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At least 829 records · Page 46Linked to original sources
PubMed1983

[Animal experimental scintigraphic studies of closed lower leg fractures during the 1st 24 hours following the fracture trauma].

A closed fracture in the medium third part of the tibia was carried out in 50 rabbits. The scintigraphy was performed in groups of 5 animals at a time 2, 4, 6, 10, 12, 14, 16, 18, and 24 hours after the fracture trauma, in each case 45 minutes after the injection of 8 MBq 99mTc diphosphonat per kg body weight. The ROI activity quotient of both shank diaphysis was analysed. The first ascent was observed at the tenth postoperative hour. The ROI activity quotient was 2.1 24 hours after the fracture trauma. No marking of the fracture area was observed but an increase of the activity altogether above the diaphysis, and no ascent of the activity quotient in the neighbouring joints was observed.

Animals↗
PubMed1993

[Incidence of pseudarthroses in open fractures: analysis of 948 open fractures].

In a retrospective and prospective analysis of 948 open fractures, treated at the institution of the authors in the years from 1981 to 1989, approximately 155 variables were used to deduce factors influencing the development of posttraumatic non-unions. This analysis reveals that only variables describing the bone injury show a statistical significant influence on posttraumatic non-union. Consideration of the results of the retrospective analysis in the management protocol of open fractures led to a significant decrease of non-union rates in the prospective series of 651 open fractures. An unchanged statistical influence in the development of non-unions could be found for factors representing the bone damage of the underlying injury. Variables describing the soft-tissue injury show a linear regression with the duration of bone healing time. Using the Hannover Fracture Scale is an appropriate tool for treatment control and risk prediction concerning post-traumatic non-unions.

Cross-Sectional Studies↗
PubMed1977

Supramalleolar fracture of the ankle (Malgaigne's fracture).

A retrospective study of 26 cases of supramalleolar fracture is presented. Types II and III were most common. All but the one had accompanying fibular fracture. The incidence of open fracture was 41.7% (10/24). The most common mechanism of injury was a high energy impacting force in the direction of axial compression. The supramalleolar fracture was subgrouped into four types. Twenty patients were treated by closed reduction and cast immobilization for an average of five months, six by open reduction and internal fixation, and two by skeletal traction in the early course of treatment. Of the 21 patients who were followed for an average of 33 months, only seven were found to have satisfactory results and were free from complications. Fourteen patients were found to have complications.

Adult↗
PubMed1997

Delayed union following stress fracture of the distal fibula secondary to rotational malunion of lateral malleolar fracture.

We present a case of delayed union following stress fracture of the distal fibula secondary to rotational malunion of a lateral malleolar fracture. The patient underwent operative excision of the nonunion, plating with autogenous iliac bone grafting, and correction of the malrotation of the distal fibular fragment. The fracture healed, and the patient was asymptomatic with full range of motion at follow-up. This report documents an unusual etiology, "external malrotation," for delayed union of a fibular stress fracture.

Adolescent↗
PubMed1997

[Treatment of open fractures exemplified by tibial shaft fracture].

Main goals in open fracture treatment is to avoid deep infections and achieve uneventful bone healing. Because post-traumatic soft tissue trauma and risk for contamination is underestimated in most cases, the therapeutical protocol must be followed consequently to avoid problems. Strategy includes decontamination by radical debridement, wound lavage, revision surgery, early antibiotics, fasciotomy to secure soft tissue perfusion, no primary skin suture and fracture management by biologic fixation methods. In special cases, temporary shortening and callotaxis after soft tissue healing is indicated. After solid soft tissue healing, fracture treatment is unproblematic in most cases. Following this concept, complication rates in open tibial shaft fractures are extremely low.

External Fixators↗
PubMed2003

The angled buckle fracture in pediatrics: a frequently missed fracture.

