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At least 19 recordsLinked to original sources
PubMed2005

The crisscross injury mechanism in forearm injuries.

INTRODUCTION: A new mechanism of injury of the forearm bones, crisscross injury, is described. It is more common than the Essex-Lopresti fracture dislocation. The old concept of isolated injury of one side of the radioulnar joint may be challenged. It often occurs in Mason type II fracture dislocation of the radial head or dislocation of radioulnar joints. MATERIALS AND METHODS: The first part was a cadaveric study of the crisscross injury of forearms. The second part was a clinical study of the crisscross injury in some cases of Mason type II fracture radial head and double dislocation of the radioulnar joint. RESULTS: The cadaveric study confirmed a stable crisscross fracture dislocation injury with intact interosseous membrane. The clinical study echoed the presence of this injury by imaging techniques. CONCLUSION: The crisscross injury mechanism explains the mirror pathogenesis of the traumatic fracture dislocation of the distal and proximal radioulnar joints with intact shaft of the radius and ulna. Co-existing subluxation or dislocation of the other radioulnar articulation must not be overlooked in cases of fracture dislocation of one radioulnar joint. Two types of crisscross injury of forearm bones are proposed.

Adult↗
PubMed1981

Ipsilateral elbow and forearm injuries in children.

Twenty-five children with combined elbow injury and forearm bone fractures have been reviewed. The incidence of serious complications was low, and only one patient was significantly handicapped. Open reduction and internal fixation of the supracondylar fracture with closed treatment of the forearm fracture gave the best results.

Adolescent↗
PubMed1991

Immediate closure of traumatic upper arm and forearm injuries with the latissimus dorsi island myocutaneous pedicle flap.

This paper reports the authors' experience with latissimus dorsi island pedicle flaps in the acute treatment of massive arm injuries. Seven patients with upper arm injuries and four patients with forearm injuries were treated with latissimus dorsi pedicle flaps. All cases involved massive soft-tissue loss and open fractures. Primary healing of wounds occurred without complications in 10 of 11 patients; the eleventh developed a wound infection. There were no instances of flap loss or vascular complications. This report compares and discusses surgical management options and details the importance of robust, immediate soft-tissue coverage for optimal functional recovery. Contrary to traditional thought, delay in definitive wound closure may be unnecessary when aggressive debridement is followed by acute flap closure.

Adolescent↗
PubMed1991

[A complex forearm injury caused by skateboarding].

Conservative treatment of forearm fractures in children is preferred. However, in a few cases an open reduction and internal fixation are required. The case of a 15-year-old boy with a complex forearm injury following a skateboard accident is reported. The surgical treatment of these injuries is presented and the indications for open reduction and internal fixation of forearm fractures in children are discussed.

Adolescent↗
PubMed1981

Management of severe forearm injuries.

A review of principles and an operative guideline for repair of severely mutilating injuries to the forearm have been set forth. These concepts and their application have been illustrated in a series of clinical cases. The following key concepts have developed from these clinical experiences: 1. The surgeon must evaluate each case based upon the potential for return of sensation and function. One cannot justify the statement that a replanted arm is always superior to a prosthesis, even if its only purpose is cosmetic. 2. Care must be taken in the emergency room to evaluate the entire patient, and not to ignore other injuries while concentrating on a mangled extremity. 3. The crush-avulsion nature of injuries seen in a large referral center necessitates aggressive debridement of damaged soft tissue and bone. Wounds that have avulsion of skin, muscle, and nerve throughout the length of the arm do not lend themselves to repair. Destruction of an elbow joint generally precludes repair. 4. A well stabilized skeleton is essential before definitive soft tissue repairs can be performed. 5. Vascular repairs are meticulously performed using magnification. All vessels are reconstructed in an effort to recreate the original anatomy. 6. Wide destruction of muscle and tendon is frequent necessitating ingenuity in connecting proximal motor units to distal tendon. After repair, early active motion of the extremity is emphasized. 7. Perhaps the strongest contraindication to reconstruction of a severely damaged upper limb is avulsion of the nerves throughout the length of the forearm. Sharply divided nerves can be repaired by group fascicular suture. Crushed, divided nerves do well with accurate epineural approximation. Crushed nerves with epineural continuity ar best treated by observation and secondary grafting as required. 8. Primary coverage of areas denuded of skin is by split graft of local transposition flaps. More sophisticated techniques may be used at a later time (myocutaneous flaps or free flaps) if further reconstruction is contemplated. 9. Dressing must be carefully applied without constricting the extremity. A protective plaster is applied beginning from above the elbow and ending in a bonnet over the hand; this allows the recovery room nurse to monitor the vascular status of the repair. 10. The physiotherapist and occupational therapist are integrated into the perioperative care. Active range of motion exercises are begun as soon as the third day after the operation. Lightweight static and dynamic splints help to restore mobility.

