Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
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Comparative Study
Management of displaced radial neck fractures in children: percutaneous pinning vs. elastic stable intramedullary nailing.
The treatment of radial neck fractures in children varies according to the displacement, angulation, and skeletal maturity. There is a general agreement that displaced radial neck fractures with more than 30° angulations (Judet type III and IV fractures) should be surgically treated. There are several treatment possibilities for Judet type III and IV fractures including percutaneous pin reduction, elastic stable intramedullary nailing (ESIN), and open reduction with or without internal fixation. In this retrospective study we compared the clinical and radiographical outcomes, and complications following intramedullary versus percutaneous pinning in displaced radial neck fractures in children. ⋯ In this research the clinical outcome, assessed with the MEPS, and the radiological alignment, were comparable between the subjects that were treated with percutaneous pinning and those with ESIN techniques; whereas the ESIN technique demonstrated higher ROM in flexion, extension and pronation. The ESIN technique seems to be the ideal approach both for the higher ROM values and for the absence of complications.
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Comparative Study
Effectiveness of synthetic hydroxyapatite versus Persian Gulf coral in an animal model of long bone defect reconstruction.
There is a continuing search for bone substitutes to avoid or minimize the need for autogenous bone grafts. Hydroxyapatite, a crystalline phase of calcium phosphate found naturally in bone minerals, has shown tremendous promise as a graft material. Coral is an osteoconductive material used as a bone graft extender. This study examined the effect of hydroxyapatite and Persian Gulf coral on osteogenesis in vivo using a rabbit model of bone healing. ⋯ According to this study, significant difference was not observed between hydroxyapatite and natural coral and these two materials were significantly better than the control group at 8 weeks postinjury.
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Fractured neck of femur patients represent a large demand on trauma services, and timely management results in improvements in morbidity and mortality. NICE guidance, advocating surgery on the day of admission or the following day, emphasises this. We set out to investigate whether a simulated fast-track management system could improve neck of femur fracture patient care. ⋯ This coordinated management pathway improves the efficiency of the service and reduces inpatient length of stay. Increased productivity may lead to financial savings and improve our ability to meet guidelines.
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Case Reports
Triple jeopardy: transscaphoid, transcapitate, transtriquetral, perilunate fracture dislocation.
Carpal injuries are frequently underdiagnosed and underreported injuries of the hand. Scapholunate perilunate dissociation is the most common perilunate instability pattern seen in clinical practice. ⋯ We describe a case with this unique pattern of injury, explaining its mechanism and treatment. Good outcome can be achieved in these injuries following open reduction and internal fixation with ligamentous repair.