The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Nov 2004
The external rotation method for reduction of acute anterior dislocations and fracture-dislocations of the shoulder.
Several methods of reducing an acute anterior dislocation of the shoulder have been described. The aim of this study was to assess the effectiveness of the external rotation method in the reduction of acute anterior shoulder dislocations with and without fractures of the greater tuberosity and to evaluate the causes of failure. ⋯ The external rotation method for the reduction of an acute anterior dislocation of the shoulder is a safe and reliable method that can be performed relatively painlessly for both subcoracoid and subglenoid dislocations provided that a displaced fracture of the greater tuberosity is not present.
-
J Bone Joint Surg Am · Nov 2004
Ununited diaphyseal forearm fractures with segmental defects: plate fixation and autogenous cancellous bone-grafting.
With current techniques of plate-and-screw fixation, diaphyseal nonunions of the radius and ulna are unusual. The few reports that have been published have discussed the use of structural corticocancellous bone grafts for the treatment of atrophic nonunions that are associated with osseous defects. We reviewed the rate of union and the functional results in association with the use of plate-and-screw fixation and autogenous cancellous (nonstructural) bone grafts. ⋯ When the soft-tissue envelope is compliant, has limited scar, and consists largely of healthy muscle with a good vascular supply, autogenous cancellous bone-grafting and stable internal plate fixation results in a high rate of union and improved upper limb function in patients with diaphyseal nonunion of the radius and/or ulna.
-
J Bone Joint Surg Am · Nov 2004
The epidemiology of posttraumatic adult respiratory distress syndrome.
Although adult respiratory distress syndrome is an important early complication of blunt trauma, the epidemiology and risk factors for its development remain poorly defined. The aims of this study were to determine the prevalence and demographics of this complication in a prospective cohort series of patients admitted to the hospital following injury. We also assessed the contribution of the severity and pattern of the injury to the risk of this complication developing. By identifying factors associated with the highest risk of the development of adult respiratory distress syndrome, we aimed to produce guidelines to facilitate earlier detection. ⋯ The prevalence of adult respiratory distress syndrome increases with injury severity and combinations of injuries to more than one anatomical region. We have been able to quantify the importance and relative risks associated with these injuries. The implications of our findings with regard to facilitating early detection of this complication are discussed.