Fractura compleja del húmero asociada a parálisis radial / Complex Fracture of the Humerus Associated with Radial Paralysis

Las fracturas de la diáfisis humeral son lesiones que se producen con frecuencia como parte de caídas o de accidentes de alta energía y se asocian con parálisis del nervio radial. Se presenta paciente de 43 años de edad, masculino, que sufre accidente automovilístico que le produce fractura diafisaria del húmero derecho multifragmentaria, por lo cual se le realiza reducción cerrada y osteosíntesis con clavo intramedular acerrojado y tratamiento conservador para la parálisis radial. La evolución fue satisfactoria, el paciente se recuperó de la parálisis a los 4 meses y logró la consolidación completa a los 5 meses. Tras un año de evolución no presenta dolor en el hombro, y tiene movilidad completa del hombro, muñeca y dedos a la extensión(AU)

Diaphyseal fracture of humerus are frequent lesions, resulting from falls or high energy accidents; they are associated to radial nerve palsy. We report the case of a 43 years old male patient, who suffered a multifragment diaphyseal fracture of his right humerus, as a result of a car accident. He underwent a closed reduction and osteosynthesis using a locking intramedullary nail for the radial paralysis. His evolution was satisfactory; this patient recovered from the paralysis after four months and he managed full consolidation five months later. After a year, he did not have any pain in his shoulder, he has full mobility of his shoulder, wrist and fingers when extendind(AU)

Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques

PURPOSE: We evaluated the clinical outcomes of tibia segmental fractures treated by intramedullary nailing using various reduction techniques. MATERIALS AND METHODS: From January 2003 to June 2009, 18 segmental tibial fracture patients treated by intramedullary nail were enrolled with a minimum 12-month follow-up. The mean follow-up was 38 months (range 15-72). According to the AO classification, the fractures were types 42C2.1, 42C2.2, and 42C2.3 in four, ten, and four patients, respectively. Ten fractures were closed and eight were open. We used various techniques for reduction during operation and investigated bone union time and complication (non-union, malunion etc.). RESULTS: Bone grafting was performed in three patients. Complete union was achieved in all patients. The mean time for union was 16.3 weeks (range 12-21), except in three delayed union patients. All radiological evaluations showed good alignment (less than 5 degree) except in two patients; and the mean deformity angle was 2.2 degree. Knee range of motion (ROM) was 129 degree, and ankle ROM was 68 degree. Local wound infection occurred in two patients. CONCLUSION: Intramedullary nailing is a successful method in the acute management of segmental tibial fractures, if accompanied by appropriate reduction technique.

Complications in Patients with Pertrochanteric Fractures Treated with a Gamma Asia-Pacific Locking Nail / 대한정형외과학회잡지

PURPOSE: We analysed perioperative and postoperative complications in a series of patients who had a pertrochanteric fracture which had been treated by using a Gamma Asia-Pacific Locking Nail. MATERIALS AND METHODS: A retrospective analysis was done on 44 patients who were available for follow-up over one year period. The Clinical analysis included their walking ability, buttock pain, thigh pain, and their leg length discrepancy. The correlation between radiological parameters and the incidence of complications was analysed. RESULTS: The average follow-up period was 26 months. The presence of buttock pain, thigh pain, a diminution of walking ability and a limb shortening were common findings. The amount of typical complications from a classic gamma nail in the pertrochanteric fractures of the femur were very low, but complications such as avascular necrosis of the femoral head or a refracture after removal of the nail occurred in patients who had been treated by a Gamma Asia-Pacific Locking Nail. The radiological parameters did not statistically correlate with the incidence of complications. CONCLUSION: There was mismatch of Gamma Asia-Pacific Locking Nail with Korean femorae. We recommend that a precise operative technique is essential and a modification of the nail must be made.