Acta Orthop Belg
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Traumatic hip dislocation is rare in children. The purpose of this study was to investigate the epidemiological features, dislocation types, treatments, and clinical and radiological outcomes. Seven cases of traumatic hip dislocation in children treated between 1996 and 2006 were included in this study. ⋯ One child had a stiff hip and a radiograph showed signs of avascular necrosis. The severity of injury was related to the age at the time of injury. Factors predisposing to avascular necrosis were delayed reduction and severity of trauma.
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Case Reports
Dorsally angulated proximal phalanx fractures: closed reduction and rigid fixation using a reversed extension splint.
Dorsally angulated proximal phalanx fractures have always presented a difficulty for treatment. A variety of options for treatment have been tried in the past, many of these are operative options and therefore carry the risks of a surgical procedure. We present a case of a conservatively managed proximal phalanx fracture using a reversed dynamic or static finger extension splint, such as Roylan Sof-Stretch. The finger was immobilised using this splint and achieved bony union and very good function at both the metacarpophalangeal and proximal interphalangeal joints.
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In a prospective study we assessed 440 patients, sequentially admitted to the trauma unit with hip fracture. Of the 403 who had a swab on admission, 5.2% (21/403) were found to be colonised with MRSA. ⋯ A high proportion (80.9%) of colonised patients had been admitted to a hospital within the previous one year, and the high prevalence of previous hospitalisation among people from institutional care may explain the higher rates of MRSA carriage among these individuals. When a patient gives a history of hospitalisation within the previous year, it is clearly sensible to consider the use of an agent such as teicoplanin for perioperative prophylaxis.
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Case Reports
Bilateral simultaneous traumatic hip dislocation in opposite directions: a case report.
Bilateral traumatic hip dislocation is rarely seen. A patient who presented with simultaneous dislocation of both hips in opposite directions is presented in this case report. A 42-year-old female patient who was injured in a motor vehicle accident as a passenger was brought to the emergency department and was diagnosed with posterior fracture dislocation of the right hip and anterior dislocation of the left hip. ⋯ No skeletal or skin traction was applied. Hip range of motion exercises were begun immediately. The patient was mobilized at the end of the sixth week and returned to daily activities without any complaint at the end of 16th week.
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The aim of this study was to assess the effectiveness of a modified (low-profile) Ilizarov fixation in the treatment of complex fractures of the distal femur such asseptic or aseptic non-unions following previous surgeries, osteoporotic fractures, and high-grade open fractures. Ten male patients with a mean age of 50 years (range, 22-72 years) were treated with a modified Ilizarov fixator. The system was composed of tensioned olive wires attached to four 5/8 rings (two proximal and two distal to the fracture line) connected to each other with three rods. ⋯ Although superficial pin-tract infection was observed at 10 pin sites, no patient developed deep infection requiring premature pin removal. There was breakage of one wire, which was replaced under anaesthesia, and one patient presented a patella fracture after a fall, which healed after tension-band wire fixation. Considering the high union and low complication rates, we suggest the use of a low-profile Ilizarov fixator in the management of certain distal femoral fractures and non-unions that may be difficult to manage using other means of fixation.