J Bone Joint Surg Br
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J Bone Joint Surg Br · Mar 1987
Comparative Study Clinical Trial Controlled Clinical TrialExternal fixation of Colles' fractures. An anatomical study.
In a prospective, controlled study 58 patients aged under 60 years with Colles' fractures were treated either by a forearm plaster or by the application of an external fixator. In 94% of those treated by a fixator it was possible to insert the distal pins of the frame into the fracture fragment, the fixation obtained being sufficient to forgo additional splintage. The external fixator proved more effective at holding the manipulated position, and the radiological loss of position during fracture union was minimal compared with that seen in patients treated in plaster.
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We have reviewed 21 cases of dorsal dislocation of carpometacarpal joints. In 15 of them the diagnosis was missed when they were first seen in an accident and emergency department. General swelling may obscure the characteristic clinical deformity and routine radiographs may not show the displacement clearly. It is recommended that a true lateral radiograph of the hand be requested when this injury is suspected.
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J Bone Joint Surg Br · Mar 1987
Comparative StudyIntramuscular pressure and muscle blood flow during exercise in chronic compartment syndrome.
In nine patients with chronic compartment syndrome, the intramuscular pressure and muscle blood flow during constant dynamic exercise was studied by the microcapillary infusion method and by the 133-xenon clearance technique. Although muscle blood flow was normal at the start of exercise, pain and impaired muscle function eventually developed; muscle blood flow decreased while muscle relaxation pressure increased. ⋯ Patients experienced no symptoms and the muscle relaxation pressure and blood flow during exercise were normal. It is suggested that chronic compartment syndrome is due to increased muscle relaxation pressure during exercise which causes decreased muscle blood flow, leading to ischaemic pain and impaired muscle function.