Buckle (torus) fractures in childhood are very common, and most assume a typical configuration wherein the trabeculae across the fracture line are compressed and the corresponding cortex bulges outward (unilateral or bilateral). In other cases the fracture merely shows cortical angulation along one side of the bone and classical buckling is not present. These latter fractures frequently are subtle and easily overlooked. However, if one knows what they look like and where they are likely to occur, one is able to detect them with greater frequency and confidence. The purpose of this communication is to bring attention to this fracture, describe the mechanism by which it occurs, and indicate its most common sites.

Journal Article↗
PubMed1997

Mandibular fracture and associated cervical spine fracture, a rare and predictable injury. Protocol for cervical spine evaluation and review of 1382 cases.

OBJECTIVES: To assess the relationship and incidence of cervical spine injuries in patients with mandibular fractures and to recommend an organized approach to cervical spine evaluation in these patients. DESIGN: A retrospective review of medical records of all patients with mandibular fractures at a level I trauma hospital from 1984 through 1993. Patient demographics, injury, mechanism of injury, associated symptoms, physical presentation, and adjuvant radiographic evaluations were recorded. SETTING: Level I, 1000-bed, urban trauma center in Atlanta, Ga. RESULTS: A total of 1382 patients with mandibular fractures were examined during the 10-year period of review. Cervical spine radiographs were obtained on 501 (36.3%) of these patients. From these radiographs, only 8 cervical spine fractures were found. All of the patients with cervical spine injuries (n = 8) had other associated maxillofacial injuries (n = 4), were involved in a motor vehicle accident (n = 7), or sustained gunshot wounds (n = 1). CONCLUSIONS: Judicious use of cervical spine radiographs in the appropriate setting of mandibular trauma is beneficial. However, clinical criteria should dictate rational use of radiographs, since the association between cervical spine injuries and mandibular trauma is rare and predictable.

Adolescent↗
PubMed2006

[Tibial tuberosity avulsion fracture and posterior fracture of the proximal tibial epiphysis].

Avulsion fractures of the tibial tuberosity are rare. In general, juvenile male athletes sustain this fracture. A combination of Ogden type 3A fracture in combination with a posterior fracture of the proximal tibial epiphysis type Salter 2 is described for the first time. The necessity for immediate surgical intervention to prevent secondary soft tissue injury is stressed.

Adolescent↗
PubMed1984

Fracture mechanics of bone--the effects of density, specimen thickness and crack velocity on longitudinal fracture.

The fracture mechanics parameters of critical stress intensity factor (Kc) and critical strain energy release rate (Gc) for longitudinal fracture of bovine tibia cortical bone were determined by the compact tension method. It was demonstrated that, for a given bone density, Kc and Gc depended on the loading rate, and resultant crack velocity, with a maximum in fracture toughness (Kc approximately 6.3 MNm-3/2, Gc approximately 2900 Jm-2) at a crack velocity approximately 10(-3) ms-1. For a given loading rate, or crack velocity, an increase in bone density, in the range from 1.92 to 2.02 Mgm-3, produced increases in Kc and Gc, but a variation in specimen thickness (from 0.5 to 2 mm) had no effect on the measured fracture mechanics parameters.

Animals↗
PubMedDate not supplied

Vitallium radial head prosthesis for acute and chronic elbow fractures and fracture-dislocations involving the radial head.

This retrospective study aims to evaluate the radiographic, functional, and patient-derived outcomes of 16 patients who each received a Vitallium radial head prosthesis for unreconstructable acute fractures of the radial head, as well as previously treated fractures of the radial head associated with residual instability, pain, and stiffness. Follow-up averaged 33 months. A trend toward greater disability and poorer motion was noted in the delayed treatment group compared with the acute replacement group. Overall, the results were excellent in 5 patients, good in 10, and poor in 1, as determined by the Mayo Elbow Performance Score. All elbows were stable at follow-up, and no patient reported wrist pain. Four required further operative treatment of their elbow injuries. Metallic radial head arthroplasty yields satisfactory results in acute unreconstructable radial head fractures or as a salvage procedure for previously treated radial head fractures.

