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Results for “Fractures, Comminuted”

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PubMed2002

[Clinical study of sodium hyaluronate in supplementary treatment of comminuted fracture of ankle].

OBJECTIVE: To investigate the effects of sodium hyaluronate in supplementary treatment of comminuted fracture of ankle. METHODS: Thirty-seven patients suffered from comminuted fracture of ankle were operated for restoration by routing methods, and received 2 ml of sodium hyaluronate injection intra-articularly before the closure of incision. The ankle was fixed and given the second intra-articular injection on the 3rd day after operation. Then, the patients were given sodium hyaluronate injection intra-articularly at a week intervals till the paste was removed after 4 weeks. All patients were followed up. The clinical results were evaluated by measuring the symptoms of pain, and the function of walking and other daily living activities. RESULTS: All the patients were followed up for 6 to 27 months, among them, 30 patients were cured completely without any symptoms, the ankle function for walking and daily living activities was normal, 6 patients felt pain with violent activity or walking exceeding 1 km, one patient suffered from comminuted fracture with compressed depression was not improved due to his ankle being not restored properly. CONCLUSION: Intra-articular injection of sodium hyaluronate is an effective supplementary treatment for comminuted fracture of ankle.

Adult↗
PubMed2002

[Biomechanical study of double-plate fixation for comminuted fractures of the distal femur].

OBJECTIVE: To explore the new treatment approach for comminuted fractures of the distal femur. METHODS: Supra- and intercondylar comminuted fractures were induced in the femurs of 20 fresh adult cadavers, 10 of which received fixation with lateral steel plates and medial polyethylenes plates while the rest with single plate in the lateral only. Biomechanical tests of bending, torsion and compression were performed. RESULTS: Biomechanical test demonstrated that double-plate fixation provided better resistance to compression (P<0.05) as well as bending and torsion (P<0.01) than single-plate fixation did. CONCLUSION: Double-plate fixation is effective and may have potential clinical value in treating comminuted fractures of the distal femur.

Adult↗
PubMed1975

Stabilization of comminuted fractures of the distal inch of the radius: percutaneous pinning.

Comminuted fractures of the distal inch of the radius have always been difficult to stabilize. Closed reduction and plaster cast fixation frequently result in recurring deformity and some loss of wrist function. A method of closed pinning with proper placement of multiple small Kirschner wires to supplement plaster cast fixation in selected comminuted fractures helps retain anatomical position of the major fragments of the distal end of the radius. This method is sound in principle and we recommend its use in the treatment of severly comminuted fractures of the distal end of the radius.

Adolescent↗
PubMed1993

Comminuted fractures of the proximal radius and ulna.

Forty-three comminuted fractures of the proximal radius and ulna in 34 patients were treated with operative stabilization using AO/ASIF techniques. The patients were divided into three groups, according to the type of injury: Group I, isolated comminuted fractures of the olecranon (18 patients); Group II, isolated fractures of the radial head (eight patients); Group III, combined olecranon and radial head fractures (eight patients). All fractures were followed until union. The average follow-up period was 18 months (range, 12-48 months). At the time of this review, the average limits of elbow motion were 20 degrees extension, 118 degrees flexion, 65 degrees pronation, and 62 degrees supination. Two patients were unable to return for follow-up examination. Using the functional classification of Broberg and Morrey, results were rated as excellent in nine cases, good in 15, fair in five, and poor in three. The complication rate in this series was 19%: Two patients developed nonunion, and one patient lost reduction during rehabilitation. All of these patients required reoperation, with eventual satisfactory outcome. Three patients developed heterotopic ossification, two of which were minor and one of which produced ankylosis of the elbow joint. Each of these patients had delayed (more than 72 hours postinjury) stabilization. A functional elbow was achieved in 29 of the 32 patients who returned for follow-up examination. Operative stabilization of comminuted fractures of the proximal radius and ulna provides a stable painless joint with a functional, but not full, range of motion.

Adolescent↗
PubMed1999

[The influence of the traction on the wrist in the course of healing of the radius distal part comminuted fractures].

