Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Dec 2014
Evaluation and management of pulseless pink/pale hand syndrome coexisting with supracondylar fractures of the humerus in children.
Elbow region fractures are the most common injuries in children. Among them, supracondylar fractures of the humerus are the most frequent. Massive displacement of the fractured bone causes severe injury to the soft tissue of that particular region. ⋯ Children who, after satisfactory closed reduction, have a well-perfused hand but absent radial pulse do not necessarily require routine exploration of the brachial artery. Conservative treatment should be applied unless additional signs of vascular compromise appear. Thus, exploration of the cubital fossa should be performed only if circulation is not restored by closed reduction.
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Eur J Orthop Surg Tr · Dec 2014
Comparative Study Observational StudyReamed versus unreamed intramedullary locked nailing in tibial fractures.
The purpose of this prospective observational study is to identify whether or not reaming of tibial shaft fractures has benefits over unreamed intramedullary locked nailing. Eighty-four adult patients with recent open and closed tibial shaft fractures were treated with reamed or unreamed intramedullary locked nail fixation. ⋯ The mean duration of surgery was shorter (p = 0.025) for the unreamed group 43 min (SD 18) compared to 55 (SD 27), but the main determinants were the fracture type and the surgeon's experience. We conclude that reamed nailing proved beneficial, but the impact on overall outcome is not superior to unreamed nailing.
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Eur J Orthop Surg Tr · Dec 2014
Reducing the risk of flexor pollicis longus tendon rupture after volar plate fixation for distal radius fractures: validation of the tendon irritation test.
We have proposed that a positive tendon irritation test is suggestive of flexor pollicis longus (FPL) tendon damage that can lead to tendon rupture after volar plate fixation for distal radius fractures. We investigated cases of postsurgical hardware removal and validated the tendon irritation test as a way to elicit a sign of FPL tendon irritation. ⋯ Our results suggest that subsequent examinations should be performed when the tendon irritation test is positive for signs of tendon irritation that may require plate removal.
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Eur J Orthop Surg Tr · Oct 2014
Delayed surgery in displaced paediatric supracondylar fractures: a safe approach? Results from a large UK tertiary paediatric trauma centre.
Displaced paediatric supracondylar humeral fractures pose a significant risk of neurovascular injury and consequently have traditionally been treated as a surgical emergency. Recently, the need for emergency surgery has been questioned. We wished to analyse our experience at a large UK tertiary paediatric trauma centre. ⋯ Our results indicate that delayed surgery appears to offer a safe management approach in the treatment of displaced supracondylar fractures, but it is important that cases are carefully evaluated on an individual basis. These results indicate that patient transfer to a specialist paediatric centre, often with consequent surgical delay, is a safe management option and also negates the obligation to carry out these procedures at night.
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Eur J Orthop Surg Tr · Oct 2014
Review Comparative StudyOperative versus nonoperative treatment of displaced midshaft clavicle fractures in adults: a systematic review.
Intervention studies of clavicle fracture treatment are numerous, but only a few high quality studies prospectively compare operative and nonoperative treatment. The objective of this study was to review evidence from randomized controlled trials on operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults with focus on fracture healing, complications and functional outcome. ⋯ It seems like operative intervention leads to fewer nonunions at the cost of an increase in minor complications compared to nonoperative treatment. However, the effects of operation on functional outcome remains controversial. High quality evidence is currently sparse supporting either operative or nonoperative treatment on displaced midshaft clavicle fractures in adults.