Biomedical subjects

M Itoman

Publications and source records attributed to M Itoman.

At least 19 recordsLinked to original sources

PubMed2002

Protective effect of ischaemic preconditioning against ischaemia-induced reperfusion injury of skeletal muscle: how many preconditioning cycles are appropriate?

We investigated the efficacy of ischaemic preconditioning (IPC), consisting of repeated brief episodes of vascular occlusion followed by reperfusion, as protection against ischaemia-reperfusion injury of skeletal muscle, using a rat amputation-like model. Wistar rats underwent temporary amputation at the level of the femur, excluding the femoral vessels. The femoral artery and vein were clamped for 4h, using a micro-clamp, in the groups exposed to ischaemia. The rats were randomly divided into eight groups: a control (C) group (n = 7) with non-amputated and non-ischaemic hind limbs; a sham control (SC) group (n = 7) with amputated but non-ischaemic hind limbs; an ischaemia-reperfusion (IR) group (n = 7) with amputated and ischaemic hind limbs; and five IPC groups (n = 7 in each) with hind limbs that were subjected to 4h of ischaemia after one to five cycles of brief ischaemia and reperfusion for 10 min each, respectively. All rats were sacrificed 24h after reperfusion. The viability of the anterior tibial muscles was evaluated using nitroblue tetrazolium staining. The total viable area ratio (T-VAR) of the muscle tissue was calculated in each animal as follows: T-VAR\total viable area/total slice areae 100%. The T-VAR values of the eight groups were as follows: C group, 100% +/- 0%; SC group, 100% +/- 0%; IR group, 73.5% +/- 1.7%; IPC1 group, 79.4% +/- 6.5%; IPC2 group, 70.5% +/- 6.2%; IPC3 group, 90.6% +/- 2.8%; IPC4 group, 90.0% +/- 1.6%; and IPC5 group, 87.8% +/- 1.8%. The T-VARs in the IPC3, IPC4 and IPC5 groups were significantly higher (alpha < 0.01) than those in the IR group. In contrast, there were no significant differences between the T-VARs of the IPC1 and IPC2 groups and those of the IR group. In conclusion, three to five cycles of IPC could protect skeletal muscle against ischaemia. 2002 The British Association of Plastic Surgeons.

Analysis of Variance↗

PubMed2001

Gluteal muscle necrosis following transcatheter angiographic embolisation for retroperitoneal haemorrhage associated with pelvic fracture.

Transcatheter angiographic emobilisation has been used as an effective control of haemorrhage associated with pelvic fracture. Although few complications of this procedure have been reported, gluteal muscle necrosis occurs occasionally. We assessed the type of pelvic fracture, concomitant injury, embolic site, embolic materials, and outcome in cases of gluteal muscle necrosis associated with angiographic embolisation for pelvic fracture-related haemorrhage, and investigated the factors associated with the development of gluteal muscle necrosis, one of the fatal complications of transcatheter angiographic embolisation. Five out of the 151 patients (incidence, 3.3%) who underwent transcatheter angiographic embolisation for haemorrhagic shock due to pelvic fracture developed gluteal muscle necrosis after embolisation. The five cases had injury severity scores ranging from 26 to 59 (mean 46.4). Three patients died (mortality, 60%) of subsequent sepsis and disseminated intravascular coagulation. These cases showed that transcatheter angiographic embolisation with gelatin sponge and/or steel coil, while effectively controlling bleeding, may also result in gluteal muscle necrosis. Aggressive management including intraarterial antibiotic treatment may have a role, but our numbers are too small to confirm this.

Adolescent↗

PubMed2001

Free vascularized fibular graft vs. Ilizarov method for post-traumatic tibial bone defect.

From 1991 to 1996, four free vascularized fibular grafts (FVFG) and four callus distraction (CD) techniques were performed for post-traumatic tibial defects at the authors' institute. They attempted to discern any differences of results between FVFGs and CDs for post-traumatic tibial defects. The mean defect length of the FVFG and CD groups were 7.3 cm and 4.6 cm, respectively (p < 0.05). They selected as contributing factors: external fixation time, complication rate, hospital charge, union rate, and functional score (Puno's criteria), in order to compare the treatment of FVFG with that of CD. The external fixation times of the FVFG and CD groups were 176 days and 261 days, respectively. One septic non-union after refracture of the grafted fibula occurred in the FVFG group. Two non-unions (50 percent) at the docking site occurred in the CD group. The mean total costs of the FVFG and CD groups were 7,398,536 yen (US $68,505) and 11,798,153 yen(US $109,242), respectively. The union rates of both groups were 75 percent and 100 percent, respectively. The mean functional scores of both groups were 69.5 and 88.8 points, respectively. The functional results of the FVFG group were as follows: one patient showed good results; one, fair; and two, poor. The functional results of the CD group were as follows: two patients showed excellent results; one, good; and one, fair. Both the costs and the functional outcomes between the two groups did not significantly differ. No clear differences between the two treatment groups could be determined. However, many more cases are needed to establish statistically significant differences between both methods.

