[Two cases of tetanus after application of plaster casts in children].
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From November 1987 to December 1988, 60 patients with recent ruptures of the fibular ligament were enrolled in a randomized trial. After randomization patients were treated with a pneumatic leg brace (Aircast) or with cast immobilization for 6 weeks. Follow-up examination was carried out 15 months after cessation of therapy and was possible in 90% of the patients studied. Clinical criteria were evaluated according to a validated questionnaire including a 120-point scoring scale. In 42 patients stress tenography was carried out. The functionally treated group had significantly better score values than the immobilized group (functional treatment group 46.4 points; immobilization group 37.2 points). There was no significant difference between the treatment groups in radiological stability after the injury or at follow-up. On the basis of this study and the literature we recommend a primary functional treatment for recent ruptures of the fibular ligaments of the ankle in adults.
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This study compares 75 consecutive patients with Frykman Type VIII fractures of the distal forearm treated by primary external fixation with 32 patients who sustained similar injuries and were treated by closed reduction and cast immobilization. The latter group of patients served as an historical control. The two groups were similar with respect to injury and demographic characteristics. All fractures treated with external fixation remained well reduced and aligned, whereas 88% of those treated with casts had unsatisfactory alignment despite the fact that 30% had a second reduction. The external fixator group also had superior results with respect to functional outcome, range of motion, and grip strength.
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