Bone transport with the ASIF-BM fixator for treatment of a 7-cm segmental defect of the tibia with distal runoff only in the posterior tibial artery.
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Adult↗
Biomedical subjects
A Barquet
Publications and source records attributed to A Barquet.
Slow, gradual external fixation distraction for treatment of postburn knee flexion contracture.
Although surgical release and reconstruction have been used extensively to treat severe postburn knee flexion contractures, the degree of correction is sometimes unsatisfactory, and the procedure is not exempt from significant complications. Based on the principle of slow, gradual external fixation distraction, we have designed a triangular articulated frame to be mounted with the ASIF-BM fixator to deal with joint flexion contractures. One successfully treated patient is reported. This is a percutaneous surgery, with very mild aggression to the patient and very low iatrogenic risks. The technique is easy, the degree of correction may be almost complete, and the hospital stay is very short because it is an ambulatory surgery.
Burns↗
Occult severe hyperflexion sprain of the lower cervical spine.
Three patients with occult severe hyperflexion sprain of the lower cervical spine are described. Because the spine radiographs obtained at the time of trauma were physiologically normal, the complete instability was initially overlooked. The authors recommend an algorithm for adequate diagnosis of this condition. Posterior cervical fusion is the treatment of choice.
Adult↗
Anterolateral dislocation of the lumbosacral junction.
An unusual case of anterolateral fracture-dislocation of the lumbosacral junction is reported, and seven additional cases from the literature are discussed. The mechanism of injury is forced hyperflexion and shear. The prevalence of neurologic involvement is high, as is the number of fractures of the adjacent spinal elements and the occurrence of disk fragments in the spinal canal. The value of plain radiography and computed tomography in diagnosis and planning treatment is illustrated.
Adult↗
The dynamic ASIF-BM tubular external fixator in the treatment of open fractures of the shaft of the tibia.
The dynamic ASIF-BM external fixator incorporates telescopic tubes for axial dynamization and angled bayonet screws to keep the tubes parallel to the bone axis, that is essential for gliding, and adjustment of rotation. The results after treatment of 70 type II and III open tibial fractures with static ASIF and dynamic ASIF-BM frames were analysed. Of the fractures, 32 were treated with the delta ASIF static frame, the other 38 with delta and uniplanar dynamic ASIF-BM frames. The groups were found to be comparable. The results of the study confirm that tubular external fixation is a safe method for treating the bone and soft tissue lesions in such fractures. The comparative study shows that axial compression, using the ASIF-BM device, with early weight bearing, gave a higher rate of union (97 per cent against 87 per cent with the ASIF frame), a shorter healing time (19 weeks against 29 weeks with the ASIF frame) and a decreased need for bone grafting (21 per cent against 84 per cent with the ASIF frame). The incidence of pin track infection was also decreased in dynamic frames. Thus it seems that the ASIF-BM dynamic fixator has a valuable part to play as a definitive mode of therapy for severe open fractures of the tibial shaft.
Adolescent↗
Ipsilateral open fracture of the femur and tibia treated using the dynamic ASIF-BM tubular external fixator: case reports.
Two cases of ipsilateral open fracture of the femur and tibia treated using the dynamic ASIF-BM tubular external fixator are described. Results were very good, with short periods of occupational disability. These cases support primary stable osteosynthesis of these simultaneous fractures and the value of dynamic axial external fixation as a definitive treatment of open fractures of the femur and tibia shaft, either isolated or simultaneous.
Accidents, Occupational↗
A combined therapeutic protocol for aseptic nonunion of the humeral shaft: a report of 25 cases.
Twenty-five patients with aseptic nonunion of the humeral shaft, treated by a combined therapeutic procedure, are reported. The initial treatment of these 21 closed and four open fractures had been nonoperative in 21 patients and surgical in four. Seven further open procedures had been performed in four of these patients, also undergoing failure. The time period between the fracture and our treatment averaged 13 months (range, 6-46 months). A uniform therapeutic protocol, consisting of decortication, internal fixation with a broad, straight DCP ASIF plate and autologous cancellous bone grafting, was performed in all cases, supplemented with the use of surgical cement in one. Radiologic healing was achieved primarily in 24 patients in periods averaging 6 months and after renewal of the protocol in one patient. Followup averaged 35 months (range, 8-69 months): results were good in 21 patients.
Adolescent↗
The AO tubular external fixator in the treatment of open fractures and infected non-unions of the shaft of the femur.
A series of 14 cases of open fractures of the shaft of the femur and another group of 13 cases of infected non-union of the shaft of the femur are reported. They were treated with the AO tubular external fixator. The complications and results are assessed and it is concluded that the AO external fixator system has a valuable part to play in these difficult cases.
Adolescent↗
Large segmental necrosis of the tibia with deep infection after open fracture.
Fifteen patients with large segmental necrosis of the tibia with deep infection, following open fractures, were treated according to the Burri-Papineau protocol. After radical debridement, the segmental bone defects averaged 8.4 (5-15) cm. Necrectomy, external fixation, and open cancellous grafting, in a two-stage procedure, gave infection control in 14 cases and bone healing in 12. Additional procedures, i.e., plating and posterolateral bone grafting, provided union in another 2 cases. One patient underwent amputation. Functional results in the other 14, after a follow-up averaging 4 years, were good in 9 cases, fair in 3, and poor in 2.