Accidents, Traffic↗

PubMed2001

Changes in nitric oxide, superoxide, and blood circulation in muscles over time after warm ischaemic reperfusion in rabbit rectus femoris muscle.

We present the sequence of changes in nitric oxide (NO) and superoxide (O2-) over time in reperfusion injuries. We examined both the changes in NO and O2- over time and the blood flow in an isolated ischaemia-reperfusion muscle model in rabbits. The ischaemic group comprised 8 animals which had had vascular pedicles clamped on the their rectus femoris muscles for 4 hours. The control group (n = 6) had a sham operation. Blood samples from the femoral vein proximal to the clamping point were collected before the operation, before clamping, before reperfusion, immediately after reperfusion, and 5, 15, 30, 60, and 120 minutes after reperfusion. NO was measured by Griess' method, and O2- by chemiluminescence. Blood flow was measured with a laser Doppler flowmeter. The amount of NO increased significantly immediately after reperfusion, and 15 and 30 minutes after reperfusion in the ischaemic group, compared with the control group (p < 0.05). O2- increased significantly at 5, 15, 60, 90 and 120 minutes after reperfusion, compared with the control group (p < 0.05). The blood flow volume curve increased by 1.4 times about four minutes after reperfusion compared with previously. After this it gradually decreased. The adverse effects of O2- became apparent when NO was extinguished by O2-.

Animals↗

PubMed2001

Technique for removing a bent intramedullary femoral nail: a case report.

The authors present a case in which an interlocked intramedullary nail placed to secure a left femoral shaft fracture was deformed twelve months after surgery because of secondary trauma. The nail was straightened by sectioning through half of its diameter with a drill for metal under minimal soft tissue dissection, then removed and replaced with another nail. The femur subsequently healed without complications.

Accidents, Traffic↗

PubMed2000

Anabolic response of mouse bone-marrow-derived stromal cell clone ST2 cells to low-intensity pulsed ultrasound.

The effects of 20-min exposure to low-intensity, pulsed ultrasound were investigated in ST2 cells of bone marrow stromal origin. They responded to ultrasound with elevated levels of IGF mRNAs, osteocalcin, and bone sialoprotein mRNAs. The upregulated expression of these messages appeared in a biphasic manner, with the first peak resistant to the protein synthesis inhibitor cycloheximide, and a second peak that was eliminated by NS398, an inhibitor of the inducive prostaglandin G/H synthase (cyclooxygenase-2). A cumulative effect of mechanical loading called the memory effect, which has been observed in vivo, can be explained from such a biphasic anabolic reaction mediated by prostaglandins. The upregulation of IGF or osteocalcin mRNAs can be observed even at 24 h after the initiation of the 20-min exposure to ultrasound. Our results suggest that this low-intensity, pulsed ultrasound, which has been clinically used to accelerate the healing processes of fractured bone, induces a direct anabolic reaction of osteogenic cells, leading to bone matrix formation.

Animals↗

PubMed2000

Involvement of cyclins in cell proliferation and their clinical implications in soft tissue smooth muscle tumors.

Expression of cyclins A and E and cyclin-dependent kinase 2 (cdk2) was examined immunohistochemically in 55 cases of soft tissue smooth muscle tumors, including vascular leiomyoma, and compared to expression of Ki-67 and proliferating cell nuclear antigen. Cyclin A was expressed in 70% of the leiomyoma cases, but with much lower labeling indexes than in leiomyosarcoma. Cyclin E was expressed exclusively in leiomyosarcoma. Although the differences of cyclin A- and cyclin E-labeling indexes between leiomyoma and leiomyosarcoma were statistically significant, no significant differences were found in the other markers. Furthermore, cyclin A- and/or E-positivity predicted a poor prognosis in recurrence- or metastasis-free survivals and overall survival. Immunoblotting revealed that cyclins A and E were expressed, in complex with cdk2, exclusively in tumors. In addition, not only leiomyosarcoma, but also leiomyoma specimens that exhibited negligible levels of complex expression, manifested detectable cdk2 activity. These results suggest 1) up-regulation of active cyclin A/cdk2 expression and associated kinase activity is critical for unrestrained cell proliferation; 2) cyclin E/cdk2 complexes may play a crucial role in leiomyosarcoma; 3) immunohistochemical detection of cyclins can be a more reliable tool for differential diagnosis between leiomyoma versus leiomyosarcoma than that of Ki-67 or proliferating cell nuclear antigen, and be a possible prognostic indicator.

