Osteossíntese de fêmur e tíbia em veado-catingueiro (Mazama gouazoubira): relato de caso / Osteosynthesis of the femur and tibia of a brown brocket deer (Mazama gouazoubira): case report

O presente estudo relata o caso de um veado-catingueiro jovem, provindo de vida livre e com histórico de atropelamento. Posteriormente à realização de exames, o animal foi diagnosticado com fratura exposta distal de tíbia (Salter-Harris tipo I) e fratura cominutiva de metáfise distal de fêmur, ambas em membro pélvico esquerdo. Para a osteossíntese da tíbia, foram utilizados pinos intramedulares de Steinmann inseridos pelos maléolos lateral e medial, de forma cruzada. A osteossíntese do fêmur foi realizada com associação de dois pinos de Steinmann, conforme técnica modificada de Rush, e placa de compressão dinâmica. As técnicas cirúrgicas adotadas foram satisfatórias para estabilização, consolidação de ambas as fraturas e retorno funcional do membro. Após 90 dias da cirurgia, o animal foi reintroduzido à natureza.(AU)

The present study reports the case of a juvenile wild brown brocket deer, with car accident history. After a complete examination, the animal was diagnosed with open distal tibial fracture (Salter-Harris type I) and comminuted fracture of the distal metaphysis of the femur, both in the left hindlimb. For the tibial osteosynthesis, Steinmann pins were used intramedullary, inserted by the lateral and medial malleolus, crosswise. The osteosynthesis of the femur was performed with a combination of two Steinmann pins, as modified Rush technique, and a dynamic compression plate. The surgical techniques used were satisfactory for stabilization, consolidation of both fractures and function return of the member. Ninety days after surgery the animal was reintroduced to nature.(AU)

Comparative study on clinical effects of therapeutic methods on child distal fracture of radius / 医疗卫生装备

Objective To explore the clinical effects of therapeutic methods on child distal fracture of radius.Methods Totally 180 children with distal 212 fractures of radius from January 2012 to December 2015 in some hospital were enrolled into three treatment groups and a control group,of whom,there were 58 ones in a treatment group with external fixation support (external fixation group),58 ones in a treatment group with T-shaped plate internal support (T-shaped plate group),56 ones in a treatment group with Kirschner wire internal fixation (Kirschner wire group) as well as 40 ones in the control group with manual reduction and plaster external fixation.The clinical effects in the four groups were observed,and function scoring was carried out according to Dienst standard.Results The excellent rates in the external fixation group,T-shaped plate group,Kirschner wire group and control group were 72.41％,53.57％,82.76％ and 45％ respectively.The external fixation group had the excellent rate with no significant difference with that in T-shaped plate group (P＞0.05),while obviously higher than that in Kirschner wire group (P＜0.05),and Kirschner wire group had the excellent rate statisticallyhigher than that in the control group (P＜0.05).The external fixation group,T-shaped plate group and Kirschner wire group had the satisfaction significantly higher than that in the control group (P＜0.05).Conclusion Compared with the traditional reduction and Kirschner wire fixation,the external fixation and T-shaped plate fixation have better clinical effects.The treatment of child distal fracture of radius should be planed according to the type of fracture,stability,age,economic condition and substance of the bones of the patient.

Treatment strategies of the fractures of distal radius and related studies: An update / 医学研究生学报

For the treatment of fractures the distal radius, open reduction and internal fixation with a volar locking plate is most frequently used in addition to conservative therapy, external fixation, and percutaneous needle puncture.Some new implants, such as bridging plates, intramedullary nails, and wrist prosthesis, have also gained clinical application.In the recent years, some new techniques like wrist arthroscopy, new bone cement, 3D printing, and digital technology have provided more accurate and stable diagnosis and treatment of the disease.In spite of a variety of strategies, the treatment of fractures the distal radius is focused on the restoration and maintenance of the volar tilting angle and the ulnar inclination in the distal radius.Doctors need to consider the injury characteristics and rehabilitation requirements of the patients and choose the simplest and safest methods to achieve optimal outcomes.

Combined Anterolateral and Lateral Approaches in Treatment of Extra-articular Fracture of the Distal Humerus

PURPOSE: The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve. MATERIALS AND METHODS: We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function. RESULTS: Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications. CONCLUSION: The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.

Operative Treatment of Distal Clavicle Fracture Nonunion

PURPOSE: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. MATERIALS AND METHODS: The subjects were 8 patients (average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. RESULTS: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. CONCLUSION: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

MIPPO Technique using DCS in Comminuted Fracture of the Distal Femur / 대한정형외과학회잡지

PURPOSE: To evaluate the advantages of transarticular reconstruction and fixation by MIPPO (Minimally Invasive Percutaneous Plate Osteosynthesis) using DCS in comminuted fractures of the distal femur. MATERIALS AND METHODS: From February, 1998 to August, 2000, we experienced 23 cases of comminuted fractures of the distal femur, which were treated by MIPPO and lateral parapatellar arthrotomy in most cases. The follow up period was minimally 12 months. Clinical results were evaluated using Neer scores, radiographic results and the presence of clinical complications. RESULTS: According to the Neer scores, 18 cases (78.3%) showed satisfactory results and 5 cases (21.7%) unsatisfactory results. The average period until radiographic union was 16 weeks (range 11-20 weeks). As for alignment measured using the tibiofemoral angle, 2 cases showed valgus deformity and no posterior angulation was present over 10dgrees. As for complications, 1 case showed a leg length discrepancy of 2 cm and 5 cases showed delayed union, which showed a gap radiographically between the bone fragment at the site of the fracture, and callus formation on ultrasound, but which did not need a bone graft. The radiographic union was achieved at the final follow-up. CONCLUSIONS: In the case of comminuted fractures of the distal femur, transarticular reconstruction and fixation by the MIPPO technique using DCS could reduce complications including non-union and infection.