Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2008
Iatrogenic Sciatic Nerve Palsy Following Hemiarthroplasty of the Hip.
We report a rare complication following insertion of an uncemented hip prosthesis that resulted in posterior perforation of the femoral stem and a sciatic nerve palsy. To our knowledge, sciatic nerve palsy due to the femoral stem perforating the cortex has not been previously described.
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Clench fist or fight bite injuries are associated with some of the worst types of infective complications but their mechanism is often poorly understood. In a retrospective case series, 34 patients seen between 1998 and 2004 presented to a local hand surgery unit with confirmed human bite hand injuries. Seventy-six percent presented with infective complications with a mean delay in presentation of 4 days. ⋯ High rates of non-compliance and incomplete follow-up was noted. Major long-term complications including limited range of movement and osteomyelitis was low and suggests the policy of prompt and comprehensive surgical and medical intervention is the optimal treatment option. A brief but in-depth discussion of the specific anatomical pitfalls is included.
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Eur J Trauma Emerg S · Apr 2008
The Role of Total Elbow Arthroplasty in Complex Distal Humeral Fractures.
Fractures of the distal humerus are routinely treated by open reduction and internal fixation in an attempt to retain a painless, stable and functional joint. However, results of fixation, even with advances in plate technology, are still dependent on screw purchase and bone quality. Reported results, over the past decade, now support consideration of primary total elbow arthroplasty, in cases of highly comminuted distal humeral fractures, especially in the elderly who have low physical demands, or in those who have significant pre-existing inflammatory joint disease resulting in marked joint destruction.
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Eur J Trauma Emerg S · Apr 2008
Radial Head Fractures: Indications and Technique for Primary Arthroplasty.
The treatment of complex radial head fractures remains a challenge for the orthopedic surgeon. Novel implants and improved surgical techniques have made reconstruction of the radial head with open reduction and internal fixation possible in most cases. However, extremely comminuted radial head fractures with associated instabilities still require replacement of the radial head with a prosthesis to allow rehabilitation with early motion of the elbow, and thereby optimizing the functional results of these potentially devastating injuries. In this article we discuss the surgical considerations related to radial head replacement, encompassing the indications for radial head arthroplasty, implant selection, surgical technique, rehabilitation protocols, and complications related to radial head prosthesis.
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Eur J Trauma Emerg S · Apr 2008
Fractures of the Coronoid Process of the Ulna: Which Ones to Fix and Which Ones to Leave Alone: A Review.
The coronoid process of the ulna forms the anterior boundary of the trochlear notch and is crucial for elbow stability. Coronoid fractures are uncommon and they occur in aproximately 10% of elbow dislocations. They are mostly associated with ligamentous and capsular disruptions as well as concomitant fractures. ⋯ Although rough guidelines can bemade, it is important to view each patient's elbow injury individually and then make a specific treatment plan. Data on treatment results are sparse. Improved understanding of coronoid fractures and their management will result in better outcomes and decrease possible complications including a certain degree of stiffness, neuropathy and arthrosis.