Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · May 1993
Case ReportsComplicated removal of the distal locking device of Brooker-Wills.
Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. ⋯ In the other patient, removal of the distal locking device and the nail was complicated by inability to engage the tip of the driver inserter into the proximal end of the distal deployment device. The method described here facilitates removal of nails and the distal locks.
-
Clin. Orthop. Relat. Res. · May 1993
ReviewCompartment syndromes of the foot after calcaneal fractures.
Approximately 10% of calcaneal fractures develop compartment syndromes of the foot, and of these, one half develop clawing of the lesser toes and other foot deformities, including stiffness and neurovascular dysfunction. Tense swelling and severe pain are the hallmarks of an impending compartment syndrome. ⋯ Immediate fasciotomy is recommended to prevent the development of ischemic contracture. It is recommended that open reduction and internal fixation of a calcaneal fracture is performed on a delayed basis, after the fasciotomy wounds are closed.
-
Clin. Orthop. Relat. Res. · May 1993
Case ReportsThe management of soft-tissue problems associated with calcaneal fractures.
Soft-tissue problems associated with fractures of the calcaneus are common and can present many pitfalls. A classification of soft-tissue problems has been devised to facilitate treatment: Type 1, closed fractures treated by open reduction and internal fixation with an inability to close the skin. Type 2, wound break down after open reduction. ⋯ Type 5, calcaneal osteomyelitis. Type 6, chronic unstable soft tissue over the calcaneus. There are various surgical options of skin graft, rotational flaps, and free-tissue transfers that best reconstruct each of these individual problems.
-
Clin. Orthop. Relat. Res. · May 1993
The operative treatment of intraarticular calcaneal fractures. Indications, technique, and results in 257 cases.
Since 1972, 257 intraarticular fractures of the calcaneus have been treated with operative intervention. A lateral incision and a third tubular plate were used in all cases. ⋯ Although 50% of patients showed a reduced mobility of the subtalar joint, pain and limited ambulation were rare. Only six patients required a late subtalar arthrodesis.