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At least 973 records · Page 54Linked to original sources
PubMed1992

[Osteosynthesis of distal radius fractures with biodegradable fracture rods. Results of two years follow-up].

Forty distal fractures of the radius were stabilized with biodegradable polyglycolic acid rods (Biofix). A forearm plaster cast was fit for 4 weeks. Nine patients developed late (4 to 16 weeks) aseptic inflammatory reactions at the pin site, which were treated by débridement. The histological specimens showed giant-cell phagocytosing fragmented polyermic debris. In two cases a bacterial wound infection occurred secondary to débridement. All local reactions healed within 4 weeks. A classification system and treatment regimen for these inflammatory reactions are proposed. Thirty-four patients (including those with local foreign body reaction) were available for the 2-year follow-up. The anatomical results of fracture reduction on the postoperative and follow-up radiograms were the same, confirming good mechanical fracture stabilization. According to the Sarmiento score, the overall results were excellent and good in 31 cases. In one of the three fair cases, the result was clearly due to the initial local foreign-body reaction. Because of the high incidence of local inflammatory reaction, for now clinical application of biodegradable implants seems problematic despite the good overall 2-year results. This should only be advocated for well-controlled prospective studies using implants with improved biocompatibility.

Adult↗
PubMedDate not supplied

A calcaneal fracture from a fall or a fall from a calcaneal fracture?

A case of a calcaneal avulsion fracture from a relatively minor traumatic incident is presented. The mechanism of calcaneal avulsion fractures is discussed. Special attention is given to the possibility of a pathologic fracture. The literature is reviewed and treatment is discussed.

Accidental Falls↗
PubMed1977

[Luxation fracture of the hip joint. I. Posterior fractures with dislocation].

41 cases of posterior sprain fracture are analysed by the authors. 4--10 years after the injury 31 patients appeared at the check-inspection. On the basis of the late results it is stated by the authors that the immediate diagnosis and the reposition of the luxation are of the greatest importance. Conservative treatment yields generally satisfactory results. In the authors' opinion, osteosynthesis is indicated but in fractures concomitant with the fracture and dislocation of great piece of the acetabulum and in juvenile patients.

Accidents, Traffic↗
PubMed1992

Clinical features and walking ability in the early postoperative period after treatment of trochanteric hip fractures. Results with special reference to fracture type and surgical treatment.

The purpose of this study was to analyze the functional outcome during the early postoperative period (six weeks) in patients with trochanteric fractures. A consecutive series of 149 patients were randomized to treatment with either the DHS or Ender operative technique. 120 patients were available at review six weeks after surgery. Groups were comparable with respect to age (mean 77 years), sex ratio (73% women), type of fracture (59% and 55% unstable), experience level of the surgeon, prefracture health condition and ambulatory status. During follow-up eight patients died and there were 19 complications of neurologic and cardiovascular types equally spread among the two groups. All four infections were found in the DHS group. Orthopaedic hospital stay averaged 19 days and more patients in the Ender group could return to their previous home at time of discharge. At the six week visit 14% in the Ender group compared to 33% in the DHS group had not recovered functional walking distance (less than 15 m). All patients in the Ender group managed to walk, but 11% of the patients in the DHS group could not walk. Walking ability was most impaired for unstable fractures. It is concluded that the Ender technique will involve less operative trauma (shorter operations with less blood loss) and in the early postoperative period it can provide better conditions for walking and less need for further hospitalization than the DHS technique.

Aged↗
PubMed1989

External fixation of fractures and fracture dislocations of the pelvis.

External fixation of pelvic fracture dislocations is appropriate when reduction must be accomplished by noninvasive methods which are nonetheless capable of precise regulation. The corrective frames described can be applied with minimal trauma and are capable of orientating the necessary corrective forces in the required directions to reduce the wide variety of bony displacements and dislocations encountered in these injuries. The apparatus is flexible and the choice of particular technique and assemblies is determined by evaluating the biomechanics of the mechanism of injury and applying the appropriate antagonist forces. These forces operate in three fundamental planes: anteroposterior, lateral and vertical. The author describes and illustrates how the assembly may be used to operate in these planes and reduce and stabilise a variety of displacements encountered in fractures and fracture dislocations of the pelvis.

Biomechanical Phenomena↗
PubMed1989

[Stress fractures of the metatarsal bone in sportsmen (Jones' fracture)].

The authors examine the peculiarities of the diagnosis, the clinical course and the roentgenologic manifestations of the fracture of the 5th metatarsal bone, the so-called Jones' fracture, in sportsmen. In this type of injury a good treatment result, i.e. the consolidation of the bone and the recovery of the foot at the early posttraumatic period is achieved by surgical treatment which provides for a necessary compression at the fracture site.

