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At least 865 records · Page 48Linked to original sources
PubMed1995

[Scaphoid fracture associated with displaced fracture of the distal end of the radius in children. Apropos of a case].

A child of 13 years, victim of a fall on his wrist at dorsal flexion position; he presented a scaphoid fracture associated with a displaced fracture of the distal end of the radius. The radius fracture was reduced under general anesthesia, by external manoeuvre; the consolidation was obtained after 10 weeks of plaster cast immobilization. The follow-up was of two years, with a good clinical and radiological result in spite of a non union of the Ulnar-styloid. It is important to remember this exceptionnel association in children not to forget the scaphoid fracture.

Adolescent↗
PubMedDate not supplied

Three epiphyseal fractures (distal radius and ulna and proximal radius) and a diaphyseal ulnar fracture in a seven-year-old child's forearm.

SUMMARY: The authors report a rare case of fracture separations at both ends of the radius combined with an epiphyseal and diaphyseal fracture of the ipsilateral ulna. A seven-year-old girl fell one story and sustained a closed injury of her forearm. A closed reduction was unsuccessful, and an open reduction was performed with three of the four fractures being secured with Kirschner wires. These wires were removed one month later, and range-of-motion exercises were started. Thirty months after surgery, both forearms were equal in length, although the proximal radial epiphyseal line appeared partially closed. Joint motions, including forearm rotation, were normal. Radiologically, the ulnar diaphysis and the radial neck were posteriorly convex 20 degrees and 18 degrees, respectively.

Child↗
PubMed1979

Open fractures of the shaft of the tibia: analysis of wound and fracture treatment.

Cooperation between orthopaedic and plastic surgeons is an important factor in the treatment of open fractures. In this article a report is made on a retrospective study of a 5-year series of open fractures of the shaft of the tibia treated at the University Hospital in Uppsala between 1972 and 1976. The study proves that the change to external fixation of these fractures and 'open' treatment of the wounds has meant that to a large extent the previous use of pedicle flaps to cover skin defects has been replaced by split skin grafts. The results in the reported series were good, with adequate function in most cases. The final results may, however, be less good than they appeared at this early review time.

Adolescent↗
PubMed2001

Fractures of the base of the fifth metatarsal: the Jones fracture.

The Jones fracture continues to be a problem fracture for the orthopedic surgeon and sports medicine physician. This injury seems to occur in athletes as well as nonathletes. The underlying inherent poor blood supply of the proximal metaphyseal diaphyseal region makes the fifth metatarsal a difficult bone to unite. Many techniques have been advocated for the treatment of this troublesome fracture, including non-weight-bearing short leg casting, orthotic management, open reduction and internal fixation, corticocancellous onlay bone grafting, and electric stimulation. The author believes that in young athletic patients, using meticulous surgical technique, reliable open reduction and internal fixation yields excellent results. In nonathletic or less demanding patients, the patient should participate in the discussion and choice of the treatment techniques. If delayed union or non-union occurs, drilling with the use of internal fixation usually produces a union.

Fracture Fixation↗
PubMed1996

Weight bearing after hip fracture: a prospective series of 596 geriatric hip fracture patients.

Five hundred ninety-six patients age > or = 65 with femoral neck or intertrochanteric fractures were allowed immediate unrestricted weight bearing after surgery and were prospectively followed. Follow-up data and hospital records were examined to identify those patients who required additional hip surgery owing to failure of fixation, nonunion, osteonecrosis, or prosthetic dislocation. Four hundred seventy-three patients were available for 1-year minimum follow-up; 16 patients (3.4%) required additional hip surgery. The revision surgery rate after intertrochanteric fracture due to loss of fixation was 2.9%. The revision surgery rate after internal fixation of the femoral neck from loss of fixation/nonunion was 5.3%; the revision rate from osteonecrosis for patients with 2-year follow-up was 5.4%. The revision rate after hemiarthroplasty due to prosthetic dislocation was 0.6%. These results support the use of unrestricted weight bearing in elderly patients after hip fracture surgery.

Aged↗
PubMed1993

Femoral shaft fractures complicated by fracture-dislocations of the ipsilateral hip.

A series of 16 consecutive adults with femoral shaft fractures complicated by fracture-dislocations of the ipsilateral hip joint was prospectively studied. There were 11 posterior dislocations and five central dislocations. The treatment consisted of early closed reduction of the dislocation with the assistance of an external fixator, delayed reamed intramedullary nailing of the femoral fracture, and conservative or surgical treatment of the hip joint according to the indications. The follow-up period was 2-8 years (median, 3.5 years). Although an 18.8% (3 of 16) complication rate was noted, the outcome was satisfactory for all 16 hip joints. When such complicated combined injuries are sustained, the technique described here is the most reasonable treatment.

Adolescent↗
PubMedDate not supplied

Analysis of fixation methods for vertical shear fractures of the medial malleolus.