Adult↗

PubMed2000

Chondrocyte transplantation for osteochondral defects with the use of suspension culture.

Cartilage graft is considered to be useful in repairing chondral or osteochondral defects. One method of the cartilage graft is achieved by autologous chondrocyte transplantation following cell culture. However, chondrocytes change their phenotype during culture. We used costal chondrocytes cultured over agarose (suspension culture) as a source of graft materials. The suspension-cultured chondrocytes formed aggregate in culture. We first examined the expressions of cartilage-specific matrices of cultured chondrocytes after two weeks in culture. The chondrocytes cultured over agarose expressed more type II collagen mRNA than those cultured on plastic dishes did after two weeks in culture. Safranin O staining showed the presence of glycosaminoglycans in the chondrocyte culture over agarose, while glycosaminoglycans were not observed in the culture on plastic dishes. We then examined the changes of rat articular osteochondral defects after transplantation of suspension-cultured chondrocytes. The aggregate of suspension-cultured chondrocytes was easily picked up with forceps and transplanted in the osteochondral defects. The defects were filled with safranin O-stained hyaline cartilage tissue two weeks after chondrocyte transplantation. On the contrary, the fibrous materials, which were not stained with safranin O, were observed in the control defects. These results suggest that the suspension-cultured chondrocytes are useful for autologous cartilage grafts by preserving chondrocyte phenotype.

Journal Article↗

PubMed2000

Time course of superoxide anion radicals generation in two ischaemia-reperfusion models: comparison between hindlimb replant model and isolated rectus femoris muscle model.

We examined differences in superoxide radical (O(2)(-)) production between a hindlimb replant model and isolated rectus femoris muscle model using rabbits. Using Japanese white rabbit hindlimbs, we made limb replant models (LR group: n = 10) and isolated rectus femoris muscle models (IM group: n = 8) by temporary 4-h clampings of femoral vessels and nutrient vessels, respectively. For sham control subjects, the same surgical procedures with no clampings in both models were done (Control-LR: n = 7, Control-IM: n = 6). The measurement of O(2)(-)was performed by our chemiluminescence (CLN) method. In both models, reperfused blood samples were collected before reperfusion, and 5, 15, 30 and 60 min after reperfusion, and CLN was measured. We defined the superoxide index (SI) in each individual specimen as post-reperfusion CLN/pre-reperfusion CLN. The time course of SI in the Control-LR group was significantly higher than that of SI in the Control-IM group (P< 0.05). There was no significant difference between the time course of SI in the LR group and that of SI in the IM group. Both the limb replant model and isolated muscle model are applicable for the evaluation of radical formation in the reperfused stage though there are potential differences between the two models caused by the surgical procedures themselves.

Animals↗

PubMed2000

Growth factor expression in the osteophytes of the human femoral head in osteoarthritis.

Osteoarthritis is characterized by marked osteophyte formation consisting of new cartilage and bone. Because several growth factors are known to be involved in chondrogenesis and osteogenesis, the expression of transforming growth factor-beta 1 and basic fibroblast growth factor in the osteophytes of the human femoral heads in osteoarthritis were examined. Transforming growth factor-beta 1 messenger ribonucleic acid was detected in the osteophytes by reverse transcription-polymerase chain reaction. All of the nine examined osteophytes expressed transforming growth factor-beta 1 messenger ribonucleic acid, whereas one of four osteoarthritic femoral heads and none of four osteonecrotic femoral heads expressed transforming growth factor-beta 1 messenger ribonucleic acid. The extent of transforming growth factor-beta 1 messenger ribonucleic acid expression varied among the osteophytes. Transforming growth factor-beta 1 or basic fibroblast growth factor was analyzed in osteophytes immunohistochemically. Transforming growth factor-beta 1 was localized in the superficial cells in the osteophyte cartilage, but it was scarcely detected in the superficial cells in the degenerative articular cartilage. Basic fibroblast growth factor was detected in the cells in the whole layer of osteophyte cartilage and in the articular cartilage. There was a difference in the localization, which suggests the different roles of transforming growth factor-beta 1 and basic fibroblast growth factor in bone and cartilage metabolism in osteophyte formation.