Adolescent↗
PubMed1989

[Functional results following surgical management of isolated orbital floor fractures (blow-out fractures)].

Sixty five orbital floor fractures of varying degrees of severity were assessed retrospectively. The operative treatment was performed via the transorbital approach within 14 days of the trauma. Pre-operatively 26 patients had sensory disorders of the infraorbital nerve. Six months later the nerve had recovered fully or partially. Preoperatively 49 patients (74%) were found to have double vision. Six months after the operation 44 patients (90%) were either much better or the double vision could no longer be detected. Only 5 cases showed no improvement. In view of the poor results of non-operative therapy of orbital floor fractures, we recommend early operative treatment for blow out fractures.

Biological Dressings↗
PubMed1989

[Surgical treatment of unstable trochanteric fractures of the femur. I. Evaluation of the surgical treatment of trochanteric fractures of the femur using angular nails].

One hundred and two patients with trochanteric fractures of the femur were treated with angular nail-plates during a four-year period between 1984 and 1987. It is proved that this method is efficient for stable fracture patients, particularly used 24 hours after trauma. Whereas concerning unstable fractures III-th and IV-th degree most results are unsatisfactory. Disadvantage of the method is that patients can not be weight bearing operated leg soon after operation, what has negative influence for healing results.

Adult↗
PubMed1987

Fatigue fracture of the interlocking nail in the treatment of fractures of the distal part of the femoral shaft.

The clinical and mechanical factors predisposing to a fatigue fracture of an interlocking nail were studied in seven patients who were treated for a fracture of the distal part of the femur. In all patients, the fracture of the femur was five centimeters or less from the more proximal of the two distal screw-holes. Finite-element analysis revealed that the stress on the nail exceeded its fatigue endurance limit and that the femur had to regain 50 per cent of its original stiffness through healing to accommodate weight-bearing without the risk of fatigue failure of the nail. The risk of fatigue failure may be minimized by using nails that have a larger diameter and by avoiding early weight-bearing.

Adolescent↗
PubMed1987

Difficult wrist fractures. Perilunate fracture-dislocations of the wrist.

Perilunate dislocations of the wrist have a common pathway of disruption that occurs from extensive dorsiflexion injuries. Open reduction and internal fixation of these injuries is required to provide accurate alignment and the option for ligament repair. Both dorsal and palmar surgical incisions may be indicated. Associated injuries to the median nerve must be recognized. Treatment includes scaphoid and radial styloid stabilization with multiple K-wires or internal compression screw (Herbert or Association for the Study of Internal Fixation [ASIF] screws). In these injuries, the lunate must be reduced first and stabilized. The scaphoid proximal segment follows the lunate unless the scapholunate (SL) ligament is torn. The distal scaphoid fragment, capitate, and triquetrum are reduced and aligned with the lunate and need to be held with K-wires. Ligament repair and augmentation may be necessary at both scapholunate and lunotriquetal areas if there has been serious ligament injury. Palmar ligament repair is often required, and we recommend a palmar exploration in most patients along with release of the median nerve. Surgical treatment results of perilunate fracture-dislocations of the wrist appear better than conservative treatment methods, but complications following both indicate the need for improved internal fixation and fracture-dislocation realignment. These fractures are a real challenge to the treating surgeon who must use patience, precise surgical techniques, and careful roentgenographic study (including tomograms and traction views) to assure the best result.

Adolescent↗
PubMedDate not supplied

[Leg fractures: choice of treatment according to type of fracture].

The authors report the experience of the Strasbourg Center of Orthopaedics and Traumatology (France). They analyse first a series of 104 tibial shaft fractures treated by dynamic casting according to Sarmiento's technique. Their conclusion show off therapeutic indications and contra-indications. Another series of 297 tibial fractures treated by intramedullary locked nailing is presented with an analysis of all the complications and the means of avoiding them. The authors specify also the use of intramedullary nailing in the management of open fractures of the leg. Finally, they point out the indications for the external fixator in Strasbourg.

Bone Nails↗
PubMed1981

[Lower leg fracture--still the most frequent fracture during skiing? (author's transl)].

Evaluation of more than 17,300 injuries caused by skiing in the Black Forest region between 1936 and 1980, shows that there has been a change in the pattern of injuries. However, the most frequent fracture occurring during skiing is, as it has always been, the fracture of the lower leg. Whereas ankle-joint fractures have receded, knee injuries have been increasing. This shows that the type of injuries to the leg have been undergoing a change as a result of modern skiing technique.