OBJECTIVE: To evaluate 4 different fixation methods used to treat vertical shear fractures of the medial malleolus. METHODS: Eighty polyurethane models of the distal tibia were osteotomized in a reproducible manner to create a vertical shear fracture of the medial malleolus. Twenty specimens were then randomly assigned to 1 of 4 fixation groups. Two fixation groups used a neutralization plate, whereas 2 groups were screw-only constructs. Ten of the specimens in each group were then randomly assigned to undergo either offset axial or offset transverse loading. RESULTS: The construct using a neutralization plate with 2 screws in the distal fragment exhibited greater stiffness in offset axial loading compared with the screw-only constructs placed an equivalent distance from the tibial plafond. All specimens in the group with the properly applied neutralization plate exhibited elastic deformation, whereas the majority of the specimens in all other groups showed residual displacement or catastrophic failure of the construct. CONCLUSION: Fixation of vertical shear fractures of the medial malleolus with a properly applied neutralization plate offers a significant mechanical advantage over screw-only constructs.

Ankle Injuries↗
PubMed1993

Fracture of the scaphoid associated with volar displacement of a lower radial epiphyseal fracture. Case report.

A 13-year-old boy fell off his bicycle and landed on his outstretched left hand, sustaining a Salter-Harris type II fracture of the lower radial epiphysis with volar displacement, and an undisplaced fracture across the waist of the left scaphoid. After manipulation, and immobilisation for six weeks, he made a complete recovery and has no residual deformity. We hypothesise that the fracture was caused by the weight of the body being taken by the relatively stiff and immobile hand, and could find no report of a similar case.

Accidental Falls↗
PubMed1995

Significance of fracture gap in open tibial fracture.

The healing pattern of medial and lateral cortical gap in open transverse or short oblique tibial fractures were retrospectively reviewed in 2 groups; In group A, 16 patients were treated by Judet external fixator in rigid mode. In group B, 6 patients were treated in biocompressive mode, which allowed predominantly longitudinal axial motion. The characteristic healing pattern in group A was gap healing without or with minimal periosteal callus. The healing time and time for consolidation per 1mm gap were significantly longer in medial cortices than lateral ones (p < 0.036, p < 0.024 respectively). In group B, the fractures were healed with periosteal callus. There was no difference in the healing time and the time for consolidation per 1mm gap between the two cortices. The consolidation time per 1mm gap in the medial cortices was significantly longer in group A than group B (p < 0.020). The longitudinal axial motion in open transverse tibial fractures seems to shorten the healing time effectively in the medial cortex.

Adolescent↗
PubMed1992

[External fixator in complicated tibial fracture. Effect of various fixation systems on fracture healing and rate of complications].

In a retrospective analysis 93 external fixations with different rigidity after open tibial shaft fractures have been reviewed and compared concerning complications and healing time. Fracture consolidation was attained in fixation with unilateral frame after 14 weeks, with bilateral v-shaped fixator after 19 weeks and with triangular configuration in about 28 weeks. Subsequent internal fixation or extension to v-shaped fixation was necessary in about 33% after initial unilateral half-pin frame, whereas 90% of the two rigid systems could be left in situ until fracture consolidation was achieved. Cancellous bone grafts were performed in 58% after triangular, in 40% after v-shaped, and 28% after unilateral fixation. Pin infections were observed in 36% after triangular, 25% after bilateral v-shaped, and in 15% after unilateral fixation.

Adult↗
PubMed1985

[Compression/flexion fractures of the radius base (Smith fractures)].

Out of 416 Colles-fractures we observed 18 of the Smith-type. The Smith fracture is a rare injury, it will generally occur in consequence of a fall on the supinated hand which is forced in pronation. The dislocation of the carpus and peripheral fragment is in the volar and proximal direction. It should be treated operatively, especially in intraarticular fractures. Surgical treatment of patients will result in better movability of he wrist and intact distal joint surfaces.

Adult↗
PubMed1985

[Significance of fracture form and bone necrosis for the treatment of open tibial fracture].

In a retrospective analysis the author deals with 370 open fractures of the tibia which were administered from 1961 to 1980. Treatment by plate osteosynthesis proved to be superior to conservative management (13% wound infections, 11,3% aseptic complications). Special importance is attached to the degree of soft tissue damage as a cause of osteonecrosis in certain types of fractures. By presenting a new classification scheme of fractures of the tibia the author is able to derive that kind of treatment which is required.

Adult↗
PubMed1981

Creatine kinase in tibial shaft fractures. Serum creatine kinase levels in patients with tibial shaft fractures.

The creatine kinase (CK) activity of the serum of 33 male and 24 female patients with tibial shaft fractures has been assayed. In 40 of the 57 patients the CK level surpassed the maximal normal limit of 1.7 mukat/l. Patients with fractures due to direct violence had significantly higher levels than those with fractures due to indirect violence. When the fracture was displaced the CK level was more often abnormal than when there was no displacement. Patients with extensive swelling of the injured leg had significantly higher levels than patients with minor or no swelling. CK determinations could be used to quantify muscle injury.

Adolescent↗
PubMed1976

The fate of the articular cartilage in intracapsular fracture of the femoral neck (articular cartilage in femoral neck fracture).

