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At least 955 records · Page 53Linked to original sources
PubMed1989

[Fractures of the radius neck associated with ulna fractures in children].

The author has described one of the typical combinations of injuries in the elbow joint area in children, i.e. fractures of the neck of the radius with a simultaneous fracture of the ulna. The study is based on 37 cases observed by the author. Two types of the above-mentioned fractures have been distinguished: abduction (32) and extension (5) fractures. The methods of closed reposition of each type have been presented. These methods allow to reach the desired results even in major dislocations (60-90 degrees) of the head of the radius.

Adolescent↗
PubMed1989

Advances in fracture management in the hand and distal radius.

Indications for internal and external fixation within the hand skeleton and distal radius have been presented and discussed. When used appropriately, these techniques will provide reliable fracture fixation and superior clinical results. Obviously, these techniques are not appropriate for all fractures. There remains a group of fractures well treated by more conservative methods. Additionally, some fractures exist which cannot be well treated by any method currently available. Nonetheless, these new techniques have added significantly to the clinical success available following the onset and treatment of complex fractures occurring within the hand skeleton and distal radius.

Adolescent↗
PubMed1989

[A clinical study evaluating bone mineral mass in the radius during skeletal growth--single photon absorptiometry].

Using 125-I single photon absorptiometry, bone mineral measurements were performed on 206 healthy Japanese children (2 to 19 years of age). Bone mineral content (BMC), bone width (BW) and BMC/BW values were determined for the radius at distal 1/6 site (metaphysis) and distal 1/3 site (diaphysis). BMC/BW values at both sites correlated well with body height and weight. Bone mass in the diaphysis (distal 1/3 site) increased linearly during the 2-19 years of skeletal growth, but bone mass in the metaphysis (1/6 site) increased steeply during the pubertal period. In children receiving glucocorticoid therapy, bone mass was reduced in proportion to the duration of drug administration. In children under anticonvulsant therapy, the yearly increase in bone mass was significantly low especially in those patients with poor physical activity levels. Bone mineral decrease in the radius occurred in the children with hypopituitalism, hypothyroidism (cretinism), hyperthyroidism and Turner's syndrome.

Adolescent↗
PubMed1989

Epidemiology of fractures of the distal end of the radius in children as associated with growth.

We determined the annual incidence of fracture of the distal end of the radius for patients of all ages and both sexes in the province of Saskatchewan, using two data sets: data on hospital admissions for 1970 through 1984, and data on physician billing for 1978 through 1985. The rate of occurrence of this fracture in children, by age and sex, was compared with longitudinal data on the velocity of growth that was collected during the same time for children from the same population. We compared the incidences of the fracture with the results of studies on the levels of activity in children and adolescents during growth. We also compared the age-specific incidence of the fracture in children with the incidence in adults. For both data sets, the age at the peak incidence of fracture of the distal end of the radius almost perfectly matched the age at which peak velocity of growth in height occurs for boys and girls. For girls, the peak incidence occurred between the ages of 11.5 and 12.5 years and for boys, between 13.5 and 14.5 years; these ages corresponded to the mean peak velocity of growth at 11.9 years for girls and 14.3 years for boys. The age-adjusted incidence of the fracture in male subjects was highest at fourteen years and was not exceeded by that in female subjects until fifty-three to fifty-four years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Sex determination with the head of the radius.

Analysis of a sample of 1108 radii corresponding to 567 black and white North Americans in the Terry Collection at the Smithsonian Institution demonstrates that the diameter of the radial head is an accurate sex discriminator for human remains. A simple "radial-head method" of sex determination consists of measuring the maximum and minimum diameters of the head and comparing such measurements with the test cutoff points. The subject is female when the maximum radial head diameter (either left or right) is less than or equal to 21 mm, and male when the maximum diameter (either left or right) is greater than or equal to 24 mm. The same decisions apply to the minimum diameters of 20 mm or less and 23 mm or more, respectively. When the maximum diameter is 23 mm or the minimum is 22 mm, the subject is more likely male; when the maximum diameter is 22 mm or the minimum is 21 mm, the subject is more likely female. The sample frequency of any one of these latter diameters is never more than 16%. Cross-validation of the method with a sample of 50 pairs of radii of the Terry Collection, different from the original specimens, resulted in 92% sexing accuracy when using the left radius singly, 94% accuracy when using the right radius singly, and 96% accuracy when using both radii jointly.

