Der Unfallchirurg
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A baby was brought into the accident and emergency department with X-ray pictures and with a plaster cast in place because of a pain reaction in the right arm. The pictures showed destruction of the epiphyseal region and double periosteal contours. ⋯ No traumatological/orthopedic treatment was given, and the plaster cast was removed. Following recognition of the signs described a complete cure was possible.
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A healthy, right-handed 34-year-old man was injured by repeated direct blows delivered to his left upper arm with a baseball bat. These blows led to a posterior dislocation of the elbow joint, associated with fractures of the radial head and the coronoid process. There was bone loss on the fractured joint surface of the olecranon, with simultaneous ipsilateral trauma to the ulna. ⋯ The results of treatment are often poor, especially because of persisting instability and stiffness of the elbow following a long period of immobilisation. Few studies have been concentrated on this topic up to now. We report on the functional and radiological results 24 months after the treatment of this rare, open "shock triad in the elbow."
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Complex regional pain syndrome (CRPS) is seldom observed in the lower extremities. A case of a 19-year-old patient with typical symptoms in the lower leg and foot after surgical treatment of an acetabular fracture is described. Differential diagnostic evaluation should include CRPS in patients with persistent or progressive pain in the distal extremity after acetabular fracture. Early diagnosis and therapy contribute significantly to a successful outcome.
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Transarticular dorsal screw fixation of atlantoaxial instability in the elderly is seldom described in the literature. This study presents the results of this technique in patients aged at least 70 years. A modified method of indirect screw fixation is used in which soft tissue dissection is reduced compared to the classic procedure. ⋯ The presented technique of transarticular C1-C2 screw fixation is associated with reliable fusion rates and good functional results. The procedure can be recommended for atlantoaxial instability in the elderly.