Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2008
Comparative StudySagittal plane analysis of the open and closed methods in children with displaced supracondylar fractures of the humerus (a radiological study).
The aim of this study was to compare the radiological outcome of open and close reduction and osteosynthesis methods in the treatment of type II and III supracondylar humerus fractures in childhood with respect to the immediate post-operative reduction quality in sagittal plane. ⋯ It is concluded that there was no significant difference between closed and open reductions of pediatric displaced supracondylar fractures with regard to the radiological criteria of reduction quality in sagittal plane.
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Arch Orthop Trauma Surg · Jul 2008
Case ReportsChildhood nonunion of ulna presenting with wrist deformity in an adult: a case report.
We describe an adult patient with traumatic, nonunion of ulna sustained at 11 years of age who presented with wrist deformity. The possible pathogenesis, differential diagnoses and its successful management are described. A 23-year- old right hand dominant male presented with a progressive wrist deformity of his right upper limb. ⋯ He had returned to preoperative activity level. Though nonunion is rare in pediatric forearm fractures, asymmetric bone and soft tissue growth can lead to deformities even in the absence of physeal injury. In addition to the standard treatment of nonunion, maintenance of the relative lengths of radius and ulna is essential, to obtain optimum function.
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Arch Orthop Trauma Surg · Jul 2008
Outcome after open reduction and angular stable internal fixation for supra-intercondylar fractures of the distal humerus: preliminary results with the LCP distal humerus system.
Fractures of the distal humerus are complex injuries that can be effectively treated with open reduction and internal fixation (ORIF). The new LCP distal humerus system allows angular stable fixation of these complex fractures with anatomically preshaped plates. The aim of the study was to evaluate operative reposition, fracture healing, and pain, function and patient satisfaction after open reduction with an angular stable fixation. ⋯ Treatment of supra-intercondylar fractures of the distal humerus is challenging. Anatomically preshaped angular stable implants facilitate operative reduction and stabilization of the fracture and may allow early postoperative rehabilitation. Clinical and radiological results are promising, with good range of motion and flexion and extension force.
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Arch Orthop Trauma Surg · Jul 2008
Case ReportsTalar body fracture combined with bimalleolar fracture.
The incidence of talar fractures is relatively low affecting usually young patients, while recent epidemiological studies have shown that talar body fractures represent a significant proportion of the total number of talar fractures. Talar body fractures are usually high-energy injuries and often a combined talar neck and body fracture is noted. An association between talar body fractures and ankle fractures has also been recorded involving the medial or lateral malleolus. ⋯ This combined injury pattern seems to be very rare, since a similar case was not found in the literature. An open reduction and internal fixation of the talar body fracture as well as the bimalleolar fracture, followed by a prolonged non-weight bearing, led to a fracture healing with no evidence of osteonecrosis. Minimal osteoarthritic changes of the tibiotalar joint were noted at 3 years follow-up with satisfactory functional results.
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Arch Orthop Trauma Surg · Jul 2008
Comparative StudyOperative treatment of tibial shaft fractures: a comparison of different methods of primary stabilisation.
Segmental fractures of the tibial shaft (AO type 42-C2) often occur after a high energy direct trauma with consecutive severe soft tissue injury and a high rate of open fractures. The blood supply of the intermediate bone fragment can be severely disturbed and therefore operative treatment is demanding. In this retrospective study, we compared three different methods of stabilisation. ⋯ Conventional intramedullary nailing is not suitable for stabilisation of segmental fracture types with a short metaphyseal fracture fragment. New nails with proximal and distal interlocking in three different planes offer better stability. Bone vascularisation should not be endangered by the stabilisation procedure and optimal reduction of the fracture is an important prerequisite for uneventful fracture healing, especially in this difficult fracture configuration.