Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1983
Supination-adduction injuries of the ankle in children--radiographical classification and treatment.
Diagnostical and therapeutical problems associated with supination-adduction injuries are presented. 457 ankle fractures were collected from a retrospective material of 919 children aged 0-18 years with fractures of the tibio-fibular shaft or the ankle. The ankle fractures were classified anatomically according to Salter and Harris and traumatologically according to Gerner-Smidt. 147 fractures were classified as due to supination-adduction, of which 128 had open growth plates. The first stage, a Salter-Harris type I, II, or III fracture through the lateral malleolus or only epiphyseal fracture without fracture through the growth plate, is easily overlooked and is probably more common than earlier registered. ⋯ The supination-adduction injuries are the second most common type of ankle fractures in children (32%) only exceeded by injuries due to supination-eversion (39%). Early recognition of the fracture pattern of supination-adduction injuries is important as growth disturbance and joint problems are not uncommon when there is fracture through the medial malleolus. The need for correct diagnosis and treatment is stressed by the risk for late problems.
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Arch Orthop Trauma Surg · Jan 1982
Case ReportsLuxatio erecta of the hip. A case report and review of the literature.
Luxatio erecta of the hip is an exceptional injury. This is the report of one such case in a 10-year-old boy, and a review of 7 other cases collected from the literature. ⋯ Reduction is to be achieved by cephalad traction, though internal rotation may have to be added in certain cases. Post-reduction treatment, as well as the incidence of complications, are not different from those concerning the other topographic varieties of traumatic hip dislocation.
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The authors examined 34 tendons under the electron microscope, excised within 48 h after rupture of the tendons. The tendons did not exhibit any signs of inflammation or lipomatosis, but fine-structurally marked hypoxic alterations in the tenocytes could be seen. The degenerative (hypoxic tendinopathy appears in three phases, and the hypoxic lesions of the tendon occur at multiple foci or diffusely, and the various phases can exist simultaneously.
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The occurrence, relation to a particular type of fracture of the pelvis and the possible mechanism of early urinary complications were studied in 186 consecutive patients with fracture of the pelvis. Eighty-eight patients (47.3%) showed early urinary complications. These complications were minor in 73 patients (83.0%; 32.9% of all pelvic features) and major in 15 (17.0%; 8.1% of all pelvic fractures). ⋯ The common pelvic fracture encountered in these patients was the Type III and the individual pelvic fracture was that of both pubic rami on one or both sides; fractures of the acetabulum and posterior segment of the pelvis were next in frequency. On the other hand, fractures of a single ischial ramus or wing of the ilium were not commonly encountered. Fractures with intact pelvic ring were associated with only 9.1% of these complications; all were minor.