Injury
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The treatment and results of a retrospective study are presented on 23 patients who underwent surgical treatment for a fracture of the base of the thumb metacarpal. The 12 patients with a Bennett fracture were not found to be suffering from limitations in their daily activities, work, sport or hobbies. ⋯ The results of the four patients with an extra-articular fracture were good. Owing to the favourable results obtained with closed reduction and Kirschner wire fixation, this technique should be given preference over the more difficult open reduction and internal fixation.
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Disruption of the radiocapitellar line (RCL) can be a useful sign in injured elbows in children. Although originally described only in the true lateral projection, it has become generally accepted to apply the sign to any radiographic projection. ⋯ In these cases, the elbow was not in the standard anteroposterior or lateral position. Radiologists and clinicians involved in trauma should be aware that radiographic positioning and normal bowing of the radial shaft can affect the validity of this sign and that it is best applied only to the true lateral projection as originally described.
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We reviewed 13 patients with monocondylar fractures of the femur. Undisplaced fractures may require extensive radiological investigation to visualize the fracture. ⋯ Joint line incongruity and resultant callus formation produces an abnormal condylar profile leading to early secondary osteoarthritis. We recommend internal fixation in all patients with monocondylar fractures.
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A total of 34 children with ipsilateral supracondylar fractures of the humerus and forearm were studied over an 8-year period. Of these, 19 patients had fractures of the distal quarter of the forearm bones while eight patients had a distal radial epiphyseal injury. Five of the patients had undisplaced supracondylar fractures. ⋯ All forearm fractures were treated by closed reduction. Nine displaced supracondylar fractures which could not be reduced by closed manipulation were treated by olecranon pin traction in two cases and by percutaneous pinning in seven cases. Excellent or good results were found in 29 children after an average follow-up of 3.8 years.