RESUMO
The results of immediate plate fixation of 97 open fractures of the tibial shaft in 95 patients are reported. Significant joint stiffness occurred in 11.4% and angular malunion of greater than 5 degrees in any plane was seen in 3.1%. The infection rate was 10.3%. However, even in those cases which develop delayed union or other complications, plate fixation of open fractures can produce excellent recovery of limb function.
Assuntos
Placas Ósseas , Fixação Interna de Fraturas , Fraturas Expostas/cirurgia , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Infecção da Ferida Cirúrgica , CicatrizaçãoRESUMO
Excellent results can be achieved by plating fractures of the shaft of the humerus in patients with multiple injuries. This helps in nursing care and in the management of other injuries. In 38 patients admitted to a regional trauma centre, 39 humeral shaft fractures were plated. There were 27 men and 11 women, with an average age of 31.5 years. Fourteen of the humeral fractures were compound and 20 had significant comminution; 23 were fixed by a plate on the day of admission and all 39 by the twentieth day. Follow-up of 34 fractures showed that all had united, 33 primarily. All patients but one had a fully functional shoulder and no patient with a fractured humerus alone had lost any elbow movement. Complications were rare--one case each of non-union, fixation failure and infection. No permanent nerve injuries were produced at operation. The plating of fractures of the humerus in these circumstances has been shown to produce excellent results and has a place in the management of the patient with multiple injuries.
Assuntos
Placas Ósseas , Fixação Interna de Fraturas , Fraturas do Úmero/cirurgia , Ferimentos e Lesões/complicações , Adulto , Placas Ósseas/efeitos adversos , Feminino , Humanos , Fraturas do Úmero/complicações , Fraturas do Úmero/diagnóstico por imagem , Úmero/diagnóstico por imagem , Úmero/cirurgia , Masculino , Complicações Pós-Operatórias , RadiografiaRESUMO
Forefoot arthroplasty is often recommended for the management of metatarsalgia secondary to rheumatoid arthritis. Concurrently, the first metatarsophalangeal (MP) joint can be fused rather than excised. The results in 37 patients with 64 arthroplasty operations (34 with fusion and 30 with excision of the first joint) show that fusion produced a better cosmetic appearance of the foot, facilitated fitting with normal shoes, and improved overall balance. Pedobarograph measurements during gait indicated that relatively more weight was transmitted through the medial ray when the first metatarsophalangeal joint was fused. Residual pain in the foot was often caused by irregular trimming of the metatarsals. There was no difference in relief of pain between fused and unfused patients. Failure of fusion at the first metatarsophalangeal joint generally was painless. Radiologic degeneration of the interphalangeal (IP) joint of the great toe was relatively common following fusion. MP joint fusion is inadvisable if there is already disease in the IP joint.
Assuntos
Artrodese/métodos , Artroplastia/métodos , Articulação Metatarsofalângica/cirurgia , Articulação do Dedo do Pé/cirurgia , Adulto , Idoso , Artrite Reumatoide/cirurgia , Parafusos Ósseos , Feminino , Humanos , Masculino , Articulação Metatarsofalângica/diagnóstico por imagem , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Complicações Pós-Operatórias , RadiografiaRESUMO
A review is presented of the results of treatment in 126 patients over 50 years of age who had suffered a displaced fracture of the ankle. Operative fixation achieved better fracture positions than conservative management, but was associated with a very high complication rate in women. Examination of 86 of the patients more than two years after injury showed little difference in function after conservative or operative treatment.