Anthropology, Physical↗
PubMed1985

[Operative long-term results in delayed radius head dislocation in childhood].

Only some cases and no long term follow-ups are reported in literature concerning the problem of delayed luxations of the radial head in children. 21 cases (19 acquired and 2 inherited) were treated in our hospital by operative procedure 12.5 months after the accident on the average. Disregarding one early and one late resection of the radial head we reconstructed the joint reposition and annular ligament plasty and if necessary correction osteotomy of the ulnar or shortening of the radius. Follow-up examination took place between 2 and 16 years after the operation, 7.9 years on the average. A reluxation was observed in 2 cases, a subluxation in 1 case. 2 patients showed a wrong axis and 4 patients signs of a beginning radio-humeral arthrosis, but most results were good or satisfactory. Therefore a reconstruction of a luxation of the radial head in children is recommended in delayed cases (sometimes in combination with a correction osteotomy of the ulna or radius) in contrast to other authors.

Adolescent↗
PubMed1987

[Choice of surgical procedure of the distal radius. Bore wire versus plate].

At the distal radius surgical treatment is indicated in fractures with defect, compression zone or re-dislocation, fractures with joint depression, open fractures and fractures with neurological and circulatory impairment. K-wire transfixation is mainly indicated in unstable fractures of elderly patients, in juvenile fractures with involvement of the epiphyseal line, and in simple intraarticular fractures, if the articular surface can be restored easily. T-plate osteosynthesis is the method of choice in fractures with volar displacement (Smith-Goyrand), in dislocated unstable intraarticular fractures with at least two main fragments to support screws securely, in unstable extraarticular fractures, especially with large zones of compression or defects, in combined fractures of the scaphoid and the styloid processus of the radius, and in corrective osteotomies after posttraumatic misalignment. Basing on an evaluation of our own experience with 226 K-wire transfixations and 159 T-plate osteosyntheses, indication, surgical technique, postoperative treatment and results of the two methods are compared.

Adolescent↗
PubMed1989

Rotational stability of diaphyseal fractures of the radius and ulna fixed with Rush pins and/or fracture bracing.

The rotational stability of fractures of the radius and ulna treated with Rush pins and/or fracture bracing was studied in six fresh cadaver forearms. Forearm rotation and fracture site motion (rotation) were measured as functions of applied forearm torque and rotation (pronation-supination). Values were obtained from the forearm: (1) intact and with both bones fractured; (2) without fixation; (3) with a fracture brace; (4) with Rush pins; and (5) with a combination of Rush pins and a fracture brace. A brace was ineffectual in reducing fracture site motion when the wrist was rotated to specified angles compared to fracture site motion for the forearm with no fixation treatment rotated to the same angles. When loading to specific torque levels, however, the brace reduced fracture site motion to one-half the motion with no fixation treatment. Under both loading conditions, Rush pin fixation significantly and markedly reduced the fracture site motion (to approximately one-eighth of the motion with no fixation treatment), whereas a brace in conjunction with Rush pins did not significantly further reduce the fracture site motion. The radius showed more motion at fracture site than the ulna.

Bone Nails↗
PubMed1989

Acute volar compartment syndrome during skeletal traction in distal radius fracture. A case report.