Adult↗
An unusual extension injury to the cervical spine. A case report.
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Adult↗
Dislocation of the shoulder with fracture of the ipsilateral shaft of the humerus.
Three cases of dislocation of the shoulder and ipsilateral fracture of the shaft of the humerus are reported. The literature is reviewed. It is suggested that X-ray films should be taken of the shoulder and elbow in all patients with fractures of the shaft of the humerus.
Adult↗
Simultaneous ipsilateral trochanteric and femoral shaft fracture.
Thirteen cases of concomitant trochanteric and shaft fracture of the same femur are reported. The hip fracture was initially missed in two cases. Osteosynthesis of both fractures was performed in ten cases. Both fractures healed in the 12 cases followed for 6 months or more. Osteosynthesis of both fractures is recommended, preferably by fixation with angled or straight plates, and Ender nailing in selected cases.
Accidents, Traffic↗
Traumatic dislocation of the hip with separation of the proximal femoral epiphysis. Report of two cases and review of the literature.
Traumatic hip dislocation with separation of the proximal femoral epiphysis is a rare injury. Twenty-six observations collected from the literature, together with two further cases presented in this paper, were statistically evaluated. Two types of injury were considered: T1, dislocation with complete separation and displacement of the epiphysis; and T2, dislocation with incomplete separation of the epiphysis. Two main therapeutic protocols had been carried out: restoration of anatomy, supplemented by different means of stabilization; and removal of the epiphysis with or without complementary procedures. Fifteen patients had been followed up for 2 years or more and avascular necrosis had been found in all of them. Leg-length discrepancy also had significant incidence. Eleven patients with T1 injury had been followed up to skeletal maturity: results were fair in four patients and poor in seven. Early surgical restoration of the proximal extremity of the femur, stabilized with Kirschner wires and cast, is the recommended treatment.
Accidents, Traffic↗
Posterior dislocation of the ulna at the elbow with associated fracture of the radial shaft.
An exceptional case of posterior dislocation of the ulna at the elbow, associated with fracture of the radial shaft, is reported. Diagnosis was established with anteroposterior and lateral radiographs of the forearm, elbow and wrist. Treatment consisted of closed reduction of the ulnar dislocation and open reduction and internal fixation of the radius with an AO plate. A long arm cast was applied for 3 weeks with the elbow held at 90 degrees. Six months later full function of the limb had been achieved.
Adult↗
Lindane poisonings.
One percent lindane, widely used to treat scabies and pediculosis, presents toxicologic problems when used excessively. A 16-year-old mentally retarded boy accidentally ingested approximately 392 g of 1% lindane shampoo and recovered. A 2-month-old, 4.5-kg, male infant was found dead in his crib after excessive application of a 1% lindane lotion. In the former patient, initial serum levels of lindane were 206 parts per billion (ppb) declining to 1.0 ppb after 25 days. In the latter, lindane was identified in the brain at a concentration of 110 ppb. Brain levels of lindane were three times greater than the levels found in the blood. Although the relationship of this pesticide exposure to the fatal outcome in the second case was conjectural, it was illustrative of the problem of interpreting CNS events that occur shortly after excessive exposure to this insecticide.
Adolescent↗
Fracture-dislocation of the femoral head with associated ipsilateral trochanteric and shaft fracture of the femur.
An exceptional fracture-dislocation of the femoral head with associated trochanteric and shaft fracture of the same femur in a severely multi-injured 25-year-old man has been treated by open reduction of the dislocation and internal fixation of the trochanteric and shaft fractures, with a 130 degrees and a straight plate, respectively. At the 27-months follow-up examination the patient showed good evidence of fracture healing, and avascular necrosis of the femoral head had not developed, even though there had been a 5-day delay in reduction of the dislocation. The reported observation not only illustrates this extremely rare combination of injuries, but also shows that this therapeutic plan, which is able to provide the basis for eventual and further reconstructive procedures, may also offer unpredictable and gratifying outcomes in certain instances.
Adult↗
Luxatio erecta of the hip. A case report and review of the literature.
Luxatio erecta of the hip is an exceptional injury. This is the report of one such case in a 10-year-old boy, and a review of 7 other cases collected from the literature. Luxatio erecta seems to result of an injury forcing the hip in extreme flexion together with further trauma displacing the femur in caudal direction. The femoral head is dislocated below the acetabulum. Reduction is to be achieved by cephalad traction, though internal rotation may have to be added in certain cases. Post-reduction treatment, as well as the incidence of complications, are not different from those concerning the other topographic varieties of traumatic hip dislocation.
Child↗
Traumatic anterior dislocation of the hip in childhood.
One hundred and eleven traumatic anterior dislocations of the hip in children were collected from the literature and statistically evaluated together with 4 cases treated at our institute. The incidence of open dislocations, associated lesions (avulsion of the greater trochanter, damage to the femoral vessels, and fracture on the shaft of the ipsilateral femur), and irreducible recent dislocations was noteworthy, demanding special methods of primary management. In 41 patients, with follow-up averaging 5 years, the incidence of complications, especially avascular necrosis, was also high. Anterior dislocation of the hip in this age group is to be considered a serious injury. Concerning the final state of the hip-joint, factors giving a poor prognosis appear to be severe injury, open dislocation, associated fractures near the joint, delayed reduction, and, possibly, open procedures.
Adolescent↗