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PubMed1975

The significance of soft tissue injury in the roentgen diagnosis of trauma.

Soft tissue damage is an integral part of trauma. This basic fact is commonly ignored in the evaluation of roentgenograms obtained because of trauma. The soft tissue component of the traumatic lesion may produce the most obvious roentgen sing of injury and is, in these instances, fundamental to the correct roentgen diagnosis. In many instances, the soft tissue lesion is frequently of greater clinical significance that the more obvious skeletal injury. An awareness of the roentgen signs that signal soft tissue injury, and of those skeletal lesions that are commonly associated with radiographically silent, but clinically more significant, soft tissue damage, leads to prompt institution of appropriate additional diagnostic studies or therapeutic measures. Thus, the soft tissue injury in the roentgen diagnosis of trauma has both diagnostic and therapeutic significance. Each will be discussed in this article.

Abdominal Injuries↗
PubMed1992

Percutaneous stabilization of unstable fractures of the humerus.

Forty-eight of fifty-four patients who had had closed reduction and percutaneous pinning of an unstable fracture of the proximal end of the humerus were available for clinical and roentgenographic follow-up at an average of three years (range, two to seven years) after the operation. According to the point-scale of Saillant et al., the result was good or excellent in thirty-four patients, fair in ten, and poor in four. Four patients had loss of fixation and had repeat fixation with percutaneous pinning after a second closed reduction. Only one of them had a poor result because of malunion. Four patients had a superficial pin-track infection and loosening of pins, one patient had a deep infection, and two had a non-union. Complete avascular necrosis with collapse of the humeral head developed in only two patients. However, eight patients had localized avascular necrosis with transient cyst formation and sclerosis in the humeral head that resolved over one to two years; these were thought to represent subtotal avascular necrosis. Although closed reduction and percutaneous pinning is a technically demanding procedure, it offered results in our patients that were comparable with or superior to those after previously described operative methods for the treatment of unstable fractures of the proximal end of the humerus.

Adolescent↗
PubMed1979

[Radiology of joint trauma (author's transl)].

Demonstration of the value of diagnostic radiology in the field of surgical trauma, especially in trauma of the skeletal system. Recommendation to place special emphasis on optimal X-ray technique - in the radiography of acute trauma as well as in follow-up studies.

Ankle Injuries↗
PubMed2003

Radiographic analysis of bone defects in chronic anterior shoulder instability.

PURPOSE: To describe the incidence of bony lesions accompanying chronic anterior shoulder instability using fluoroscopically controlled radiography. TYPE OF STUDY: Case series of radiographic findings of patients with chronic anterior shoulder instability. METHODS: Radiographs of 160 shoulders in 156 patients with recurrent anterior shoulder instability were retrospectively evaluated; 132 shoulders had experienced recurrent dislocations, 18 shoulders had experienced recurrent subluxations, and 10 shoulders showed evidence of anterior instability at arthroscopy despite no reported history of instability. Fluoroscopically controlled radiographic views included an anteroposterior view with the humeral head in 3 rotations and a glenoid profile view with a comparison view of the contralateral shoulder. RESULTS: A humeral impaction fracture was identified on the anteroposterior radiographs in 117 of 160 shoulders (73.1%). The glenoid profile view showed an osseous lesion of the glenoid in 126 of 160 shoulders (78.8%). The anteroposterior radiograph showed an osseous lesion of the glenoid in an additional 13 shoulders (8.2%). Overall, an osseous lesion, either humeral or glenoid, was identified in 152 of 160 shoulders (95.0%). CONCLUSIONS: This study shows the frequent presence of bony lesions in patients with anterior shoulder instability.

Adolescent↗
PubMed2007

[Management of complications after angularly stable locking proximal humerus plate fixation].

PURPOSE: In this prospective study, complications observed after angularly stable proximal humerus plate fixation (locking proximal humerus plate) were analysed by deriving specific therapies. PATIENTS: Fifty patients (median age 65 years, range 25-84 years, 39 female, 11 male) with displaced proximal humerus fractures (seven single, 36 double, and seven triple fractures) were evaluated 3, 6, and 12 months after angularly stable plate fixation using a standard protocol. RESULTS: Age- and gender-matched median constant scores 12 months postoperatively showed for the three fracture types 86, 87, and 55 points and complication rates of 14, 19, and 100%, respectively. There were seven primary and seven secondary implant displacements, five humeral head necroses, four osseous malalignments, two nonunions, two deep infections, and one heterotopic ossification. Nine reoperations were required in six patients: implant removal (n=3), reosteosynthesis (n=2), revision because of nonunion (n=2), and deep infection (n=2). CONCLUSIONS: Differentiated analysis of complications and the development of specific prevention and therapeutic strategies considering surgical technique, implant, fracture morphology, and humeral head perfusion minimize the rate of complications observed after angularly stable locking proximal humerus plate fixation.

Adult↗