ABSTRACT
Humeral fractures in the setting of multi-trauma are usually managed with internal fixation. We prospectively followed nine patients treated with an expandable nail (Fixion, DiscoTech, Medical Technologies, Herzliya, Israel), until union. Internal fixation rapidly stabilises the injured limb, and the lack of distal cross-bolting in this device markedly reduced our operative time. There were no complications in our series and there was evidence of clinical and radiological union within 6 months. We found the nail easy to use and effective in this clinical setting.
Subject(s)
Bone Nails , Fracture Fixation, Intramedullary/instrumentation , Humeral Fractures/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Female , Fracture Fixation, Intramedullary/methods , Humans , Humeral Fractures/diagnostic imaging , Male , Middle Aged , Multiple Trauma/surgery , Prospective Studies , Radiography , Range of Motion, Articular , Shoulder Joint/physiopathologySubject(s)
Abscess/etiology , Arthroplasty, Replacement, Hip/adverse effects , Diverticulitis, Colonic/etiology , Fistula/etiology , Abscess/surgery , Diverticulitis, Colonic/surgery , Hip Prosthesis , Humans , Male , Middle Aged , Postoperative Complications , Prosthesis Failure , Reoperation , Sepsis/etiologyABSTRACT
In a prospective study, 63 tibial shaft fractures were managed by intramedullary nailing with a solid nail inserted without reaming. The patients were followed to union or a definitive outcome (non-union or death). Three patients died early in the post operative course as a result of other injuries. This left 60 nails in the series for complete follow up. Eighty-two per cent of the fractures were the result of motor vehicle accidents, 44 nails were inserted within 72 h of injury. Fifty-six fractures united (93%) at a mean of 21.1 weeks (8-52). There were 4 non-unions among this population of multiply injured patients. All closed fractures united at a mean of 19.5 weeks. Those nailed acutely united at a mean of 16.8 weeks. The open fracture group (classified according to Gustilo and Anderson) included the 4 non-unions (2 type II, 1 type IIIa and 1 type IIIb). A union rate of 86.2% was achieved in these fractures. All type I fractures united. One deep infection occurred in the series. The major complication identified in the current series was failure of the distal cross bolts.
Subject(s)
Bone Nails , Fracture Fixation, Intramedullary/methods , Multiple Trauma/surgery , Tibial Fractures/surgery , Adolescent , Adult , Aged , Female , Fractures, Closed/surgery , Fractures, Open/surgery , Humans , Male , Middle Aged , Postoperative Complications , Prospective Studies , Radiography , Tibial Fractures/diagnostic imaging , Treatment OutcomeABSTRACT
A significant association between slipped upper femoral epiphysis (SCFE) and subtalar arthritis causes peroneal spastic flatfoot. Three patients with this association were observed in 136 cases of SCFE, an incidence of 2.3%; the anticipated incidence would be 0.4%. We postulate that both conditions reflect an underlying immunologic disorder.
Subject(s)
Epiphyses, Slipped/complications , Flatfoot/etiology , Muscle Spasticity/complications , Adolescent , Bone Nails , Epiphyses, Slipped/surgery , Female , Humans , Male , Peroneal NerveABSTRACT
Reduction of a femoral shaft fracture before introducing a guidewire may be difficult, and time consuming. We report the use of a clamp to facilitate reduction and reduce exposure of the operator to radiation.
Subject(s)
Femoral Fractures/surgery , Femur/surgery , Fracture Fixation, Intramedullary/instrumentation , HumansABSTRACT
Our experience of five children with chronic thorn synovitis indicates that removal of free thorn fragments and all the macroscopically abnormal synovium is required in order to achieve a complete cure. Four children required total synovectomy for diffuse proliferative synovitis and one needed partial synovectomy of the area immediately around the embedded thorn. Joint washouts and partial synovectomy were unsuccessful in children with diffuse synovitis. Careful review is required following removal of a thorn as fragments may be retained within the joint.
