ABSTRACT
The effect of head injury on systemic physiology, including bone healing is still a topic of vivid discussion. Whether the observed changes genuinely represent accelerated fracture healing or are a form of local heterotopic ossification remains unclear. We aimed to investigate whether in patients with long bone fractures the presence of head injury is associated with accelerated bone healing and excessive callus formation. In total 67 patients were studied 17 with head injury and 50 without head injury (25 treated with reamed and the other 25 with the unreamed nailing technique). Both groups were comparable in terms of age, sex, ISS. All underwent stabilisation of their femoral fracture with intramedullary nailing. The quantification of fracture healing response was estimated by taking the radiological ratio of the largest diameter of callus formed into two planes and the adjacent normal diameter of femoral canal. The minimum follow up of the patients was 12 months. In patients with head injury, the mean time to fracture union was significantly shorter than either the reamed or unreamed group (10.5 weeks compared with 20.5 and 26.9 weeks, p<0.001). The difference between the mean callus to diaphyseal ratio was statistically significant for both the AP and Lateral projections (AP: mean difference 0.462, 95% CI 0.312 to 0.602, p<0.0001, LAT: mean difference 0.289, 95% CI 0.142 to 0.436, p<0.001) with the head injured patients having more florid callus compared to the control group.
Subject(s)
Bony Callus/physiology , Femoral Fractures/physiopathology , Fracture Healing/physiology , Adolescent , Adult , Case-Control Studies , Female , Femoral Fractures/diagnostic imaging , Femoral Fractures/surgery , Fracture Fixation , Humans , Male , Middle Aged , Retrospective Studies , Tomography, X-RayABSTRACT
We retrospectively analyzed 202 patients admitted between 1990 and 1994 with femoral neck or trochanteric fracture. The age of the patients ranged between 52 and 95 years and all 202 patients were surgically managed, with either screw fixation, screw and plate fixation or hemiarthroplasty, depending upon the fracture type and the patient's age. Overall, mortality was 18% during the first year, being higher in the elderly, and in patients with cardiorespiratory diseases. In addition, if the operation was delayed more than 3 days or if hemiarthroplasty was performed, the rate of death was higher. Rehabilitation was difficult if patient had cardiorespiratory diseases or had difficulty in walking before the operation.
Subject(s)
Fracture Fixation, Internal , Hip Fractures/mortality , Aged , Aged, 80 and over , Cardiovascular Diseases/complications , Female , Hip Fractures/complications , Hip Fractures/rehabilitation , Hip Fractures/surgery , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Seven cases of pigmented villonodular synovitis with invasion of the bone are described, four affecting the hip and the remaining three involving the knee, shoulder and ankle joint, respectively. The pathogenesis of the bone changes and the radiographical appearance of the involved joints are described. The methods of treatment are discussed.
Subject(s)
Bone Diseases/complications , Synovitis/complications , Adult , Bone Diseases/diagnostic imaging , Bone Diseases/pathology , Female , Humans , Male , Middle Aged , Pigmentation , Radiography , Synovial Membrane/pathology , Synovitis/diagnostic imagingABSTRACT
Two cases of the rare injury of avulsion of the triceps tendon are presented. The difficulties in clinical diagnosis and proper evaluation of the roentgenographic findings whenever present are discussed and the treatment is outlined.
