The American journal of orthopedics
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Case Reports
Fat embolism syndrome in an adolescent before surgical treatment of an isolated closed tibial shaft fracture.
Fat embolism syndrome (FES) occurs most commonly in adults with high-energy trauma, especially fractures of the long-bones and pelvis. Because of unique age-related physiologic differences in the immature skeleton, as well as differences in fracture management in pediatric patients, FES is rare in children. ⋯ A high index of suspicion is required to make the diagnosis promptly and institute appropriate treatment. Intramedullary nailing of a long-bone fracture can be done safely and successfully after resolution of the FES.
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We evaluated the stability of locking and nonlocking plate fixation of the pubic symphysis in a cadaveric model of an unstable pelvic injury. Five fresh cadaver pelves--intact and with an unfixed simulated Tile B injury--were tested under compressive load simulating a 2-legged stance. ⋯ Symphysis pubis fixation alone reduced the anterior superior pubic symphysis mean gap displacement by 95% and the anterior inferior pubic symphysis by 78%, compared with the noninstrumented Tile B injury. There is no evidence that anteriorly placed locking constructs confer an advantage, in terms of pubic symphysis stability, over standard anterior compression plates for Tile B injuries.
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Many studies have attempted to define a safety zone for the axillary nerve in lateral approaches to the deltoid, but with varying results. The main objective of our study was to analyze the variations in the position of this nerve, especially in relation to the length of the humerus. Overall, 16 cadaveric shoulders were dissected. ⋯ Correlation analysis was performed between each distance and the length of the humerus. The average anterior and posterior distance were 7.2 cm ± 0.84 cm and 7.9 cm ± 0.92 cm, respectively; the average length of the humerus was 30.7 cm ± 3.2 cm. A significantly high positive correlation was found between the length of the humerus and both anterior distance (P = .94), and posterior distance (P = .92). In shoulder surgery, prior measurement of the length of the humerus could predict the distance between the acromion and the axillary nerve, and determine its position.