ABSTRACT
A humeral shaft fracture results in a nonunion in less than 10% of cases, regardless of the technique used. The treatment of such cases must be different from the initial treatment. In a pseudarthrosis of the medial shaft of the humerus with a transverse or short oblique line, a suitable procedure is medullary filling with Hackethal nails or a Küntscher nail. If the fracture line is long and oblique, spiral, fragmented or distant from the narrow part of the humeral shaft, a modified interlocking intramedullary nail is recommended.
Subject(s)
Bone Nails , Humeral Fractures/complications , Pseudarthrosis/etiology , Adult , Aged , Female , Fracture Fixation, Intramedullary , Humans , Humeral Fractures/diagnostic imaging , Male , Middle Aged , Pseudarthrosis/diagnostic imaging , Pseudarthrosis/surgery , RadiographyABSTRACT
Healing was obtained in 21 fractures with delayed union or pseudarthrosis by stimulation of the bone with electromagnetic waves. The interest of this method lies in a number of factors: the apparatus Centicure is miniaturized and very easy to handle; the daily treatment is performed by the patient himself; and application may be split, allowing normal and even professional activity. The method requires no immobilization nor surgical electrode implantation, the cost of the treatment is low and the apparatus can be used for several patients. Bone healing was seen in 15 cases of the 19 reviewed after a brief treatment period. Stimulation by means of magnetic fields, on the other hand, has obvious drawbacks, including high costs.
Subject(s)
Fractures, Ununited/radiotherapy , Pseudarthrosis/radiotherapy , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Osteogenesis/radiation effects , RadiationABSTRACT
In a reported case of accidental high pressure injection of white spirit into a finger, the authors emphasise the great contribution of regional anaesthesia maintained from the initial trauma until the lesions are stable. Trauma to the hand caused by injection of paint or grease solvents results in tissue destruction and later necrosis and fibrosis. Secondary amputations are required in many cases. Regional anaesthesia of the stellate ganglion and brachial plexus produces analgesia and vasodilatation of peripheral arteries by inhibition of the sympathetic tone. This vasodilatation limits the necrotic process and promotes the supply of drugs to the injured tissues. Regional anaesthesia is of great benefit for surgical excision and avoids extended amputation.