The fate of the articular cartilage of the hip joint with intracapsular neck fracture was studied by histological, histochemical and autoradiographic techniques and by using a polarized microscope and a scanning electron microscope. Cartilage specimens from 93 femoral heads and 7 acetabula were obtained from fractured hips 2 days to 4 1/3 years postfracture and from control hips with various disorders. The cartilage degeneration appeared 2 weeks after fracture and advanced steadily with time. The matrix was covered, invaded and ultimately replaced by the fibrous tissue. Chondrocyte viability, though it was lost from the surface, was recognized in the deep matrix even in the oldest fracture examined. It is concluded that the humoral factor directly caused by the injury as well as the biomechanical impairment, i.e. a loss of physical stress, may play an essential role in the pathogenesis of the degeneration. The possibility of regeneration was discussed.

Acetabulum↗
PubMed1995

Delayed complications of ethmoid fractures: a "growing fracture" phenomenon.

Delayed complications of ethmoid fractures are considered relatively rare. However, meningitis, recurrence of previously ceased cerebrospinal fluid rhinorrhea and delayed onset of cerebrospinal fluid rhinorrhea are possible even years after trauma. We report 10 consecutive patients with delayed complications of ethmoid fractures, whom we treated over the past 11 years. All patients had previously sustained a closed head injury and had remained anosmic. Variously after trauma (ranging from 2 months to 31 years), these patients were re-admitted because of meningitis (6 cases), recurrence of previously ceased cerebrospinal fluid rhinorrhea (3 cases), and delayed onset of cerebrospinal fluid rhinorrhea (1 case). In all cases the delayed complications were associated with relatively large defects of the ethmoid bone. These bone lesions were now evident even in those patients whose radiological assessments had been normal after trauma. All patients underwent a successful surgical repair and remained well during the follow-up. We discuss the possibility that delayed complications of ethmoid fractures are due to a mechanism like that of "growing fractures" in children.

Adolescent↗
PubMed1998

Bone fracture history and prospective bone fracture risk of hemodialysis patients are related to apolipoprotein E genotype.

This investigation of 219 hemodialysis patients relates the history and prospective risk of bone fractures to apolipoprotein E (apoE) genotype. A greater percentage of the 41 patients with the E3/4 and E4/4 genotypes than of the 38 patients with the E2/3 and E2/2 genotypes had a history of bone fractures at the time of recruitment (44% versus 16%, P < 0.005). During the 4 years following recruitment, more of the patients with apoE genotypes E3/4 and E4/4 than with apoE genotypes E2/3 and E2/2 suffered bone fractures, but this difference was not statistically significant (17.1 versus 5.3%, P < 0.1). ApoE genotype appears to be an important genetic risk factor for bone fracture, possibly due to its previously reported influence on vitamin K concentrations in blood.

Adult↗
PubMed2004

[Interobserver variation of the sonographic diagnosis of orbital floor fractures and fractures of the infraorbital margin].

PURPOSE: The aim of the study was to evaluate the interobserver variation of the ultrasound diagnosis of orbital floor fractures and fractures of the infraorbital rim. MATERIAL AND METHODS: A total of 25 patients with a clinical diagnosis of an orbital trauma were investigated prospectively by computed tomography (CT) and ultrasonography (US). Inter-observer variation was calculated using the lambda coefficient (lambda). The US images were reassessed by two inexperienced investigators. RESULTS: The lambda value for the US investigation of the orbital floor showed poor reliability comparing the US findings with the results of the re-investigators. The comparison between the two re-investigators showed a good reliability for the US evaluation of the orbital floor. The lambda for the US investigation of the infraorbital margin showed a good reliability comparing the US findings with the results of the both re-investigators. The comparison of the two re-investigators showed a good reliability as well. CONCLUSION: Ultrasound is not yet an alternative method for the evaluation of orbital floor fractures and fractures of the infraorbital margin. To replace CT which is accepted as the current gold standard, further studies have to be done to reach a better diagnostic quality of the method and to achieve a better calibration of the investigations.

Adolescent↗
PubMed1993

A review of cervical fractures and fracture-dislocations without head impacts sustained by restrained occupants.

Crash injury reduction via lap-shoulder belt use has been well documented. Like any other interior car component, lap-shoulder belts may be related to injury in certain crashes. Relatively unknown is the fact that cervical fractures or fracture-dislocations to restrained front seat occupants occur where no head contact was evidenced by both medical records and car inspection. A review of the available literature on car crash injuries revealed more than 100 such cases. A review of the National Accident Severity Study (NASS) 80-88 file was also conducted, revealing more examples. Case capsule descriptions from the authors' files are also detailed along with examples of such injuries in infants and children in child restraints. However, cervical fractures or fracture dislocations are rare, as evidenced by the relatively few cases identified in the literature, in the author's files, and by an analysis of NASS 80-90 data that revealed a cervical spine injury frequency of only .4% at the AIS-3 level (Huelke, Morris, and Mackay 1992).

Accidents, Traffic↗