Journal of orthopaedic trauma
-
Comparative Study
The role of plain films and computed tomography in the evaluation of scapular neck fractures.
To assess the ability of plain films and computed tomography scans to show the pattern, displacement, and angulation of scapular neck fractures. To assess the ability of computed tomography to identify concomitant occult shoulder injuries. ⋯ Scapular neck fracture displacement, angulation, and anatomic classification showed moderate interobserver reliability by plain films but were not enhanced by computed tomography. Computed tomography confused, rather than clarified, the assessment of these characteristics. Computed tomography may be useful to identify associated injuries to the superior shoulder suspensory complex, which can be missed by plain films alone. Routine computed tomography in patients with scapular neck fractures cannot be recommended based on this study. Computed tomography of scapular neck fractures may be useful in selected cases in which intraarticular extension is noted on plain films.
-
To locate the proper insertion point for a tibial intramedullary nail in the coronal plane. ⋯ The insertion point of a tibial nail should be over the medial aspect of the tibial tubercle in the coronal plane. Our data supports using a medial or patellar splitting approach for nail insertion. Insertion sites lateral to the tibial tubercle should be avoided.
-
The case of a patient who sustained an avulsion fracture of the femoral head (Pipkin Type I) that was unrecognized is described. The patient was referred to the authors' institution four months after injury, and radiographic studies showed a malunited avulsion fracture of the femoral head to the acetabulum. The patient subsequently went on to an excellent result after surgical debridement. The authors recommend additional radiographic studies in cases to exclude unrecognized fractures where a possible hip subluxation may have occurred.
-
Case Reports
Posteromedial dislocation of the elbow with associated intraarticular entrapment of the lateral epicondyle.
Traumatic elbow dislocation is relatively common in adolescents. Most cases occur in a posterolateral direction. Elbow dislocation is often accompanied by fractures, most frequently of the medial epicondyle. The authors report a rare case of posteromedial elbow dislocation and associated fracture of the lateral humeral epicondyle trapped within the joint.
-
To determine whether teleradiology improved clinical decision making for the treatment of patients with acute fractures. ⋯ The routine use of electronically transmitted digitized radiographic images has the potential to improve clinical decision making for the care of patients with acute fractures.