ABSTRACT
The displaced supracondylar fracture of the humerus in children is a very difficult injury to treat. Manipulation and splint immobilization is perhaps the most common method. A review of the literature on 1708 comparable cases revealed that several different treatments were used. The worst results occurred with manipulation and splint immobilization alone. The best results occurred with traction techniques and well-performed Kirschner-pin transfixation, either open or closed. Complications such as Volkmann's ischemic contracture and myositis ossificans are rare. A completely displaced supracondylar fracture in a child should not be treated by manipulation and splint immobilization alone.
Subject(s)
Elbow Injuries , Humeral Fractures/therapy , Joint Dislocations/therapy , Bone Wires , Child , Fracture Fixation, Internal , Humans , Humeral Fractures/complications , Joint Dislocations/complications , Manipulation, Orthopedic , Splints , TractionABSTRACT
Osteoid osteoma has been accepted as a distinct clinical and pathologic entity for more than 50 years. Surgical curettage will often cure the lesion, although en bloc excision is now the preferred treatment. The development of local recurrence after surgery, although rare, has been well documented after both curettage and en bloc excision. Symptomatic recurrence of an osteoid osteoma was seen ten years after surgical curettage. Its occurrence at the same site as the original lesion is consistent with the concept that it had originated from residual tissue and is in keeping with the concept of osteoid osteoma as a benign tumor.
Subject(s)
Bone Neoplasms/surgery , Osteoma, Osteoid/surgery , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/pathology , Female , Humans , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/pathology , Osteoma, Osteoid/diagnostic imaging , Osteoma, Osteoid/pathology , RadiographyABSTRACT
The use of the Wagner leg lengthening external fixator is described in six patients with extensive segmental fractures of the femoral shaft. Good fixation of the fracture is combined with the facility for distraction and lengthening of the early reparative callus up to 10 weeks after injury. The method is recommended for those patients in whom shortening and malalignment of the fracture persist as union proceeds.
Subject(s)
Bone Lengthening/instrumentation , Femoral Fractures/therapy , Fracture Fixation/methods , Adult , Female , Femoral Fractures/diagnostic imaging , Fracture Fixation/instrumentation , Humans , Male , Middle Aged , Radiography , Time FactorsABSTRACT
Two patients sustained circumferential burns to the fingers associated with metal rings. The first case was caused by molten zinc and was treated by early burn excision and split skin grafting, while the second case was an electrical burn caused by a car battery and was treated conservatively.
Subject(s)
Burns, Electric/etiology , Burns/etiology , Finger Injuries/etiology , Gold , Platinum , Adult , Burns/surgery , Burns, Electric/therapy , Electric Conductivity , Finger Injuries/therapy , Humans , Male , Thermal ConductivityABSTRACT
A retrospective questionnaire study, by post, revealed that 69% of patients, still living following first tumour recurrence, had detected the recurrence themselves prior to routine clinic appointments. Nearly 90% developed their first recurrence in the first 5 years following primary surgical treatment. Not only could the length of routine clinic follow-up after primary melanoma treatment be shortened, but with further education of the patient and involvement of the general practitioner it seems likely that patients can be trusted to detect their own recurrences and seek appropriate advice.
