Abstract
We hypothesized that accidental humerus fractures in pediatric patients under the age of 4 years can be accurately distinguished from child abuse using a combination of history, physical exam findings, radiographic findings, and age. We searched our institutions Suspected Child Abuse and Neglect and...
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PMID: 20606597
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Abstract
The objective of this paper is to report clinical and radiographic long-term results of a neglected fracture of the medial humeral epicondyle, which was entrapped into the elbow joint. At follow-up, 48 years after the trauma, the patient complained of occasional discomfort around the elbow, but the...
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PMID: 20505539
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Abstract
We present the case of an 11-year-old girl with an elbow dislocation treated by closed manual reduction. The medial epicondyle fracture was missed initially until she developed an ulnar nerve palsy 2 months later. Intraoperatively we discovered the bony epicondyle piercing the joint capsule and comp...
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PMID: 20555271
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Abstract
During the last 20 years, the author has treated 1120 cases of supracondylar fractures of the humerus in children and has proposed a new hypothesis. In supracondylar fractures of the humerus it is the rotational force at the time of the injury, which determines the antero-posterior displacement. Med...
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PMID: 20512063
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Abstract
This is a case of late-onset radial nerve palsy associated with the nonunion of the humeral shaft. Nonunion formation was caused by insufficient osteosynthesis and lack of proper biomechanical conditions for fracture healing. A good final outcome was achieved by simultaneous surgical treatment both...
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PMID: 21121152
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Abstract
A 15 years old girl was found to have isolated trochlea fracture 10 weeks after an injury caused by a fall on her left elbow. Movement of the elbow was severely restricted. Radiographs showed a half moon-shaped and anterosuperiorly displaced osteochondral fragment. Medial approach capsulotomy of the...
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PMID: 20670584
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Abstract
Distal humerus fractures continue to be a complex fracture to treat. This article describes two surgical techniques that can be used to tackle these difficult fractures: Parallel plating and orthogonal plating. Both techniques have yielded excellent outcomes after open reduction and internal fixatio...
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PMID: 20670806
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Abstract
In conclusion, a screening program for osteoporosis is necessary and should be a tool in the armamentarium of every traumatology department....
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PMID: 20375916
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Abstract
Regular sport activity and the muscle strength are important factors for the injury intensity. Further studies are necessary to confirm this theory.
Georg Thieme Verlag KG Stuttgart, New York....
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PMID: 20517803
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Abstract
Isolated avulsion fracture of the subscapularis from the lesser tuberosity of the humerus is rare in the pediatric population and only a couple of cases have been described in the literature. In our case, a 13-year-old young man suffered an avulsion of the subscapularis tendon from the lesser tubero...
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PMID: 20186061
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Abstract
Union was achieved in all patients. There was no superficial or deep infection or hardware failure. Two patients required removal of plates for pain and prominence but not all screws could be completely removed. The mean flexion was 132 degrees and extension was 29 degrees . The mean DASH score was...
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PMID: 20036579
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Abstract
Radiation exposure is significantly affected by surgical and fluoroscopic techniques and by the surgeons' level of training. Exposure can be decreased significantly by awareness and behavioral modification. LEVEL OF EVIDENCE: Level II therapeutic study....
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PMID: 20502229
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Abstract
Our study revealed that common dogma regarding watchful waiting of pulseless and perfused supracondylar fractures needs to be questioned. In the vast majority of published cases, an absence of pulse is an indicator of arterial injury, even if the hand appears pink and warm, suggesting the need for m...
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PMID: 20502231
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Abstract
We present a case of an adolescent baseball pitcher who had both proximal humeral and ulnar shaft stress fractures, as well as spondylolysis of the lumbar spine. This particular patient also had an underlying endocrine abnormality of secondary hyperparathyroidism with a deficiency in vitamin D. A bo...
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PMID: 20502233
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Abstract
To study the outcome in the arthroscopic treatment of acute greater tuberosity fractures.
Twelve cases with acute great tuberosity fractures received reduction with arthroscopic treatment from August 2006 to December 2007. There were 7 males and 5 females. Eight cases were on left side and 4 on righ...
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PMID: 20973223
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Abstract
We present two cases of patients with delayed ulnar nerve palsies after operative fixation of displaced medial epicondyle fractures. These fractures are common childhood injuries and the optimal management for the ulnar nerve is not universally agreed. The ulnar nerve is at risk of compression dista...
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PMID: 20093953
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Abstract
We have found no difference in complication rates when treatment of supracondylar fractures is delayed. Supracondylar fractures which are not grossly displaced, have no neurovascular deficit or risk of skin compromise, can be safely deferred without an increased risk of complication. Operative treat...
