Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2010
The Volkmann dogma: a retrospective, long-term, single-center study.
There has been (and still is) some controversy about the treatment of malleolar fractures with an additional fracture of the posterior malleolus (Volkmann triangle) in the last few years. Should a posterior malleolus with a fragment that is larger than 25% of the articular surface be fixed? Can long-term results be influenced by the fixation of the Volkmann triangle? ⋯ In conclusion, the presence of a Volkmann triangle impairs prognosis; fixation, even with anatomic results, does not return the score to "normal." Cartilage damage seems to play a crucial role in the long-term outcome.
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Eur J Trauma Emerg S · Dec 2010
Proximal humerus fracture with a pink, pulseless arm in a teenage boy and literature review.
Proximal humeral fractures associated with vascular compromise are extremely rare in children. We describe the presentation, diagnosis and management of one such injury in a child.
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Eur J Trauma Emerg S · Dec 2010
Limb salvage or amputation? The use of a gentamicin coated nail in a severe, grade IIIc tibia fracture.
Severe grade IIIc tibial fractures have limited treatment options. The decision between limb salvage or amputation depends on many factors, including the age and health status of the patient, as well as the soft tissue status and associated injuries. Until recently, intramedullary nailing was not a favoured treatment option in such tibial fractures, since it is associated with an increased risk of deep wound infections and osteomyelitis. ⋯ The gentamicin-loaded coating of the UTN-PROtect(®) nail, which releases the antimicrobial agent directly at the bone-implant inter-face, overcomes the limitation of insufficient antibiotic delivery. Awareness of this case and the existing literature supporting the use of an antibiotic coated nail may assist surgeons in their decisions on how to treat severe grade IIIc fractures.
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Eur J Trauma Emerg S · Dec 2010
Corynebacterium septic arthritis of the knee presenting as a ruptured septic popliteal cyst.
A rare case of a septic knee arthritis presenting as an infected ruptured popliteal cyst is described. Infection of a popliteal cyst is an uncommon complication of septic arthritis and presentation can mimic that of an acute deep vein thrombosis, leading to delay in diagnosis and treatment. ⋯ Invasive infections caused by Corynebacterium spp. seem to have a predilection for patients who are immunocompromised. It is especially important in this subset of patients that delays in diagnosis are avoided by including it in the differential of an immunocompromised patient presenting with unilateral lower-extremity pain and swelling.
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Ankle fractures continue to be a common injury. They involve various mechanisms of injury and produce, when treated correctly, fairly good results. ⋯ The principles of the operative treatment of these fractures are discussed in this paper, illuminating the surgical technique and biomechanics of lateral, medial and posterior malleolar fractures. Even though there have been no fundamental changes in the treatment of these fractures in the last several years, new implants such as angular-stable plates and new surgical techniques such as the minimally invasive plate osteosynthesis (MIPO) technique help to treat these fractures more individually, depending on the type of fracture, quality of bone and soft tissue conditions.