The American journal of orthopedics
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Case Reports
Femoral fracture at the proximal end of an intramedullary supracondylar nail: a case report.
Retrograde intramedullary supracondylar nails have been added to the orthopedic armamentarium for treatment of distal femoral fractures. Major complications of this new technique have not been noted. We report a case of a femoral fracture at the proximal end of a retrograde intramedullary supracondylar nail. We hypothesize that this complication may be due to the proximal end of the nail acting as a stress riser, with the cortical holes drilled for the interlocking screws compounding this effect.
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Twenty children with fractures of both bones in the middle third of the forearm were immobilized in extension after closed reduction. Unlike distal-third fractures, these fractures are prone to develop rotary and angular deformities that may lead to permanent functional impairment and visible deformity. Mid-third forearm fractures with the radius fracture proximal to the ulnar fracture are even more troublesome. ⋯ Extension casting can be used initially for proximal fractures or to salvage forearms that lost reduction in flexed elbow casts. Extension cast application is easy while the reduction is maintained, whereas the problems are often encountered while applying a flexed elbow cast. This unorthodox treatment is safe and effective and may alleviate the need for surgical intervention.
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This paper describes a new technique of closed reduction for a dislocated normal hip or a dislocated prosthetic total hip. The Rochester method is unique in that it can usually be done by one trained medical care provider, whereas many other reduction techniques require one or more assistants. ⋯ The medical care provider uses his or her non-dominant arm for pelvic counterforce, while the other arm provides longitudinal traction and rotation control. Most reductions can be done in the emergency department.