Adolescent↗
PubMed1999

Emergency department evaluation and treatment of elbow and forearm injuries.

This article reviews the anatomy of the elbow and discusses several different types of elbow fractures and dislocations. A review of forearm anatomy and common injuries, trauma, and fractures follows. Methods for treatment and management for both elbow and forearm injuries are discussed.

Emergency Service, Hospital↗
PubMed1992

Free flaps in the reconstruction of hand and distal forearm injuries.

We report a series of 32 free flap reconstructions following acute hand and forearm trauma. The series consists of two dorsalis pedis flaps, four scapular flaps and 26 lateral arm flaps. One flap became infected and failed completely, and a partial necrosis occurred in another flap. The transfers covered large skin defects, exposed tendons, tendon grafts, bone, bone grafts, joints, nerves and nerve grafts. The donor site morbidity was negligible. Our study shows that free microvascular flaps are a safe and convenient alternative to conventional flaps in hand surgery. The lateral arm flap seems very suitable for small and medium size defects.

Adolescent↗
PubMed1985

[Indications for free groin flap-plasty in severe forearm injury (case report)].

A case with a severe gun shot wound of the palmar ulnar distal forearm and wrist is presented. The initial treatment included reconstruction of the ulnar nerve by means of nerve grafts and soft tissue coverage using a free microvascular groin flap. This represents a procedure which is certainly applied only very exceptionally at our department. Inspite of consequent complete flap necrosis due to arterial thrombosis, sensory recovery was sufficient for protective sensibility. The probable reasons of arterial thrombosis are discussed.

Adult↗
PubMed2002

[Repetitive strain injuries. Forearm pain caused by tissue responses to repetitive strain].

According to the National Research Council, painful work-related upper limb disorders are caused by different pathophysiological mechanisms, one of which is repetitive strain injury (RSI). Forearm pain, tenderness, and paresthesias are thought to result from a continual risk of exceeding limits of "cumulative trauma load tolerance" (CTLT, cf. NRC 2001) in soft tissue by thousands of high-frequency, repetitive movements. On the other hand, repetitive painful stimulations also produce neuroplastic changes in the spinal and supraspinal nociceptive systems. Thus, repetitive motor and nociceptive impulses become part of the same motor programs, which are also responsible for high-frequency movements and tissue damage. In this way RSI pain may be felt as a task-related response, even after all injuries are completely healed. Consequences of this neuroplastic CTLT model for RSI prevention and therapy are discussed.

Adolescent↗
PubMed1992

Hand and forearm injuries from penetrating projectiles.

Compared with other surgical literature published after the Vietnam and Persian Gulf wars, hand surgery literature has been relatively void of information regarding projectile injury. Wound ballistics research of the past 10 years has shown that objective evaluation of tissue disruption is the only valid guide to treatment. The hand's anatomy requires hand surgeons to be more careful in tissue excision. Hand surgeons, therefore, do not have the luxury of "cutting till it bleeds." The purpose of this article is to support the methods that hand surgeons have traditionally used and to caution the inexperienced surgeon who may be inclined to excise uninjured tissue.

Animals↗
PubMed1997

Complex injuries of the forearm. Coverage considerations.

Complex forearm injuries involve damage to the skin and underlying tissues. The best results are obtained when a multidisciplinary approach is taken to their management. Management of the acute injury should be done in a manner that takes into consideration late reconstructive procedures and best possible final function outcome. This article reviews initial management and options for soft-tissue coverage. Advantages and disadvantages of a wide variety of procedures are discussed and in addition the authors review some of the more controversial areas and give personal preferences.

Debridement↗