Journal of orthopaedic trauma
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Case Reports
Maisonneuve fracture associated with a bimalleolar ankle fracture-dislocation: a case report.
The Maisonneuve fracture consists of a proximal fibular fracture with associated syndesmotic ligament disruption and injury to the medial ankle structures. The accepted mechanism of injury is an external rotation force applied to the ankle with the foot in either supination or pronation. ⋯ A case report is presented of an unusual fracture pattern-i.e., that of a distal fibular fracture with lateral ankle dislocation associated with a Maisonneuve fracture. To our knowledge, only two other similar cases are reported in the English literature.
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Acute compartment syndrome has been described as a result of thigh contusion in several contact sports, and emergent fasciotomy has routinely been recommended. However, recent data suggest that thigh contusions in athletes presenting with isolated elevation of compartment pressures in the absence of neurovascular deficits may be treated expectantly. ⋯ This case demonstrates that expanding hematoma formation may result in delayed increase of intramuscular pressures and compromise of myoneural perfusion in patients with severe thigh contusions. Early evacuation of the hematoma may help to prevent late development of compartment syndrome and reduce the risk for long-term complications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail.
To compare the results between a sliding compression hip screw and an intramedullary nail in the treatment of pertrochanteric fractures. ⋯ There is no advantage to an intramedullary nail versus a sliding compression hip screw for low-energy pertrochanteric fractures AO/OTA 31-A1 and A2, specifically with its increased cost and lack of evidence to show decreased complications or improved patient outcome.
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To determine the efficacy and optimal application parameters of circumferential compression to reduce external rotation-type pelvic fractures. ⋯ Application of circumferential compression to the pelvic soft tissue envelope with a pelvic strap was an efficient means to achieve controlled reduction of external rotation-type pelvic fractures. This study derived application parameters with direct clinical implication for noninvasive emergent management of traumatic pelvic ring disruptions.
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To evaluate the outcome of a minimally invasive treatment of unstable two-part proximal humeral fractures using a J-nail. ⋯ J-nail fixation has the advantage of being an almost closed method without the disadvantage of muscle transfixation associated with other methods. The procedure is simple and involves minimal invasion of the soft tissue. Shoulder and elbow function is not impeded because the nails are inserted just below the distal part of the deltoid muscle insertion. This surgical technique may be one of the more reliable and effective treatments for proximal humeral fractures.