Fractures of the distal end of the radius rarely cause acute compartment syndrome of the forearm. Acute compartment syndrome of the forearm occurred after a fracture of the distal end of the radius in a 17-year-old boy who developed symptoms after application of skeletal traction. Satisfactory recovery was obtained by early decompressive fasciotomy. In this case a combination of traction and elevation of the forearm appeared to have increased the susceptibility of the limb to acute compartment syndrome.

Adolescent↗
PubMed1988

Classification and management of intra-articular fractures of the distal radius.

A classification of distal radial articular fractures is described, based on observations of consistent patterns of fracture fragmentation and displacement. The classification categorizes articular fractures into four types, with the medial complex assuming a pivotal position as the cornerstone of both the radiocarpal and distal radioulnar joints. The purpose of this classification is four-fold: (1) to afford identification and an understanding of the displacement characteristics of the major fracture components, (2) to provide practical and rational guidelines for the management of these injuries based on specific fracture patterns, (3) to emphasize the frequency of concurrent soft tissue and other skeletal injuries associated with the more severe types of articular disruption, and (4) to serve as a prognostic gauge for the varied spectrum of distal radius articular injury. Optimal management of distal radius fractures necessitates the differentiation of articular from extra-articular fractures as well as prompt detection of unstable injuries. While the majority of unstable fractures can be successfully managed by closed methods, a substantial and increasing number require open treatment for restoration of articular congruity as well as repair of concomitant soft tissue and skeletal injuries. In all cases, precise reduction of the key medial fragments is essential to maximum recovery.

Bone Nails↗
PubMedDate not supplied

The effect of low frequency magnetic fields on the healing of the osteotomized rabbit radius.

The object of this experimental work was to evaluate the effect of a noninvasive method of electrical stimulation on the healing of freshly-created osteotomies of the rabbit radius. The apparatus consisted of a solid core electromagnet energized by a square wave unidirectional current. The magnetic field was pulsed transversely across the osteotomy site of the radius while the animal was confined to a restraining device 6 hours daily for 5 days per week. In one group of animals the influence of different pulse frequencies, using 0.1 Hz, 1 Hz, and 4 Hz, was evaluated, while the period of stimulation was kept constant at 2 weeks. In another group of animals, exposure was continued for 3 and 4 weeks while the pulse frequency was kept constant at 1 Hz. Histologic and radiologic comparison with control animals revealed that the initiation of the healing process can be accelerated in magnetic fields pulsed at 1 Hz, but that this effect is not maintained, and that the total period of time required for union is not significantly shortened. In view of these findings, this form of treatment is not recommended for clinical use in the treatment of recent fractures of long bones.

Animals↗
PubMed1988

[Avulsion fractures of the distal part of the radius with anterior displacement in children].

The authors report 7 cases of fractures of the distal part of the radius, with a frontal displacement with children. This fracture is rare in pediatric traumatology. There is no particular type of mechanism that will provoke that fracture; in five cases the child was falling down on the palm of his hand and in two cases in a forced flexion. The problem about this fracture is the stability of the reduction. A proper function of the wrist is impossible with an imperfect result. The orthopedic treatment is often unable to stabilize the fracture. The authors need a surgical management using a plate type "Kerboull", put on the front part of the radius. They do not put the screws on the distal part of the plate to protect the epiphyseal plate. In only one case, they use Kirschner wires. The plates have been taken off one year later. The results are in all cases very good both functionally and anatomically.

Adolescent↗
PubMed1988

Fracture of the upper end of the ulna associated with dislocation of the head of the radius in children.

Dislocation of the head of the radius associated with fracture of the upper end of the ulna is a common elbow injury in children. The literature on diagnosis, however, is relatively limited. The injury can be misdiagnosed and consequently mismanaged. In the present series of 46 children, the age range was from 2.5 to 12 years. The dislocation of the radial head was lateral in 50% of the cases, posterolateral in 28.2%, anterolateral in 17.4%, and anterior in 4.3%. Thorough clinical and radiological examinations are essential. Simple bending of the upper end of the ulna may help to avoid missing an associated subluxation or dislocation of the radial head. The lower end of the forearm bones should be included in the roentgenographic examination; in 11 out of 46 children (26%) the dislocation of the elbow was associated with a fracture of the lower end of the ipsilateral radius and ulna. Closed reduction is the treatment of choice but if this fails, operative treatment should follow without delay. Posterior interosseous nerve palsy was noted in eight patients (17%), but recovered fully in all of the treated cases.