Fibroblast Growth Factor 2↗

PubMed2000

Contributing factors influencing the functional outcome of floating knee injuries.

The purpose of the present study was to retrospectively review the floating knee injuries treated at our institute and to determine various factors, such as severity of soft-tissue or skeletal injuries, site of fractures, and treatment methods that may significantly influence the final functional result in these injuries. Between 1986 and 1996, 65 patients with 66 floating knee injuries were treated in our institution. Among 66 fractures of the femur, 19 (29%) were open. There were 43 open tibial fractures. Fifty cases were Fraser type I floating knee fractures, 7 were type IIa, 2 were type IIb, and 7 were type IIc. In 63 cases (95%), both bones had been surgically stabilized with interlocked nails, Ender pins, plates, screws with/without pinning, or external fixations. Final functional results were evaluated according to Karlström and Olerud's criteria. Satisfactory results were rated as cases with excellent or good results. The mean follow-up time was 16.6 months range, (12-50 months). We assessed various factors influencing functional results, including Fraser type, severity of open injury grade (Gustilo) in both fractures, combination of open/closed injuries, fracture types (AO/ASIF type), existence of multiple trauma, neurovascular injuries, polyskeletal trauma, and stabilizing method or operation timing of both fractures. Satisfactory rates in Fraser type I and type II were 64% and 25%, respectively (P= .02). The satisfactory rate in closed, grade I+II, and grade III injuries of the femoral fractures was 53.2%, 81.8%, and 25%, respectively (grade I+II vs. grade III: P < .03). There were no significant correlations between the functional result and the following factors: soft-tissue injuries of the tibia; the fracture pattern of both fractures; the combination of open/closed injuries in each fracture; injury severity score; the existence of neurovascular injuries and double femoral fractures; treatment methods; and operation timing. Severity of damage to the knee joint and open injuries in the thigh were found to be significant factors contributing to the functional outcome in floating knee injuries.

Adolescent↗

PubMed1999

Time course of post-ischemic superoxide generation in venous effluent from reperfused rabbit hindlimbs.

In order to clarify the early time course of the generation of O2- produced from reperfused extremities after ischemia, the authors directly quantified the O2- of venous effluent from reperfused hindlimbs following various time periods of warm ischemia, using a rabbit reperfusion model. Using a total of 30 rabbit hindlimbs, the hindlimb-reperfusion model was created by temporarily cutting both soft-tissue and bony structures, exclusive of femoral vessels, around the thighs, and clamping the vessels with a microvascular clip. The various vascular pedicle clamping times at normothermia (25 degrees C) were used for three animal groups: 2-hr (n = 10), 4-hr (n = 10), and 6-hr (n = 10). For sham-operated controls (n = 7), the same surgical procedures with no clamping were performed. Venous effluent blood samplings from the femoral vein at the proximal side of the clamping point were collected before reperfusion, and from 5 min to 60 min after reperfusion at 5-min intervals in each animal, and peripheral blood was sampled to quantify O2- by a chemiluminescence (CLN) method using a derivative of luciferin (CLA). The time course of the production of O2- during reperfusion of all three experimental groups and controls showed polyphasic patterns with two or three peaks, but no significant changes throughout reperfusion. The time course of superoxide production after reperfusion in the 2-hr, 4-hr, and 6-hr groups showed significant differences (p < 0.05) in repeated measures by ANOVA, compared with controls. Superoxide production in the 6-hr group was greater than controls at relatively late times of reperfusion (20 min, 30 min, and 40 to 55 min after reperfusion). In the present study, it was found that the time course of superoxide production in ischemia-induced reperfused limbs showed a late polyphasic pattern without a significant initial peak, especially in the 6-hr ischemia group. In addition, the amount of superoxide production correlated with ischemic time period to some extent.

Animals↗

PubMed1999

Effect of coenzyme Q10 on superoxide production in rats with reperfusion injuries.

