1/54. Sideswipe elbow fractures.A retrospective review of all cases of sideswipe elbow fractures (SSEFs) treated at two community hospitals from 1982 to 1992 was conducted to determine the functional outcome of the operative treatment of SSEFs. All five injuries involved the left elbow, and they included open fractures of the olecranon, the radius and ulna, the ulna and humerus, the humerus, and traumatic amputation of the arm. Concomitant injuries included three radial nerve palsies and two injuries each to the median nerve, ulnar nerve, and brachial artery. Treatment included irrigation, debridement (repeated if necessary), open reduction and internal fixation, external fixation (one case), and delayed amputation (one case). An average of 130/-10 degrees elbow flexion/extension, and 60/60 degrees supination/pronation was obtained for the three of four patients with reconstructions who returned for follow-up.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
2/54. Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression-osteodistraction.We have treated 33 young men with medium to large (3-8 cm) bony and soft tissue defects of the lower third of the face caused by gunshot wounds. After debridement, collapsing the proximal segments for primary approximation of soft and hard tissues and a closed osteotomy of a small fragment of mandible, we used an original compression-distraction device, designed in 1982 and tested during 1983 (analogous devices were absent at that time) to reposition the mandible and cause callus to form (during distraction) between the fragment and to use the remaining stumps of bone to fill in the defect. The soft tissues were repaired at the same time. Twenty-eight of the patients presented within a few hours of injury, and the remaining five had old injuries. The only complications were in the group with old injuries where four patients developed abscesses that required drainage, but these did not interfere with the process of osteogenesis. All 33 patients had good functional and aesthetic results within 3-4.5 months. The method allows a bloodless minimally traumatic procedure which can be carried out in one stage. The results compare very favourably with the classic methods of the treatment of mandibular gunshot injuries.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
3/54. Unilateral comminuted and complicated fracture of the mandible due to dog attack.Fractures of the mandible and their management are discussed in detail in textbooks and articles dealing with facial trauma. This paper presents the management and treatment of a case of a unilateral comminuted and complicated fracture of the mandible due to dog attack on a geriatric patient. The attack also severed the patient's right arm. Due to the severity of the trauma, an emergency surgery was performed on the mandible and arm.- - - - - - - - - - ranking = 2keywords = trauma (Clic here for more details about this article) |
4/54. Comminuted pelvic ring disruption in toddlers: management of a rare injury.Pediatric pelvic fractures are rare injuries. The clinical management, classification, and operative treatment of this type of injury was presented in two toddlers ranging in age from 1 to 3 years. The CT examination proved to be the most reliable diagnostic tool for the assessment of the fracture morphology. The findings of the CT examination provide the possibility for an exact classification and operative planning. The surgical treatment was performed with the AO instrumentation for small fragments by using the approved standard approaches of adult surgery. The postoperative management has to be adapted to the physiology of the children. It is important to remove the osteosynthesis material in due time to avoid the risk of epiphysiodesis at the pelvis. To detect late sequelae of the trauma, follow-up should be performed regularly until growth is completed.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
5/54. Centralization of ulna for infected nonunion of radius with extensive bone loss. A modified Hey-Groves procedure.We describe a case of infected nonunion of the radius with extensive bone loss in an 11-year-old boy treated by centralization of the ulna. The technique used differs from the original Hey Groves procedure in that it preserves the distal end of the ulna with its important triangular fibrocartilage complex, thereby retaining stability and contour of the wrist joint. Our patient obtained a functionally and cosmetically satisfactory, stable forearm and wrist. We present the technique as a useful armament in the management of extensive bony defect of the radius arising from trauma or infection.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