Traction and external fixation are the methods of choice by treating the comminuted fractures of the distal part of the radius. Bringing in two screws into the second metacarpal bone and the radius proximity from the fracture makes possible the traction and fixate the fractured bone splinters. The reposition of the comminuted fractures needs a very strong traction and provides to expand the ligaments and the wrist articular capsula. The aim of our study is to explain the mechanical influence of the external stabilization on the wrist and the wrist function after the immobilisation with the distraction. In 15 patients the examination was performed. The wrist was estimated on the base of clinical examination and rentgenography. Those examinations were performed within the moment of reduction of the dislocation, than 6 weeks and after next 6 weeks. All results are illustrated on graphics and x-ray pictures. The results of our study prove the profitable influence of the traction on the healing of the damaged articular surface in good clinical and functional position. Even a strong traction has in comparison to the control group (healing conservatively or by using various methods of the internal fixation) no influence on the wrist function.

Adult↗
PubMed2000

[Metaphyseal comminuted fracture. A therapeutic challenge].

The most frequent localization of fractures in elderly patients are the metaphysis of the distal radius, the metaphysis of the proximal humerus and the metaphysis of the proximal femur. Displaced fractures of the distal radius should be reduced anatomically with a broad indication for surgery. A unilateral frame is the method of choice in multi-fragmentary and articular fractures although this procedure carries some disadvantages. Displaced proximal fractures of the head of the humerus should be reduced and fixed operatively. Minimal invasive procedures like tension band fixation lead to better results than fixation with plates. Non-reducible four-part fractures require primary prosthetic replacement. If standard procedures in the treatment of distal fractures of the humerus fail because of severe osteoporosis, tension band fixation may allow functional post-operative treatment. Fractures of the trochanteric region of the femur can be stabilized by several dynamic standard implants that permit early weight bearing. If fixations should fail, corrective osteotomies or changing of implants--in rare cases combined with bone cement--may be necessary. Each case requires an individualized procedure in order to ensure optimal restoration of function and mobility in elderly patients.

Aged↗
PubMed1997

Treatment of comminuted fractures of the mandible.

Management of comminuted mandible fractures requires careful planning. Treatment is based on a thorough understanding of the medical management of severely injured patients, biology of these injuries, the biomechanics of the mandible, and principles of fracture fixation.

Anti-Bacterial Agents↗
PubMed1995

[Treatment of comminuted fractures of the lower end of the radius with internal osteosynthesis, traction and early mobilization].

Goals for treatment of comminutive fractures of the distal radius include restoration of the articular profile of the proximal part of the joint, while axial loading forces must be avoided as much as possible to prevent secondary displacement. The choice of an internal fixation protected by an external wrist distractor-fixator, with early activo-passive mobilisation, seems to achieve the goal. Twelve patients with a comminuted fracture of the distal radius, including axial articular impigment displacement were reviewed for this study. All fractures were Frykman's type III, IV, VII or VIII. Distraction was done with a specific external apparatus, allowing an internal fixation, using an anterior plate and posterior Kirschner wires for the more complex cases. Distraction was released at the end of the surgical procedure, while the distractor was left in place. The wrist was mobilised early in the post-operative period, and the distractor was removed two months later. At a mean follow-up of 8.5 months, two patients were still painful. Mean motion of the wrist joint was 115 degrees for flexion-extension and 35 degrees for radio-ulnar deviation. Radiological results were good (10 cases), in both planes sagittal and frontal, and stable with time. The radio-ulnar index was correct in 11 cases. Only two cases of Sudeck's atrophy were noted. Authors use a specific external wrist distractor to obtain and maintain reduction in comminuted fractures of the distal end of the radius, using internal fixation in combination. Early motion of the wrist, protected by the wrist distractor seems to lower rates of Sudeck's atrophy.

Biomechanical Phenomena↗
PubMedDate not supplied

Primary ankle fusion using blair technique for severely comminuted fracture of the talus.

OBJECTIVE: We report a case of a severely comminuted fracture of the body of the talus treated by primary Blair tibiotalar fusion. CLINICAL PRESENTATION AND INTERVENTION: A very severely comminuted open fracture of the body of the talus was treated on the same day of injury by debridement and tibiotalar fusion using the Blair fusion technique. CONCLUSION: Blair fusion may be indicated in cases of severely comminuted fractures of the talar body. It has the advantage of giving a near-normal appearance to the foot, producing less shortening and allowing motion to remain at the talonavicular and anterior subtalar joints.

Adult↗