We examined the effect of coenzyme Q10 (Co Q10) on superoxide radical (O2-) production in a model of rat reperfusion injury. The chemiluminescence method using a derivative of luciferin was used to quantify O2- production by erythrocytes in the reperfused limb after a period of ischaemia. A total of 20 limbs from Lewis rats were preserved at 4 degrees C in Euro-Collins solution for 72 hours, and were grafted orthotopically to syngeneic rats by a microsurgical technique. In the treated group (n = 10), Co Q10 (10 mg/kg) was injected intraperitoneally into the recipients one hour before reperfusion. In the control group (n = 10), the same dose of solvent was given. To measure the extent of oxidative stress, heparinised blood from the treated and control recipients was collected before, and at 15, 30, and 60 minutes after reperfusion for the measurement of chemiluminescence. O2- production in the Co Q10-treated group was significantly lower than in the control group (p < 0.05). Although these findings suggest that Co Q10 scavenged O2- that was produced in the replanted limbs as a result of ischaemia-reperfusion injury, we should consider other possible mechanisms by which this agent may protect against ischaemia-induced reperfusion injury.

Animals↗

PubMed1999

Cortical revascularization after reamed and unreamed intramedullary nailing in the rabbit femur: a microangiographic histometric analysis.

BACKGROUND: Intramedullary nailing leads to a reduction in cortical bone blood flow. The relative effect of reamed versus unreamed nailing on the degree of avascularity and on revascularization of the cortex remains controversial. We compared the effects of reamed versus unreamed intramedullary nailing on cortical revascularization and the time course for its recovery in the unfractured rabbit femur. METHODS: A total of 56 New Zealand white rabbits were used as experimental animals. Reamed nailings with Kirschner wire (diameter, 3 mm) were performed in the right femora (group R, n = 49), and unreamed nailings with Kirschner wire (diameter, 2 mm) were performed in the left femora (group UR, n = 49) of the same animals after a standard surgical procedure. Microangiography that used Indian ink was performed for each killed animal at one of seven postoperative time periods: 2 hours, 3 days, and 1, 2, 3, 4, and 5 weeks after surgery. The right femora and the left femora of seven rabbits were used as the postoperative day 0 controls of group R and those of group UR, respectively. We evaluated the vascularization ratio (VR) in cross-sections according to the following formula: VR = the number of enhanced vessels with Indian ink/total cortical vessels. Each cross-section was divided into an inner and outer half, which were in turn divided into quarters, so that the entire cross-sectional are is represented by eight regions. The VR was calculated for each regions and then comparison was made between group R and group UR at various time periods and areas. RESULTS: No statistically significant differences were observed in VR at any time period between group R and group UR in total cortical area and total periosteal side. However, on the total medullary side, the VR of group UR was significantly higher than that of group R at postoperative day 3 (p = 0.04). Statistically significant differences were observed between the VR on the periosteal side and that on the medullary side in both groups at all time periods aside from the 5-week period (p < 0.05). Revascularization of the cortex occurred 4 weeks after intramedullary nailing in both group R and group UR. CONCLUSION: The periosteal circulation was maintained better than the medullary circulation, irrespective of whether the canal was reamed or not. The present study failed to detect any statistically significant differences in cortical revascularization between reamed nailing and unreamed nailing. Thus, we concluded that reamed and unreamed nailing are not differentially advantageous in the unfractured rabbit femur, in terms of impairment of cortical blood supply.

Angiography↗

PubMed1999

Deep infection and fracture healing in immediate and delayed locked intramedullary nailing for open femoral fractures.

Fifty-nine patients with 61 open femoral fractures were treated with immediate locked intramedullary (IM) nailing (group 1; n=15), delayed IM nailing following nonoperative treatment (group 2; n=42), and delayed IM nailing following external fixation (group 3; n=7). Sixteen fractures were Gustilo type I, 28 were type II, 7 were type IIIA, 6 were type IIIB, and 4 were type IIIC open fractures. Four (6.6%) deep infections occurred. Significant differences existed in the deep infection rate (DIR) between types I and II and all type III fractures (2.3% for types I and II versus 17.6% for type III). The deep infection rate did not differ significantly among the nailing groups (13.3%, 2.6%, and 15.3% for groups 1, 2, and 3, respectively), nor did the deep infection rate correlate with the degree of fracture comminution, the existence of polytrauma or polyskeletal trauma, or preexistence of superficial or pin-site infections. Seven (11.7%) of these fractures resulted in nonunion, excluding one secondary amputation; the nonunion rate correlated with fracture location. There were no significant differences in the mean fracture healing times between any of the nailing groups. These results suggest that IM nailing for the treatment of type III open femoral fractures should be considered carefully, regardless of whether it is performed immediately or delayed.

