Asymmetric dysplasia epiphysealis hemimelica.
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Biomedical subjects
Publications and source records attributed to D M Heilbronner.
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This is a preliminary report of the authors' first 40 patients treated by posterior spinal fusion with Wisconsin interspinous segmental instrumentation (WISSI) with a minimum 18-month follow-up period. No major complications because of the instrumentation were encountered. The patients were allowed to sit in a chair on the second or third postoperative day. Early elimination of postoperative casts resulted in an increased rate of problems with fixation and led to reintroduction of a postoperative orthosis, but not the body cast. Some fixation problems may have been related to technical errors and use of the earlier one-button technique. In two patients who had hook dislodgement, the WISSI maintained spinal correction thereby demonstrating its stabilizing effect.
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In 7 cases of fracture of the humerus occurring in arm wrestlers, each patient sustained a simple spiral fracture of the distal third of the humerus. No patient had any neural or vascular compromise. Three patients underwent open reduction and internal fixation with 2 screws, at which time, muscle was found to be interposed between the fracture fragments. The other 4 patients were treated in hanging arm casts. All of the fractures united. Of the 41 cases of this injury reported in English medical literature there were 5 patients with radial nerve palsy and 16 patients who had had operative treatment of the injury. Because of the possibility of participants sustaining such an injury, arm wrestling should not be considered a totally benign sport.
Dislocation of the shoulder in infancy is an uncommon entity. Unlike the majority of reported cases, true congenital dislocation is present at birth and has no associated anomalies or injury. It appears to be related to in utero positioning. With appropriate immobilization in reduction, stability can be achieved, although development of the ossific nucleus of the proximal humerus is delayed as in congenital hip dislocation.
A dislocation of the elbow occurred in a 7-year-old boy during overhead skeletal traction treatment for a supracondylar fracture of the humerus. Closed reduction of the dislocation was successful. A review of the literature failed to reveal a report of a similar incident.