Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Jun 1996
Use of the minicondylar plate in metacarpal and phalangeal fractures.
The minicondylar plate is used for unstable intraarticular and periarticular fractures of the phalanges and metacarpals to provide stability and to allow early motion. This low profile implant can be placed laterally to avoid injury to the extensor mechanism. The authors retrospectively reviewed 53 consecutive patients from 2 institutions in whom 68 fractures (41 metacarpal and 27 phalangeal) had been treated with 1.5-mm or 2-mm minicondylar plates. ⋯ Metacarpal fractures had a significantly higher percentage of excellent results than did phalangeal fractures. Final motion did not correlate significantly with complication rate, severity of soft tissue injury, location in the bone, open versus closed fracture, or use of bone graft. When fractures cannot be restored and stabilized reliably by less invasive methods, the minicondylar plate provides secure fixation and can result in adequate function, even in the presence of severe combined injuries.
-
Clin. Orthop. Relat. Res. · Jun 1996
Overlooked spine injuries associated with lumbar transverse process fractures.
Transverse process fractures of the lumbar spine often are considered benign fractures related to direct trauma or psoas muscle avulsion. Treatment of these usually stable injuries is primarily administered when the patient becomes symptomatic. However, significant force often is required to cause these injuries, and other injuries may occur concomitantly. ⋯ Three of the 28 patients (11%) had a lumbar spine fracture that was identified by computed tomography but overlooked on plain radiographs. Approximately 11% of patients with major injuries may be misdiagnosed if only plain radiographs are used in the evaluation of transverse process fractures. Computed tomography scanning of all lumbar spine transverse process fractures resulting from acute trauma should be considered because this diagnostic measure decreases the risk of overlooking potentially serious injuries.