Acute Disease↗
PubMed2002

High-pressure pulsatile lavage irrigation of contaminated fractures: effects on fracture healing.

To evaluate the effects of high-pressure pulsatile lavage (HPPL) irrigation on new bone formation and fracture union in a contaminated intraarticular fracture, 45 New Zealand white rabbits were divided into three equal groups. The control group (C) underwent an osteotomy of the medial femoral condyle, contamination with a slurry of clay mixed with Staphylococcus aureus, stabilization and closure. The bulb syringe and pulsatile groups (B and P) underwent an identical procedure, with the addition of irrigation with 11 of saline by bulb syringe or pulsatile lavage system. Two fluorescent bone stains that mark new bone formation were administered subcutaneously: xylenol orange at the time of surgery and calcein green one week postoperatively. Animals were euthanized two weeks postoperatively and femurs were retrieved for histological analysis. Union was determined by examination of microradiographs. The viability of bone along the osteotomy site in the first and second weeks after irrigation was determined by evaluation of the two fluorescent stains. The density of new bone two weeks after irrigation was assessed by digitization of the microradiographs. Nonunion was present in 77%, 53%, and 43% of animals in groups C, B, and P, respectively. There was an increase in the presence of bands of both fluorescent stains along the osteotomy site in the groups B and P compared to group C. There was no statistically significant difference between groups B and P in either fluorescent stain. On digitization of microradiographs, there was more calcified new bone on postoperative day 14 in group P than in either group B or C (p = 0.04). The addition of contamination and foreign material to an intraarticular fracture model results in lower rates of new bone formation and fracture union. Irrigation in this setting is clearly beneficial, whether the irrigant is delivered by bulb irrigation or by HPPL. The results of this study indicate using HPPL in this setting does not cause greater damage than using bulb syringe irrigation.

Animals↗
PubMed1994

Mandibular fractures in children. A retrospective study of 99 fractures in 59 patients.

Fifty-nine children younger than 16 years with mandibular fractures were studied by age, sex, type of fracture, cause, methods of treatment, and complications. The cases were divided into three age groups. The male-to-female ratio was 2.9:1. Motor vehicle accidents were the most common cause of mandibular fractures. Associated injuries were more common in young children. The condyle was involved in 43.3% of fractures. Intermaxillary fixation was the most common treatment used. Complications appeared to be rare.

Accidental Falls↗
PubMed2005

Fracture in the chin area: an unusual case of mandibular torus fracture.

Mandibular torus fracture as a result of accidental trauma has not been reported to date in the dental literature. This study describes the case of a young adult male who suffered multiple fractures affecting the teeth and mandibular torus secondary to chin area trauma due to a bicycle accident; the first manifestation of bone damage being left unilateral paraesthesia of the lip. An occlusal x-ray study of the affected area was made to evaluate possible fracture, as unlike centred periapical x-rays and orthopantomography, it is able to reveal the existence of a fracture line of the alveolar wall. In the associated presence of paraesthesia, a computed tomographic study is advisable.

Adult↗
PubMed2001

Condylar process fractures in children: a follow-up study of fractures with total dislocation of the condyle from the glenoid fossa.

PURPOSE: The purpose of this study was to investigate the long-term clinical and radiologic outcome of nonsurgically treated, dislocated condylar fractures sustained during childhood. PATIENTS AND METHODS: Dislocated condylar process fractures were diagnosed in 34 children aged 15 years or younger from 1980 to 1991. Of these, 26 had been treated nonsurgically and were asked to participate in a follow-up examination. Eighteen patients, representing 69% of the total sample, took part in the study. All patients underwent a clinical investigation with special emphasis on temporomandibular joint (TMJ) function. The patients also underwent a radiologic investigation, focusing on fracture remodeling and symmetry of the mandible. RESULTS: After a follow-up period ranging from 4.8 to 16.4 years (mean, 8.6 years), 56% had some subjective symptoms, and 72% had some objective signs of TMJ dysfunction. In general, however, the symptoms and signs of dysfunction were very slight. No correlation was observed between the method of nonsurgical treatment and the clinical results. Radiologic investigation showed incomplete remodeling (76.5%) and asymmetry of the mandible (64.7%) in most patients. The asymmetry was slight, however, and could not be observed clinically. CONCLUSIONS: Conservative treatment of dislocated condylar process fractures in children results in satisfactory long-term outcome of jaw function despite a high frequency of radiologically noted aberrations. Soft diet with immediate mobilization seems to be the treatment of choice.

