Chondro-epiphyseal separation of the distal humerus in the newborn. A case report and review of the literature

Chondro-epiphyseal separation of the distal humerus is a rare injury, and when it occurs in the newborn, it may be difficult to diagnose and is easily mistaken for a dislocation of the elbow. The unimpressive clinical appearance of such an injury of the elbow in an infant, as well as the absence of ossific nuclei of the distal humerus in the newborn, are responsible for the dilemma in making the diagnosis. Ultrasonography, a readily available, non-invasive technique, can be used to evaluate the non-ossified epiphysis about the elbow of infants to demonstrate dislocations, fractures, and physeal separations. Closed reduction with or without percutaneous Kirschner wire fixation is the treatment of choice for these injuries. In this article, we report on a case of complete epiphyseal separation in a neonate and discuss the problems arising in its diagnosis

Lateral rotation osteotomy of the humerus fixed by plate for obstetrical brachial plexus palsy

Plate fixation for a lateral rotation osteotomy of the humerus was used in 8 patients with disabling loss of lateral rotation at the shoulder due to brachial plexus birth injuries. The study was performed in Orthopedic Department at Assuit University Hospital between 1991 and 1994. The youngest patient was 4 years old and the oldest was 11. The osteotomy was performed between the humeral attachment of the pectoralis major and deltoid muscles. The length of the plate ranged between 4-6 holes according to the age of the patient. The operative technique and complications were discussed. Plate fixation could control the desired amount of lateral rotation of the humerus which could improve the function, the appearance and the independence of these handicapped patients

Lesión obstétrica de plexo braquial: una entidad clínica poco conocida / Obstetric injury of brachial plexus: a not much known clinical disease

This complication is possible to observe in about 900 new cases per year, but 20 for percent are submitted to surgical treatment. In our hospital, the microsurgical unit have developed the technique in order to treat this complication

Lesiones traumáticas periféricas durante el parto / Peripheral lesions occurred during delivery

Se hizo un estudio retrospectivo de la incidencia de traumatismo de parto en un piso de Neonatología en el Hospital ERM-IPSS, en un total de 8535 casos, correspondientes a 3 años. Se les agrupó según peso, tipo de parto y clase de traumatismo, relacionando estos parámetros entre sí. En cuanto al peso, se consideró 3 categorías: bajo, normal y macrosómico. Los tipos de parto considerados fueron: parto normal, cesárea, podálico e instrumentado. Se estudió las lesiones periféricas ocasionadas durante el parto, habiéndose encontrado 221 traumatismos (2.5 por ciento), que incluían: fractura de clavícula, cefalohematoma, parálisis obstétrica y otros. Se encontró que la mayor incidencia de traumatismos se produjo en los RN con vacuum y las lesiones que predominaron fueron el cefalohematoma y la fractura de clavícula, no hallándose entre ellas diferencia estadísticamente significativas