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PMID: 20303886
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Abstract
We treated these both fractures of the distal forearm and the supracondylar humeral by respectively cast plaster and a collar and cuff with an anatomical reduction. The radiological and clinical results were excellent with the 29 months follow-up.
Copyright 2009 Elsevier Masson SAS. All rights reser...
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PMID: 20117955
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Abstract
In cases of humeral fractures of the supratrochlear foramen, the surgeon must keep in mind that it is better to perform an antegrade medullary nailing than a retrograde one; as there is higher chance of a secondary fracture, due to the extreme narrowness of the canal at the distal portion of humeri...
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PMID: 20357712
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Abstract
The mean value for the 3 mm gap strength was 1356.29+/-226.97 N for group 1 and 882.63+/-305.21 N for group 2. The mean value of the maximum load strength was 1487.13+/-298 N for group 1 and 1232+/-107.62 N for group 2. There were significant differences in 3 mm gap strengths of the two groups (p=0....
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PMID: 20302560
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Abstract
Our meta-analysis suggests stastistically insignificant differences between plates and nails in the treatment of humeral shaft fractures. Small sample sizes, study heterogeneity, and methodological limitations argue strongly for a definitive, large trial. We recommend that this trial should be a ran...
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PMID: 20170424
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Abstract
In 13 cases, functional range of motion was obtained within 6 weeks of surgery. At final follow-up, 14 patients had a stable, pain-free elbow with a mean active range of motion of 13 degrees to 140 degrees . The average score on the Mayo elbow performance score was 98. INTERPRETATION: The use of the...
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PMID: 20180722
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Abstract
All the patients obtained union within a mean 4.5 months. The functional scores for the shoulder (Constant) and the elbow (Mayo) were 77 and 97 points (mean), respectively.Two patients developed transient paresis related to radial nerve and musculocutaneous nerve injuries and one had a recurring fra...
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PMID: 20417912
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Abstract
INTRODUCTION: Five adult patients, with posttraumatic cubitus varus deformity underwent corrective surgery by the Ilizarov method of distraction osteogenesis. METHOD: A standard technique was applied in all patients. The average follow-up was 28 (range, 24-38) months. Preoperative carrying angle ran...
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PMID: 19440722
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Abstract
The approach has the advantages of leaving the muscular bed of the ulna nerve undisturbed, whilst still providing excellent exposure of the distal humerus. The triceps mechanism is not divided or split allowing rapid recovery of extensor function. Additionally, because of the natural carrying angle...
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PMID: 20412674
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Abstract
MIPO is a promising option for humeral shaft fractures because of the early recovery of motion in adjacent joints. Elbow function requires longer recovery time than the shoulder, and this may be due to the distal approach....
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PMID: 20335753
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Abstract
The addition of a third screw in the locked plate construct did not add to the mechanical stability in axial loading, bending, or torsion. In testing to failure, the addition of a third screw resulted in lower load to failure....
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PMID: 20335752
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Abstract
We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I) during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 co...
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PMID: 20424666
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Abstract
In the distal section, bone volume was the greatest in the anterior part of the lateral condyle and the least in the posterior part of the lateral condyle. Cortical thickness in the distal section was the thickest in the posterior medial and the thinnest in the anterior aspect followed by lateral as...
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PMID: 19959376
PDF is available here.
Abstract
We report an unusual injury with co-existing fractures of the proximal humerus and humeral shaft without shoulder dislocation. We discuss our experience in the diagnosis and treatment of a 39-year-old man with co-existing fractures of proximal humerus and ipsilateral humeral shaft with radial nerve...
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PMID: 20353631
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Abstract
We present two cases of children who developed compartment syndrome after upper limb fractures. Morphine patient-controlled analgesia was used in a bolus-only mode for analgesia (bolus 20 microg/kg, five minute lockout and hourly limit of 150 microg/kg). An increase in patient-controlled analgesia u...
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PMID: 20369773
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Abstract
The lateral pin placed parallel to the metaphyseal flare of the lateral humeral cortex, in combination with a second diverging pin crossing the fracture site at the medial edge of the coronoid fossa (position 4), provided the optimum fixation for supracondylar fractures of the humerus. CLINICAL RELE...
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PMID: 20179560
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Abstract
Using our novel composite playground safety score, we found that the incidence of supracondylar humerus fractures was increased in districts with playgrounds with lower scores, suggesting that improvements in playground infrastructure may potentially reduce the incidence of supracondylar humerus fra...
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PMID: 20179553
PDF is available here.
Abstract
Low-energy shotgun fractures involving the arm are complex injuries. Previously published reports have emphasized various problems associated with these injuries. This case report describes a low-energy shotgun wound managed by a staged treatment protocol involving: (1) a spanning external fixator a...
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PMID: 20358713
PDF is available here.
