ABSTRACT
We describe the treatment by subperiosteal resection of an aneurysmal bone cyst in the distal fibula in eight patients and highlight the role of the periosteum in the regeneration of bone defects. The mean age of the patients was 13.5 years (12 to 17). Seven had an open growth plate. The mean size of the resected specimen was 5.12 cm (3.5 to 8.0). None of the patients received instillation of bone marrow, autogenous bone graft, allograft or any synthetic bone substitutes. All had complete regeneration of the bone defect within three to nine months, with no joint instability or recurrence. The mean length of follow-up was 11.5 years (2 to 18). At the final follow-up there was no difference in the range of movement, alignment or stability of the ankle when compared with the opposite side. The periosteum played a major role in the complete filling of the bone defects and avoided the morbidity of other techniques.
Subject(s)
Bone Cysts, Aneurysmal/surgery , Fibula/surgery , Periosteum/surgery , Adolescent , Bone Cysts, Aneurysmal/diagnostic imaging , Bone Regeneration/physiology , Child , Curettage/methods , Female , Fibula/diagnostic imaging , Humans , Male , Periosteum/diagnostic imaging , Radiography , Secondary Prevention , Suture Techniques , Treatment OutcomeABSTRACT
One hundred seventeen children with tibial shaft fractures were treated by above knee cast with or without traction depending on stability. All fractures united in an average period of 37 days. Reevaluation after 3-10 years showed that initial shortening, fracture type, fracture location, and age of the patient affected growth acceleration, whereas the initial angular magnitude, direction, and planes, as well as the type of the fracture, the age of the patient, and length of follow-up period, affected correction of angulation. We concluded that: shortening can be compensated by growth acceleration; varus deformities can undergo spontaneous correlation whereas valgus deformity and posterior angulation partially persist and rotational deformities persist.
Subject(s)
Tibia/growth & development , Tibial Fractures , Accidental Falls , Accidents, Traffic , Adolescent , Age Factors , Casts, Surgical , Child , Child, Preschool , Evaluation Studies as Topic , Female , Follow-Up Studies , Fractures, Open/surgery , Humans , Immobilization , Infant , Leg Length Inequality/etiology , Male , Tibial Fractures/therapy , Traction , ViolenceABSTRACT
The main problems encountered in the management of comminuted four-part intertrochanteric fractures in the elderly are instability, severe osteoporosis and the need for early mobilization. Thirty-one patients, average age 75 years, with such fractures were operated on using a sliding blade-plate and the Debrunner-Cech valgus osteotomy. The follow-up was from 1-5 years with an average of 3.2 years. All patients were got out of bed on the first postoperative day and walked with help on the second day. The fractures united in 29 patients. The one exception occurred when the blade cut out of the neck; the operation was repeated with a good result. Two further patients died in the postoperative period. We conclude that this method is the best treatment for osteoporotic four-part intertrochanteric fractures.
Subject(s)
Hip Fractures/surgery , Osteoporosis/complications , Osteotomy/methods , Aged , Aged, 80 and over , Bone Plates , Bone Screws , Female , Follow-Up Studies , Hip Fractures/complications , Hip Fractures/diagnostic imaging , Humans , Male , Middle Aged , RadiographyABSTRACT
A rare case of bilateral traumatic dislocation of the hip with ipsilateral femoral shaft fractures occurred in a 29-year-old man. Reduction was achieved by manipulation, despite the presence of a femoral shaft fracture on one side. A review of the literature reveals reports of three similar cases.