Adolescent↗
PubMed1981

[Surgical fixation of displaced pelvic fractures and dislocations of the symphysis pubis (excluding acetabular fractures) (author's transl)].

For many years, the author has advocated systematic surgical fixation of displaced acetabular fractures. In this study he analyses the indications and technique of fixation of pubic dislocations (22 cases), sacro iliac dislocations (18 cases) combined dislocations (5 cases) and pelvic fractures associated with acetabular fractures (48 cases). The choice of a satisfactory approach is important. Accurate reduction and sound fixation is always possible within a week following the trauma, but in some cases operation was made after one month or even later. Surgical management aims to avoid malunion which is difficult to correct.

Fracture Fixation, Internal↗
PubMed1981

Irreducible fracture-dislocations of the ankle associated with interposition of the tibialis posterior tendon: case report and review of the literature of a specific ankle fracture syndrome.

A severe closed pronation-eversion fracture-dislocation of the ankle that was irreducible by closed means was encountered. Exploration to accomplish open reduction revealed displacement of the tibialis posterior tendon through the diastasis between the distal tibia and fibula. The tibialis posterior tendon was found to pass posteriorly to an anteriorly between the distal tibia and fibula and laterally to medially across the anterior surfaces of the distal tibia and neck of the talus. Reduction was blocked by the tibialis posterior tendon in its abnormal course. After replacement of the tibialis posterior tendon in its anatomic position, reduction was accomplished. Internal fixation was then performed uneventfully. Two previous similar cases of irreducible ankle fractures due to displacement of the tibialis posterior tendon through the diastasis between the distal tibia and fibula have been reported in the literature. This uncommon syndrome is reported as a possible etiology to be considered when failure of reduction of an ankle fracture is encountered.

Adult↗
PubMedDate not supplied

[The ECMES [Centro-Medullary Elastic Stabilising Wiring) osteosynthesis method in limb fractures in children. Principle, application on the femur. Apropos of 250 fractures followed-up since 1979].

The theoretical basis of this new technique were recalled: a closed operation respecting the conjugation cartilages. The material, composed of flexible wires of adequate diameter are bent and stabilised forming a non traumatic fixation which is inserted into the medullary canal of the fractured bone under fluoroscopic surveillance. The second part of this paper deals with the results of 250 fractures of the femur followed up since 1979. Late outcome in terms of complications and stimulation of the post-trauma growth, which is a problem in all forms of fractures in the child, especially of the femur, is presented.

Adolescent↗
PubMed1994

[Diagnosis, therapy and prognosis of Pipkin fractures (femur head dislocation fractures)].

Fractures of the femoral head combined with a dislocation of the hip are rare injuries. In the period from 1975 to 1993 nine of our 231 operatively treated patients who had a hip injury sustained a Pipkin fracture. According to the history of our patients and the results of the last 18 years we discuss the possibilities of diagnosis, treatment and prognosis of the fracture of the femoral head with dislocation of the hip.

Adult↗
PubMed1997

[Changes in therapeutic principles in fractures of the extremities with severe soft tissue injuries exemplified by tibial fracture].

Functional results after open fractures have been improved during the last decades. Especially the rates of amputation and chronic osteitis after open tibial fractures have been reduced from 30% to less than 5%. The initial management of this type of fracture includes reconstruction of the perfusion of the involved vessels, subsequent debridement with resection of avascular tissues, decompression of compartments by fasciotomy and initial shortening of the tibia by osteotomy and followed by callus distraction in order to achieve the physiological length of the leg. Cortical bone with periostal stripping has to be covered by local muscle transfer or by free vascularized tissue transfer within 3-7 days. Bone defects are either reconstructed by cancellous bone graft or, if the defect is longer than 2 cm, by continuous segmental transfer, according to the technique described by Ilizarov.

Amputation, Surgical↗
PubMed1998

Unreamed intramedullary nailing of acute femoral shaft fractures using a traction device without fracture table.

The authors present a simple distraction apparatus that makes it possible to perform nonreamed intramedullary nailing of the femur on a normal operating table. Nonreamed intramedullary (IM) nails were inserted in 24 femoral shaft fractures using this device. The setup time of this device was 60% shorter compared with a stratified group of 28 femoral nailings performed using the fracture table. The authors feel that this device is a safe and effective alternative to using a fracture table. It is especially useful in the polytrauma patient where the additional lesions can be treated without the need for patient transfer to another table.

Adult↗