6/54. Management of severe postnasal haemorrhage: the Kingsley splint revisited.Postnasal haemorrhage accompanying severe craniofacial trauma may have catastrophic consequences if not arrested promptly. The airway has usually been secured and the cervical spine stabilized, but apart from fluid replacement, other attempts to control haemorrhage in the resuscitation room of the accident and emergency department may be to no avail. We wish to draw attention to a simple device that was introduced over 100 years ago and which may rapidly aid haemostasis and prevent the onset of hypovolaemic shock.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
7/54. Traumatic posterior rotatory fracture-dislocation of lumbo-sacral spine.Fracture-dislocation of the lumbo-sacral spine was an unusual injury and was divided into anterior, posterior and lateral types depending on the displacement of the cephalad portion of the spine over the caudal portion. According to the authors' knowledge, only 31 cases of traumatic fracture-dislocation of the lumbo-sacral spine were reported in the English literature. Only 3 previous reports referred to this injury with a posterior displacement, which was an even rarer injury. This was the fourth report of this type of injury.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
8/54. titanium mesh repair of the severely comminuted frontal sinus fracture.BACKGROUND: Severely comminuted frontal sinus fractures are difficult to contour and immobilize. Frequently, plates or wires are inadequate in fixating all fragments together, resulting in less than optimal outcomes. Advancements in the development of biomaterials have now made titanium mesh a new option for the repair of severely comminuted fractures. methods: Fourteen patients with severely comminuted frontal sinus fractures were treated with titanium mesh from 1994 to 1999. The fractures were reduced and immobilized using a simple algorithm: (1) Isolated anterior table fractures were repaired with reduced bony fragments attached to titanium mesh. (2) Anterior table fractures with nasofrontal duct involvement were repaired by sinus obliteration and anterior wall reconstruction with reduced bony fragments attached to titanium mesh. (3) Anterior and posterior table fractures with cerebrospinal fluid leak or displacement were treated with the cranialization of the sinus and anterior wall reconstruction with reduced bony fragments attached to titanium mesh. RESULTS: Of the 14 patients treated, 12 were available for postoperative evaluation. Parameters such as nasal function, cranial nerve V and VII function, cosmesis, and complications (hardware extrusions, sinusitis, meningitis, osteomyelitis, mucopyocele, brain abscess, pneumocephalus, and cerebrospinal fluid leak) were evaluated. All patients had good function of the superior division of cranial nerves V and VII. Two patients (16%) had minor wound infections, which resolved under treatment with antibiotics. All had excellent cosmetic results as measured by postreduction radiographs and personal and family perceptions of forehead contour. CONCLUSION: titanium mesh reconstruction of severely comminuted frontal sinus fractures has few complications while providing excellent forehead contour and cosmesis.- - - - - - - - - - ranking = 0.25388063831624keywords = brain (Clic here for more details about this article) |
9/54. Secondary ulnar nerve palsy in adults after elbow trauma: a report of two cases.Secondary ulnar nerve palsy, an unusual condition in which the onset of ulnar nerve dysfunction occurs 1 to 3 months after elbow trauma, can be the cause of sudden deterioration of elbow function. Initially recognized in 1899, this condition has not been reported often. We describe 2 patients who had no subjective or objective evidence of ulnar nerve dysfunction after elbow trauma but had a sudden loss of motion, pain, and clinical and electrophysiologic evidence of ulnar nerve compression at the elbow 4 to 5 weeks after trauma. Marked improvement occurred after ulnar nerve subcutaneous transposition and contracture release.- - - - - - - - - - ranking = 7keywords = trauma (Clic here for more details about this article) |
10/54. Proximal ulna shaft fractures and associated compartment syndromes.In 1996, 6 (7%) of 84 ulna shaft fractures treated at our institution developed compartment syndrome. These 6 isolated, comminuted, proximal-third ulna fractures were secondary to low-velocity gunshot (5) or high-velocity blunt trauma (1). The 5 gunshot-induced fractures did not initially require immediate surgical intervention, but increasing compartment pressure prompted fasciotomy and open reduction and internal fixation. The blunt trauma fracture developed compartment syndrome while the patient awaited surgery; emergent fasciotomy and open reduction and internal fixation were performed. Three patients had vascular injury (interosseus system). The orthopedist must have a high index of suspicion for compartment syndrome in association with isolated, comminuted, proximal-third ulna fractures.- - - - - - - - - - ranking = 2keywords = trauma (Clic here for more details about this article) |
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