Classifications of fractures of the distal radius.
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We present a method for the reducing a displaced radial head in children, by rotating the forearm while pressing over the displaced fragment. This has been successful in a series of 10 cases.
We describe a patient with a Mason type-III fracture of the head of the radius associated with traumatic dislocation of the elbow. The radial head was intact throughout its circumference despite being completely detached from the shaft and devoid of any soft-tissue attachments. Severe comminution of the radial neck prevented reconstruction by internal fixation and precluded prosthetic replacement of the head. The head was fixed to the shaft with a tricortical iliac-crest bone graft which replaced the neck. Two years later, the patient had a stable elbow with flexion from 10 degrees to 130 degrees. Radiologically, the head of the radius appeared to be viable and the bone graft had incorporated.
UNLABELLED: Former male young athletes partially lost benefits in BMD (g/cm2) with cessation of exercise, but, despite this, had a higher BMD 4 years after cessation of career than a control group. A higher BMD might contribute to the lower incidence of fragility fractures found in former older athletes > or =60 years of age compared with a control group. INTRODUCTION: Physical activity increases peak bone mass and may prevent osteoporosis if a residual high BMD is retained into old age. MATERIALS AND METHODS: BMD was measured by DXA in 97 male young athletes 21.0 +/- 4.5 years of age (SD) and 48 controls 22.4 +/- 6.3 years of age, with measurements repeated 5 years later, when 55 of the athletes had retired from sports. In a second, older cohort, fracture incidence was recorded in 400 former older athletes and 800 controls > or =60 years of age. RESULTS: At baseline, the young athletes had higher BMD than controls in total body (mean difference, 0.08 g/cm2), spine (mean difference, 0.10 g/cm2), femoral neck (mean difference, 0.13 g/cm2), and arms (mean difference, 0.05 g/cm2; all p < 0.001). During the follow-up period, the young athletes who retired lost more BMD than the still active athletes at the femoral neck (mean difference, 0.07 g/cm2; p = 0.001) and gained less BMD at the total body (mean difference, 0.03 g/cm2; p = 0.004). Nevertheless, BMD was still higher in the retired young athletes (mean difference, 0.06-0.08 g/cm2) than in the controls in the total body, femoral neck, and arms (all p < 0.05). In the older cohort, there were fewer former athletes > or =60 of age than controls with fragility fractures (2.0% versus 4.2%; p < 0.05) and distal radius fractures (0.75% versus 2.5%; p < 0.05). CONCLUSIONS: Although exercise-induced BMD benefits are reduced after retirement from sports, former male older athletes have fewer fractures than matched controls.
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