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At least 973 records · Page 54Linked to original sources
PubMed2003

Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates.

Between 1996 and 2000, we treated ten patients with severely comminuted fractures of the radial head using low-profile mini-plates. Their mean age was 42 years (24 to 71). Three fractures were Mason type III and seven were Mason-Johnston type IV. At a mean follow-up of 28.5 months (15 to 44), all fractures had united. The plates were removed in nine patients. No patient had difficulty with daily activities or symptoms of instability of the elbow. The mean range of flexion of the elbow was from 7 degrees to 135 degrees, with 74 degrees of supination and 85 degrees of pronation. According to the Broberg and Morrey functional elbow index, the mean score was 90.7 points (73 to 100), and the outcome was excellent in three patients, good in six and fair in one. These results compare favourably with those reported previously. The technique is applicable to severely comminuted fractures of the radial head which otherwise would require excision.

Adult↗
PubMed2003

Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella.

Comminuted and displaced fractures of the inferiorole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. We have evaluated the clinical effectiveness of the separate vertical wiring technique in acute comminuted fractures of the inferior pole of the patella. A biomechanical study was also performed using ten pairs of embalmed cadaver knees. A four-part fracture was made on the inferior pole of the patella and fixed by two separate vertical wires on one side and two pull-out sutures after partial patellectomy on the other. The ultimate load to failure in the first group was significantly higher than in the second (250.1+/- 109.7 N v 69.7 +/- 18.9 N, p < 0.002), as was the stiffness (279.9 +/- 76.4 N/mm v 23.2 +/- 11.4 N/mm, p < 0.001). The separate wire technique was used in 25 patients with comminuted fractures of the inferior pole of the patella who were followed up for a mean period of 22 months (10 to 50). All the fractures healed at a mean of seven weeks (6 to 10). No breakage of a wire or infection occurred. The mean grading at the final follow-up was 29.5 points (27 to 30) using the Böstman method. This technique preserved the length of the patella, fixed the comminuted fragments of the inferior pole and avoided long-term immobilisation of the knee.

Adolescent↗
PubMed1983

Pseudotumor after metal fixation of a fracture surgery. A case report.

The present report describes an unusual complication after surgical treatment of a femoral fracture. Metal particles, produced by mechanical damage to an intramedullary rod by the insertion of screws perpendicular to the rod, were found to have initiated a tumor-like change in the soft tissues 4 years after removal of the metal implants. Conventional X-ray, angiography and CT-scan showed adjacent to the healed fracture a large tumor mass, which was interpreted as a soft tissue sarcoma. However, histopathological assessment revealed extensive necrotic changes around scattered metal particles in the biceps femoris muscle, which may be assumed to have been induced either chemically or bacterially.

Adult↗
PubMed1995

Compartment pressure monitoring during intramedullary fixation of tibial fractures.

Twenty-six legs in 25 patients were monitored prospectively for compartment pressures during intramedullary nailing of open and closed tibial shaft fractures. Twenty-three patients were treated within 24 hours of admission. Twenty-three unreamed and three reamed intramedullary rods were utilized. Compartment pressures were measured initially, following fracture reduction, and during reaming. Pressures were also measured at the completion of nailing with the ankle dorsiflexed and at rest (plantar flexed) to determine positional effects on compartment pressures. Nine fractures (35%) were found to have persistently elevated pressures (> 40 mm Hg) and underwent immediate four-compartment fasciotomy. The remaining group of 17 fractures (65%) was monitored throughout the intraoperative period. No patient monitored intraoperatively developed postoperative compartment syndrome.

Adolescent↗
PubMed1976

Intramedullary fixation of pathological fractures and lesions of the subtrochanteric region of the femur.

The Zickel intramedullary appliance was used without methylmethacrylate in forty-six patients to stabilize thirty-five fractures and eleven impending fractures associated with osseous lesions in the subtrochanteric region of the femur. Early mobilization or ambulation was possible in nearly all cases. The patients with actual fractures survived an average of 4.7 months, while those with lesions stabilized prophylactically survived an average of 13.8 months postoperatively. Fourteen of the thirty-five patients with fractures showed union after an average of 4.5 months.

Adult↗
PubMedDate not supplied

Immediate passive mobilization of the hip after internal fixation of acetabular fractures.

The authors report the results obtained in 16 patients affected with displaced fracture of the acetabulum treated surgically and mobilized passively immediately after surgery by means of a continuous passive mobilization apparatus for the hip. The age of the patients at the time of trauma ranged from 21 to 54 years. The posterior wall was involved in 12 cases, while the anterior column was also involved in 4. Excellent or good reduction of the fracture was obtained in all of the cases. Immediately after surgery, a continuous passive motion apparatus for the hip was applied to be used for approximately 3 weeks. At final follow-up, which was obtained after a mean time of 5 years, all of the patients except 2 had obtained good results. Moderate joint deficit was present in 1 case, while sciatic nerve palsy that had already been observed prior to surgery persisted in another. Evident radiographic signs of coxarthrosis were not present in any of the cases. Based on the opinion of Salter et al. (1980), who in an experimental study had observed better healing of the cartilaginous lesions in the joints submitted to movement, immediately after surgery we applied a continuous passive motion apparatus for the hip in a group of patients affected with fracture of the acetabulum. As none of the patient followed-up by us presented evident signs of hip arthrosis, the authors hypothesize that continuous passive movement, immediately carried out after osteosynthesis, plays a significant role in preventing post-traumatic arthrosis of the hip. In truth, small irregularities of the acetabular cavity, possibly present after an apparently anatomical reduction, could be minimized by the plasmating effect of the head of the femur in movement.

Acetabulum↗