Clinical orthopaedics and related research
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Twenty-six patients with suspected forearm compartment syndromes were evaluated clinically and by intracompartmental pressure determinations. The most reliable physical findings indicating a forearm compartment syndrome were marked pain on passive digital extension and reduced hand sensibility or paresthesias. ⋯ A curvilinear volar incision and, when indicated, a straight dorsal incision provided adequate decompression in the ten operatively treated patients. Postfasciotomy pressure determinations were helpful in assessing the adequacy of volar and dorsal decompression.
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Clin. Orthop. Relat. Res. · Oct 1981
Case ReportsIrreducible fracture-dislocations of the ankle associated with interposition of the tibialis posterior tendon: case report and review of the literature of a specific ankle fracture syndrome.
A severe closed pronation-eversion fracture-dislocation of the ankle that was irreducible by closed means was encountered. Exploration to accomplish open reduction revealed displacement of the tibialis posterior tendon through the diastasis between the distal tibia and fibula. The tibialis posterior tendon was found to pass posteriorly to an anteriorly between the distal tibia and fibula and laterally to medially across the anterior surfaces of the distal tibia and neck of the talus. ⋯ Internal fixation was then performed uneventfully. Two previous similar cases of irreducible ankle fractures due to displacement of the tibialis posterior tendon through the diastasis between the distal tibia and fibula have been reported in the literature. This uncommon syndrome is reported as a possible etiology to be considered when failure of reduction of an ankle fracture is encountered.
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Clin. Orthop. Relat. Res. · Oct 1981
Case ReportsHypophosphatemic vitamin D refractory osteomalacia with bilateral femoral pseudofractures.
The case of a young adult female who developed multiple orthopedic problems associated with genetic osteomalacia is presented. Pathologically in the subcapital regions of both proximal femurs severe osteomalacic callus through stress fractures was demonstrated.
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Clin. Orthop. Relat. Res. · Sep 1981
Anesthetic considerations for the patient with osteogenesis imperfecta.
Anesthetizing a patient with osteogenesis imperfecta is an uncommon and challenging event for most anesthesiologists. The manifestations of this disease directly affect anesthetic management. ⋯ Local or regional anesthesia is very useful in patients with osteogenesis imperfecta, but when general anesthesia is mandatory ketamine hydrochloride is often a good choice. Close monitoring during anesthesia and surgery is essential.