTS: We found five reruptures in 29 patients treated with a cast (17%). No reruptures occurred in 21 patients treated with a CAM walker. The difference was not statistically significant (p = 0.066). There was no difference in age, sex, patient satisfaction, dominant/non dominant leg, muscle strength, or range of motion. DISCUSSION: The CAM walker is a useful alternative to a cast, with few complications and lower costs. Owing to the risk of type two error (44%), it is possible that we could have found a significant difference in the number of reruptures if the number of patients had been larger.

Achilles Tendon↗

[Treatment of redislocated fragments of long bones using plaster cast wedging].

The authors wish to remind of the advantages of an old conservative therapeutic method used in redislocated long bone fractures--cast wedging, Gipskeilung. This mode of treatment makes it possible to restore axial as well as planar dislocation and it is used in corrections of redislocated fractures of the leg and is applied during the last 3 years also in the treatment of fractures of the forearm in children. In 1997-2000 this procedure was used for treatment at the Clinic of Paediatric Surgery, Orthopaedics and Traumatology, 33 children aged 3-16 years, with a redislocated fracture of the leg, 21 children aged 3-16 years, mean age 9.8 years, and with a redislocated fracture of the forearm 12 children aged 5-15 years, mean age 10.2 years. In no instance this treatment failed or was associated with serious complications. According to experience with our group of patients a method is involved which in correct indications holds a justified place in treatment of fractures of the leg and forearm in traumatology of child an adolescent age.

Adolescent↗