1/46. 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) |
2/46. Complete transection of the median and radial nerves during arthroscopic release of post-traumatic elbow contracture.Arthroscopic debridement and capsular release was performed in a 57-year-old woman because of post-traumatic stiffness in the dominant right elbow joint. During this procedure, the median and radial nerves were completely transected. A few recent reports of small series have described encouraging results after arthroscopic capsular release of post-traumatic elbow contracture, but the present case demonstrates the inherent risk of damage to neurovascular structures.- - - - - - - - - - ranking = 6keywords = trauma (Clic here for more details about this article) |
3/46. Transcranial doppler detection of fat emboli.BACKGROUND AND PURPOSE: The fat embolism syndrome (FES) is characterized by the simultaneous occurrence of pulmonary and neurological symptoms as well as skin and mucosal petechiae in the setting of long-bone fractures or their surgical repair. Its pathophysiology is poorly understood, and effective treatments are lacking. We present 5 patients with long-bone fractures in whom in vivo microembolism was detected by transcranial Doppler. methods: Five patients with long-bone fractures were monitored with transcranial Doppler for microembolic signals (MESs) after trauma. Two patients also had intraoperative monitoring. A TC-2020 instrument equipped with MES detection software was used. Detected signals were saved for subsequent review. Selected signals satisfied criteria defined previously and were categorized as large or small. RESULTS: Cerebral microembolism was detected in all 5 patients and was transient, resolving within 4 days of injury. Intraoperative monitoring revealed an increase in MESs during intramedullary nail insertion. The characteristics of MESs after injury varied among patients, with large signals being more frequent in the only patient with a patent foramen ovale. CONCLUSIONS: Cerebral microembolism after long-bone fractures can be detected in vivo and monitored over time. These findings may have potential diagnostic and therapeutic implications.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
4/46. Consequences of a fracture through a minimally ossified apophysis of the olecranon.The case of a 12-year old boy with a missed olecranon fracture after an elbow trauma is presented. knowledge of the ossification patterns around the elbow is essential in evaluating elbow trauma in children. Certain fractures of the immature elbow present diagnostic difficulty, which can lead to missed or delayed diagnosis, with possible permanent functional loss that timely diagnosis and treatment might avoid. This is particularly true for those fractures running through unossified portions of the elbow. Such a case is described.- - - - - - - - - - ranking = 2keywords = trauma (Clic here for more details about this article) |
5/46. Transient posttraumatic cystlike lesions of bone.Cystlike cortical defects appearing after minor greenstick fractures in children have occasionally been described. These lesions are typically asymptomatic and appear just proximal to the fracture line within the area of subperiosteal new bone formation. Although the pathogenesis of these lesions remains in doubt, complete resolution is the rule, with no adverse effect on fracture healing. Only 18 cases of these transient postfracture cysts have previously been reported in the English-language literature. We present two additional cases of cyst formation after greenstick fracture of the distal radius in children aged 2.5 and 5.5 years. The natural history of such lesions is discussed and the current theories on their pathogenesis are reviewed.- - - - - - - - - - ranking = 4keywords = trauma (Clic here for more details about this article) |
6/46. 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) |
7/46. Surgical treatment of posttraumatic radioulnar synostosis in children.The authors describe two children who underwent surgical treatment of radioulnar synostosis. One case involved simple excision; the other, excision and interposition of Gore-Tex vascular graft material. In a review of the literature, no other report of the latter type of surgical treatment was found. A discussion of the literature concerning this rare complication in children and the current surgical treatment options are included.- - - - - - - - - - ranking = 4keywords = trauma (Clic here for more details about this article) |
8/46. Limb conservation using non vascularised fibular grafts.This paper highlights the use of non-vascularised fibular graft in limb reconstruction from bone loss due to trauma and infection. Bone loss can occur from severe high velocity injuries due to road traffic accidents, severe neglected infections, and osteolytic tumours. In majority of cases, the surgeon is left with the only option of an amputation especially where there is no access to microvascular surgery and microvascular bone grafting devices. This is a major problem in the West African subregion hence the need for this article. We present illustrative cases of limb conservation in an adult involved in a high velocity trauma and a child with a destructive osteolytic infection culminating in bone loss. The patients are still been followed up in our surgical outpatient clinics.- - - - - - - - - - ranking = 2keywords = trauma (Clic here for more details about this article) |
9/46. Rapid diagnosis of an ulnar fracture with portable hand-held ultrasound.Orthopedic fractures are a common injury in operational activities, which are injuries that often occur in isolated or hostile environments. Clinical ultrasound devices have become more user-friendly and lighter, allowing them to be easily transported with forward medical teams. The bone-soft tissue interface has a very large acoustic impedance with a high reflectance that can be used to visualize breaks in contour including fractures. Herein reported is a case of an ulnar fracture that was quickly visualized in the early phase of a multisystem trauma resuscitation with a hand-held ultrasound device. The implications for operational medicine are discussed.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
10/46. Posttraumatic radioulnar synostosis treated with a free vascularized fat transplant and dynamic splint: a report of two cases.Two cases of posttraumatic radioulnar synostosis are presented. The patients were treated with excision of the cross-union and interposition of a free vascularized fat transplant. A newly devised pronation-supination dynamic splint was employed for 3 months postoperatively in both patients. After a 1-year postoperative follow-up, an increased range of motion was restored in both cases, and there was no evidence of recurrent synostosis formation in subsequent radiographs. We suggest that an interposed vascularized fat graft may be an ideal biologic barrier to fill the space created by cross-union excision.- - - - - - - - - - ranking = 5keywords = trauma (Clic here for more details about this article) |
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