Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 1984
Randomized Controlled Trial Clinical TrialEarly results after Colles' fracture: functional bracing in supination vs dorsal plaster immobilization.
A randomized clinical study of functional bracing in supination (FUSU) versus dorsal plaster immobilization (DPI) was conducted in 145 patients with Colles' fracture. A dynamic wrist unit was developed and used in 68 patients allocated for FUSU. The anatomical end result after FUSU was excellent or good in 80% of the patients versus 64% after DPI (P less than 0.05), in particular due to less dorsal angulation (P less than 0.001) and less radial shortening. ⋯ At 6 months, 92% satisfactory results were achieved after FUSU versus 86% after DPI (P less than 0.05). Both anatomical and functional benefits were recorded in Frykman type V, VI, and VIII fractures and in the group of displaced intra-articular fractures. The functional benefit from FUSU is suggested primarily to be secondary to decreased fracture redislocation.
-
Arch Orthop Trauma Surg · Jan 1983
Animal experiments to examine the histology of fracture healing in osteosynthesis with external fixation and compression.
Tibia osteotomies in sheep were stabilized in nail-fixed and wire-fixed external devices with static longitudinal compression. During the 8-week study programme the mechanical situation of the osteotomies was checked via continuous measurements of interfragmentary tension, used as a functional indicator of stabilization. ⋯ Under stable osteosynthesis conditions primary bone healing occurred analogous to findings in flattened experimental shaft fractures. On grounds of varying stability performance of external pressure osteosynthesis differences in secondary healing of osteotomies were observed due to interfragmentary instability.
-
Arch Orthop Trauma Surg · Jan 1983
Case ReportsRadiation induced osteosarcoma of the sacrum following radiation of an undiagnosed bone lesion.
Years ago a 20-year-old patient presented with low back pain. Radiologically a cystic lesion of the sacrum was found and interpreted as malignant tumor. Without biopsy and histological diagnosis the patient was given radiation therapy with 21 000 rad. ⋯ A pathological fracture ensued recessitating several operations. Twenty years after initial radiation therapy the patient developed a rapidly growing tumor of the sacrum, metastasizing to the lungs. One year later he died.
-
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.
-
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.