Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Comparative StudyDisplaced distal radius fractures. A comparative study of early results following external fixation, functional bracing in supination, or dorsal plaster immobilization.
A comparison of the radiographical and functional results after displaced distal radius fractures in 41 patients treated by external fixation (EF), 36 patients treated by functional bracing in supination (FUSU), and 49 patients treated by dorsal plaster immobilization (DPI) was performed. The rate of initial complications after EF was 53%, compared with 22% after FUSU and 14% after DPI. The radiographical result after EF was significantly better than after nonoperative treatment, but the functional result after 3 and 6 months demonstrated no significant difference between the three series. Consequently, EF and FUSU do not restore wrist function faster than conventional plaster treatment (DPI), but EF improves the radiographical result, though the rate of complications is higher.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsTreatment of fractures of the humeral capitulum using fibrin sealant.
Three patients with fresh displaced fractures of the capitulum humeri were treated by the fibrin sealant method, without additional internal fixation. At follow-up, between 1 1/2 and 4 1/2 years after surgery, clinical results were very good. Fibrin sealant has many advantages over traditional osteosynthesis techniques and is therefore recommended as an effective method for treating such serious but uncommon fractures of the elbow joint.
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Arch Orthop Trauma Surg · Jan 1990
Separate centre of ossification of the lateral malleolus with instability of the ankle joint.
Four cases of recurrent instability of the ankle joint are reported. The instability was associated with a separate centre of ossification of the lateral malleolus and abnormal movement between the ossicle and the distal fibula. All patients were successfully treated by surgery: two underwent internal fixation and ligamentous reconstruction and two, ligamentous reconstruction after removal of the ossicle.
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A transverse fracture of the proximal part of the fifth metatarsal is rarely caused by direct trauma but is usually secondary to overload. These fractures, when treated conservatively, have a high recurrence rate and give rise to prolonged sporting inactivity. The clinical and radiographical difference between an acute versus a stress fracture will decide on further treatment. A reversed graft, by an asymmetrical trapezoid autograft, offers a simple and effective surgical solution for nonunion and delayed union of Jones fractures in sportsmen.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsBizarre parosteal osteochondromatous proliferation of a phalanx.
A rare proliferative osteochondromatous malformation of a proximal phalanx is described. This malformation may mimic the appearance of a sessile osteochondroma or parosteal osteosarcoma on X-rays and may be mistaken for a low-grade osteosarcoma on histology, with disastrous therapeutic consequences. We found that cryotherapy followed by local excision was adequate to remove the tumour.