Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 1988
Case ReportsGaleazzi injury with an associated fracture of the radial head.
A 36-year-old man sustained an injury that was a combination of Essex-Lopresti and Galeazzi fractures. His injuries consisted of a distal radial shaft fracture, a radial head fracture, and disruption of the distal radioulnar joint. ⋯ The mechanism of the causative forces and the position of the forearm on impact is different in each of these injuries. These differences may explain the rarity of the combination.
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Clin. Orthop. Relat. Res. · Sep 1988
Review Case ReportsAcute compartment syndrome in the thigh. A case report and a review of the literature.
Compartment syndrome in the thigh is an uncommon condition, and acute compartment syndrome without an associated fracture is even less common. An 18-year-old male developed an acute anterior compartment syndrome in the thigh from a contusion without an associated fracture. This syndrome was treated successfully with a fasciotomy.
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Clin. Orthop. Relat. Res. · Sep 1988
Changes in serum myoglobin levels caused by tourniquet ischemia under normothermic and hypothermic conditions.
Serum myoglobin levels have been found to be elevated for a few hours after removal of a tourniquet. In the present study, levels of serum myoglobin were measured by radioimmunoassay from local blood samples in patients who were treated with surgery of the hand in a bloodless field. ⋯ When the upper extremity was cooled with ice water before application of the tourniquet, however, the increase of serum myoglobin was statistically significantly inhibited when compared with the normothermic condition. Muscle injury due to tourniquet ischemia may be decreased by cooling of the upper extremity prior to tourniquet application.
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Clin. Orthop. Relat. Res. · Sep 1988
Radial head fractures with acute distal radioulnar dislocation. Essex-Lopresti revisited.
Seven adults with displaced radial head fractures had concurrent dislocation of the distal radioulnar joint. Because support of the radius was lost at both the elbow and wrist, proximal migration of the radius from 5 to 10 mm occurred. Different types of fractures were classified to designate the best method of restoring radial length to prevent chronic wrist pain and stiffness. ⋯ Recommendations include meticulous clinical and roentgenographic examination of the distal radioulnar joint in all patients with displaced radial head fractures. Preservation of the radial head with anatomic reduction and rigid internal fixation is preferred, but radial head replacement may be necessary in cases with extensive comminution. Radial head excision alone, though contraindicated, may be restructured by ulnar shortening and radial head prosthetic replacement.