Treatment options for brachial plexus injuries.

The incidence of brachial plexus injuries is rapidly growing due to the increasing number of high-speed motor-vehicle accidents. These are devastating injuries leading to significant functional impairment of the patients. The purpose of this review paper is to present the available options for conservative and operative treatment and discuss the correct timing of intervention. Reported outcomes of current management and future prospects are also analysed.

Brachial plexus injuries in adults: evaluation and diagnostic approach.

The increased incidence of motor vehicle accidents during the past century has been associated with a significant increase in brachial plexus injuries. New imaging studies are currently available for the evaluation of brachial plexus injuries. Myelography, CT myelography, and magnetic resonance imaging (MRI) are indicated in the evaluation of brachial plexus. Moreover, a series of specialized electrodiagnostic and nerve conduction studies in association with the clinical findings during the neurologic examination can provide information regarding the location of the lesion, the severity of trauma, and expected clinical outcome. Improvements in diagnostic approaches and microsurgical techniques have dramatically changed the prognosis and functional outcome of these types of injuries.

Transcalcaneal talonavicular dislocation associated with an open comminuted calcaneal fracture: a case report.

The combination of dorsal dislocation of the navicular from the talus and a comminuted fracture of the calcaneus (transcalcaneal talonavicular dislocation) is an unusual and severe injury. It occurs due to a forced plantarflexion of the talar head through the anterior portion of the calcaneum and is usually associated with a potential for skin and neurovascular compromise. Few cases have been reported in the literature. This article reports an unusual case of an open transcalcaneal talonavicular dislocation associated with the presence of a calcaneal comminuted calcaneal fracture.

Bent intramedullary femoral nail: surgical technique of removal and reconstruction.

A secondary high-velocity trauma to a previously stabilized femoral fracture with intramedullary nailing is rare. In this paper, we present the management of a 40-year-old man presented with a bent intramedullary nail due to secondary trauma. A lateral longitudinal femoral osteotomy was used for the resection of the distorted nail. The femur was reconstructed with a new nail, and the fixation of the osteotomy was achieved with plate and cerclage wires. Five months postrevision surgery, callus formation was evident and the patient regained a normal range of motion and gait, walking with a single cane.

Epoetin alfa reduces blood transfusion requirements in patients with intertrochanteric fracture.

PURPOSE: The purpose of this study is to identify the potential benefits or complications from the use of epoetin alfa in patients with intertrochanteric fracture. MATERIALS AND METHODS: Seventy-nine patients who sustained an intertrochanteric fracture were divided into 2 groups. One group received 10 daily doses of 20 000 IU of epoetin alfa beginning from the day of trauma, whereas the control group received placebo. RESULTS: We found a statistically significant difference in the required units of allogenic blood used between the 2 groups (P = .034). The group that received epoetin alfa also showed an elevation of hematocrit and hemoglobin values, which was statistically significant at the seventh postoperative day (P = .019 and .015, respectively) compared to the control group. No complications were evident during our study. CONCLUSIONS: Patients with intertrochanteric fractures seem to benefit from the use of epoetin alfa because it is safe and reduces the need for blood transfusions.