Child↗
PubMed1988

Anterior and posterior marginal fracture-dislocations of the distal radius. An analysis of the results of treatment.

Anterior and posterior marginal fractures of the distal end of the radius associated with dislocation of the carpus are rare injuries. The results of 20 patients with 12 anterior and eight posterior marginal fracture-dislocations of the distal radius were reviewed. Eleven patients had closed reduction and plaster cast immobilization, including three with external fixation, while nine patients required surgery and internal fixation. At a mean of 3.2 years, 40% were rated as excellent, 45% as good, 5% as fair, and 10% as poor. There was roentgenographic evidence of posttraumatic arthritis in 13 patients (65%). Major factors affecting the clinical results were accurate articular realignment and the presence of ipsilateral carpal injuries. There were no significant differences in results between anterior and posterior marginal fractures or between closed or operative methods of treatment when the radiocarpal articular surface was restored to less than 1 mm residual displacement. Restoration of articular congruency is the primary goal of management of these fractures.

Adult↗
PubMed1988

Compartmental syndrome complicating Salter-Harris type II distal radius fracture.

Distal radius fractures are common in children, yet complications are rare. A rarely described complication, acute volar compartmental syndrome, occurred in a 15-year-old boy. An accurate physical examination and awareness of the syndrome are essential for diagnosis. Compartmental pressures can be obtained easily and afford a rapid means of corroboration. Once the diagnosis is established, adequate decompression of all involved compartments, including carpal tunnel release, is essential. The literature is unclear regarding the etiology of this complication. There is nothing structurally intrinsic to the distal radius that should lead to a compartmental syndrome. Both the amount of soft tissue damage at the time of fracture and the mode of immobilization (excessive elevation, constricting splint, etc.) are the ultimate determinants of a successful (or unsuccessful) outcome.

Adolescent↗
PubMed1986

Giant cell tumor of the distal end of the radius treated by the resection and free vascularized iliac crest graft.

Juxtaarticular giant cell tumor involving the distal radius presents a special problem of reconstruction after tumor excision. A tailored block of vascularized iliac crest graft with its feeding artery (i.e., the deep circumflex iliac artery) joined to the ulnar artery was used as a replacement for the resected distal radius, thereby creating a new wrist joint. Excellent graft survivals were observed in all four cases. The wrists, when assessed 24-48 months after surgery, were found to have good ranges of movement, although with mild dorsal subluxation. These results compared well with other means of wrist reconstruction (i.e., the vascularized fibular graft). Although conventional means of arthrodesis give acceptable hand function, the absence of wrist motion is unacceptable to the young and active, who may prefer the method described in this article.

Adult↗
PubMed1986

Pulverized bone matrix as an injectable bone graft in rabbit radius defects.

A segment of the rabbit radius diaphysis was excised, demineralized, and pulverized. The demineralized matrix particles were mixed with autologous bone marrow from the femoral canal and injected into the defect from which it had been excised. On the contralateral side, the demineralized bone was reimplanted without pulverization, but with bone marrow. The bone yield was measured by radiographic planimetry and Tc99m MDP scintimetry. The forearms of the rabbits were sectioned into transverse segments, including the middle of the radius defect. The ash weights and the Ca45 content of these segments were measured. After two weeks, the ash weight was greater on the pulverized than on the unpulverized side; but by four weeks, measurements showed no difference. In general, the injectable bone matrix preparation did not interfere with bone repair. In comparing the Tc99m and Ca45 methods, the latter provided high-precision data with respect to the biologic variation.

Animals↗