Adolescent↗
PubMed1989

Fractures of the posterior tibial margin: their role in the prognosis of malleolar fractures.

One hundred forty-two patients with malleolar fractures were followed up for an average of 5.7 years postoperatively. In 80 cases (56.4%) we found no lesion of the distal articular surface of the tibia; 62 patients (43.6%) had a fracture of the posterior tibial margin. Both groups were closely matched with regard to fractures of the lateral and medial malleolus. The long-term results were significantly poorer when a fracture of the posterior tibial margin was additionally present, even in cases with a small marginal fragment of the lip of the tibia. Further, we found a clear relationship between the articular involvement and the incidence of post-traumatic osteoarthrosis in cases with no additional osteosynthesis of the fragment. In cases of larger fragments, the long-term results after anatomic reduction and additional osteosynthesis were on the whole far better than in cases treated conservatively.

Adult↗
PubMed1991

Central fracture-dislocation of the hip with ipsilateral femoral neck fracture: case report.

Central fracture dislocation of the hip with associated fracture of the femoral neck is rare. Treatment of choice consists of open reduction of the displacement and internal fixation of both fractures. Nevertheless, inadequate reduction of the burst fracture of the acetabulum may lead to hip arthritis, and the surgical approach to the femoral neck jeopardizes its vitality. In elderly patients early full motion and prompt physical rehabilitation can be achieved by total hip arthroplasty after fusion of the displaced femoral head to the acetabular wall.

Accidents, Traffic↗
PubMed1985

Biomechanical factors affecting fracture stability and femoral bursting in closed intramedullary rod fixation of femur fractures.

Intramedullary rodding of femur fractures, although a safe and rapidly performed procedure, can result in several complications. If the rod fit is too loose, fracture instability, rod migration, and delayed union may result. If the rod fit is too tight, cracking of the femur may occur during rod insertion. These complications were investigated in terms of geometric and mechanical parameters of the bone-implant system. Results showed that rods of the same nominal size from different manufacturers showed more than twofold difference in flexural rigidity and a threefold difference in torsional modulus. These differences appear to be due to differences in cross sectional shape and wall thickness of the rods. Measurements of pushout force and hoop stress in cadaver femora showed a large difference in pushout force with different rods, and significantly lower forces in distal than in proximal femoral fracture components. Pushout force decreased with fracture component length proximally and dropped to zero in distal components less than 170 mm long. An increase in ream diameter in the distal components of just 1 mm was found to decrease the mean pushout force from 740N to 90N. The most significant variable was found to be anterior offset of the starting hole more than 6 mm from the centerline of the medullary canal which resulted in consistent lifting of the anterior cortex during insertion of the rod.

Adult↗
PubMed1992

Marginal fractures of the lateral malleolus in association with other fractures in the ankle region.

Eight cases of avulsion-type fracture of the distal fibula associated with fracture of the calcaneus, talus, or ankle region were identified. This avulsion fracture can be identified on routine radiographs as well as on CT scans of the ankle and is pathognomonic of rupture of the superior peroneal retinaculum with or without peroneal tendon displacement. Recognition of this avulsion fracture, with subsequent proper management of the underlying peroneal tendon pathology by immobilization or surgery, may prevent future tendon dysfunction. It may also alter the treatment of other associated injuries.

Adult↗