ABSTRACT
The authors report 7 cases of septic and aseptic pseudoarthrosis in the humerus, with or without tissue loss, treated with the Ilizarov apparatus. The method proved to be therapeutically effective, guaranteeing a short amount of time required for consolidation, with bone callus of the periosteal type which was abundant and mechanically effective, immediate functional recovery, and no important complications.
Subject(s)
Humeral Fractures/therapy , Orthopedic Fixation Devices , Pseudarthrosis/therapy , Biomechanical Phenomena , Humans , Humeral Fractures/physiopathology , Pseudarthrosis/physiopathology , Time FactorsABSTRACT
Between January 1980 and October 1986 26 cases of Volkmann's syndrome were submitted to preoperative CT scan. Thirteen were localised in the upper limb, 11 in the lower limb, and 2 were cases of pseudo-Volkmann's disease. CT scan allowed us to confirm the densitometric features and distribution of muscle infarction in the various muscle planes. Thus, two groups were distinguished, each with different densitometric features: a first group with diffuse hypodensity of the muscular sheaths with unclear borders, and a coefficient of attenuation at approximately 30-40 H.U., which at operation corresponded to diffuse fibrosis; a second group with defined hypodensity of the various muscle groups equal to 10-20 H.U., which at operation gave a macroscopic picture of infarction. CT scan provides a detailed preoperative topographical and morphological evaluation of the infarction area, and therefore a treatment plan based on a more accurate knowledge of the anatomical and pathological lesions.
Subject(s)
Compartment Syndromes/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Arm , Child , Child, Preschool , Compartment Syndromes/classification , Compartment Syndromes/surgery , Diagnosis, Differential , Female , Humans , Leg , Male , Middle Aged , Preoperative Care , Pronation , SupinationABSTRACT
From 1970 to 1985, 13 patients were treated as a result of an upper limb traumatic sub-amputation. Three of them were younger than 15 years and another one was only 3 years old at the time of the trauma. All the elements involved in the treatment of the lesions are described. When it was possible, an end-to-end anastomosis was used for the repair of arteries and veins. Otherwise, when the loss of tissue was marked, a saphenous vein graft was used. The fracture was treated, when possible, with an intramedullary fixation, surely less traumatizing for soft tissues than a plate. The repair of the nerve was at times simultaneous at other times delayed. The followup has shown a good functional restoration of the limb and of the joints affected by the trauma and a normal development of the patients in terms of age.
