The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 1985
Comparative StudyInternal fixation of fractures and non-unions of the humeral shaft. Indications and results in a multi-center study.
We performed ninety-six internal-fixation procedures for fracture or non-union of the humeral shaft in eighty-four patients, with a mean follow-up of 32.6 months (range, three months to fourteen years). The primary indications for operative intervention included humeral shaft fracture in a patient with multiple trauma, non-union, inadequate reduction of a humeral shaft fracture by closed methods, pathological humeral-shaft fracture, and progressive radial-nerve palsy. Methods of internal fixation included compression plates and screws and intramedullary Küntscher nails or Rush rods. ⋯ Ten patients with non-union of a humeral shaft fracture had an 80 per cent rate of union with the use of an AO/ASIF compression plate. The use of a Küntscher nail in eleven patients with non-union resulted in a rate of union of only 73 per cent and frequently caused subacromial impingement. Fractures of the humeral shaft that had had an inadequate reduction by closed means or were associated with progressive radial-nerve palsy were best managed by a compression plate or the modified Hackethal technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Bone Joint Surg Am · Jun 1985
Classification, diagnosis, and treatment of transitional fractures of the distal part of the tibia.
I studied the anatomical relationships in thirty-two transitional fractures of the distal part of the tibia by standard radiography and in thirteen of these patients by computerized axial tomography. Three different configurations of fractures could be identified: biplane fractures and two different types of triplane fractures (Type I and Type II). In the biplane lesion the fracture is restricted to the epiphysis, while the triplane fractures are characterized by a wedge of metaphyseal bone. ⋯ However, the evaluation of undisplaced or only slightly displaced Type-II triplane fractures will still occasionally require the use of computerized axial tomography. Displaced transitional fractures with a fracture gap of more than two millimeters in the weight-bearing portion of the epiphysis require open reduction. If the gap is less than two millimeters, non-operative treatment with a plaster cast is sufficient.