Abstract
We present a case of a fully immunized 20-month-old boy with Streptococcus pneumoniae posttraumatic septic arthritis without evidence of an open fracture....
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PMID: 20145504
PDF is available here.
Abstract
In the face of costly fixation hardware with varying performance for treatment of distal humeral fractures, a novel technique (U-Frame) is proposed using conventional implants in a 180 degrees plate arrangement. In this in-vitro study the biomechanical stability of this method was compared with the...
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PMID: 20684752
PDF is available here.
Abstract
We present a case of a 9-year-old girl with formation of heterotopic bone tissue in the elbow after surgical treatment of a fracture of the lateral humeral condyle. Eight months after the first operation the girl was re-operated to resect the heterotopic bone tissue. We believe that radical surgical...
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PMID: 20514847
PDF is available here.
Abstract
Elastic stable intramedullary nailing (ESIN) of humerus shaft fractures has a low complication rate if attention is paid to biomechanical principles. The observed complications are based on mistakes concerning the indication or technical errors. The ESIN shows very good functional and cosmetic resul...
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PMID: 20135597
PDF is available here.
Abstract
I injuries are treated with cast immobilization while type II and III injuries are treated operatively. The reported interobserver reliability ranges from moderate to full agreement, which is on par with other frequently referenced classification systems such as Lauge-Hansen for adult ankle fracture...
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PMID: 20055347
PDF is available here.
Abstract
The results indicate a trend toward nonunion in patients with the following risk factors: obesity (37%); a history of cigarette smoking (53%); metabolic bone disease (32%); cardiovascular disease (37%); short oblique fractures (89%); open fractures (26%); and fractures of the proximal third of the d...
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PMID: 20336955
PDF is available here.
Abstract
The patients were followed up for an average time of 18.2 months (range, 1-3 years). All nounion of lower segment of humerus were healed and no radial nerve injury occurred. Primary healing of wound was achieved at both donor and recipient sites. Bony union was achieved in all cases after an average...
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PMID: 20135977
PDF is available here.
Abstract
We examined perioperative complications of corrective osteotomy for malunited supracondylar humerus fractures in 41 patients treated at Children's Hospital Los Angeles between 1987 and 2002, and we established the risk factors associated with these complications. The overall complication rate was 32...
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PMID: 20305836
PDF is available here.
Abstract
All fractures united within a mean of 11.9 weeks (range 9 to 17 weeks) except for one type C3 fracture. Functional results were excellent in 10 patients (47.6%), good in eight patients (38.1%), moderate in two patients (9.5%), and poor in one patient (4.8%). Two patients with a moderate outcome had...
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PMID: 20676012
PDF is available here.
Abstract
Supracondylar fracture of humerus is the second most common fracture in children which account for 60-75% of all fractures around the elbow. There are various treatment modalities for type-III fracture, i.e., closed reduction and casting, skeletal traction, close reduction and percut...
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PMID: 21409899
PDF is available here.
Abstract
We hereby report a logistic delayed successful treatment of a complex arm gunshot wound with a free fibula flap. The significance of this case report is related to the necessity of emphasising the organised and multidisciplinary approach required to cure these patients in the proper way from a surgi...
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PMID: 20422725
PDF is available here.
Abstract
Of nerve injury associated with extension-type fractures, anterior interosseous neurapraxia ranks highest, whereas of flexion-type neuropathy, ulnar nerve injury predominates. We confirm that medial pinning carries the greater overall risk of nerve injury as compared with lateral-only pinning and th...
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PMID: 20357592
PDF is available here.
Abstract
We have operated 193 patients with injury of radial nerve. Among them, 97 (50.2%) have had combined injury of the humeral shaft or proximal part of radius. Rest of injuries of the radial nerve were associated with manipulation during treatment. Surgical treatment has been performed in a period betwe...
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PMID: 20681205
PDF is available here.
Abstract
Results of two methods, conventional open reduction-internal plating and minimally invasive plating osteosynthesis (MIPO), in the treatment of mid-distal humeral shaft fractures were compared. Thirty-three patients were retrospectively analysed and divided into two groups. Group A (n = 17) patients...
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PMID: 19301000
PDF is available here.
Abstract
Microbiological studies revealed positive isolates in 31.5% fracture gaps in group A and 16.4% in group B (p < 0.05). The most frequent isolates were S. epidermidis, S. aureus and S. warneri, capitis, sciuri and lentus, in lower percentage micrococci and enterococci. Amplification of 16S rRNA was po...
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PMID: 20496780
PDF is available here.
Abstract
A young epileptic woman with twin pregnancy (IUD) was posted for orthopaedic correction under general anaesthesia on assisted ventilation with laryngeal mask airway (LMA). The present article focuses on anaesthetic concerns in pre-operative preparation and management of such patients.
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PMID: 20509474
PDF is available here.