Adolescent↗

PubMed1998

Thyroid hormone-induced chondrocyte terminal differentiation in rat femur organ culture.

Thyroid hormone plays a role in skeletal maturation. The present study was undertaken to investigate the effect of thyroid hormone on growth and maturation of the epiphyseal cartilage in the rat femur organ culture system. The femora increased in both weight and size over time in culture in the absence of serum. The growth rate was suppressed by thyroxine treatment. Thyroxine induced chondrocyte hypertrophy in the area adjacent to the articular surface in the femoral condyle. In this area, the expression of type X collagen, a marker of chondrocyte terminal differentiation, was detected after 21 days in culture by immunohistochemistry and reverse transcription/polymerase chain reaction. These data suggest that thyroxine suppresses cartilage growth by stimulating chondrocyte terminal differentiation.

Animals↗

PubMed1998

Time course of superoxide generation in reperfusion after arterial ischaemia and venous congestion.

In order to identify differences in superoxide (O2-) production after reperfusion following arterial ischaemia and venous congestion, we directly quantified O2- in the venous effluent from reperfused hindlimbs in the rabbit. Using a total of 20 rabbit hindlimbs, we made hindlimb-reperfusion models by section of both soft tissue and bony structures exclusive of femoral vessels around the thighs and clamping of the artery alone (group A: n = 10) or vein alone (group V: n = 10) by microvascular clamp. A pilot study revealed that the critical time for venous congestion was 2 h. Accordingly, clamping was performed at 25 degrees C (normothermia) for 2 h. Sham operations were performed in the control (n = 7). Venous effluent blood samples from the femoral vein proximal to the clamping point were collected before reperfusion, and from 5 to 60 min after reperfusion at 5 min intervals. Effluent blood samples were used to quantify O2- using a chemiluminescence method using a derivative of luciferin. The time course of O2- production after reperfusion in group A and group V showed significant differences (P < 0.05), compared with the controls. There was no significant difference in the time course of O2- production in group A and that in group V. In the early reperfusion phase, no difference in O2- production was observed after arterial ischaemia or venous congestion. In future studies, we will test the contributions of free radicals by setting longer ischaemic times, longer reperfusion times, and studying secondary ischaemia.

Animals↗

PubMed1998

Functional outcomes of "floating elbow" injuries in adult patients.

OBJECTIVES: To assess elbow function, complications, and problems of floating elbow fractures in adults receiving surgical treatment. DESIGN: Retrospective clinical review. SETTING: Level I trauma center in Kanagawa, Japan. PATIENTS: Fourteen patients with fifteen floating elbow injuries, excluding one immediate amputation, seen at the Kitasato University Hospital from January 1, 1984, to April 30, 1995. INTERVENTION: All fractures were managed surgically by various methods. In ten cases, the humeral and forearm fractures were treated simultaneously with immediate fixation. In three cases, both the humeral and forearm fractures were treated with delayed fixation on Day 1, 4, or 7. In the remaining two cases, the open forearm fracture was managed with immediate fixation and the humerus fracture with delayed fixation on Day 10 or 25. MAIN OUTCOME MEASUREMENTS: All subjects underwent standardized elbow evaluations, and results were compared with an elbow score based on a 100-point scale. The parameters evaluated were pain, motion, elbow and grip strength, and function during daily activities. Complications such as infections, nonunions, malunions, and refractures were investigated. RESULTS: Mean follow-up was forty-three months (range 13 to 112 months). At final follow-up, the mean elbow function score was 79 points, with 67 percent (ten of fifteen) of the subjects having good or excellent results. The functional outcome did not correlate with the Injury Severity Score of the individual patients, the existence of open injuries or neurovascular injuries, or the timing of surgery. There were one deep infection, two nonunions of the humerus, two nonunions of the forearm, one varus deformity of the humerus, and one forearm refracture. CONCLUSION: Based on the present data, we could not clarify the factors influencing the final functional outcome after floating elbow injury. These injuries, however, potentially have many complications, such as infection or nonunion, especially when there is associated brachial plexus injury. We consider that floating elbow injuries are severe injuries and that surgical stabilization is needed; beyond that, there are no specific forms of surgical treatment to reliably guarantee excellent results.

Activities of Daily Living↗