PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Fractures, Comminuted”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1977

[Procedure for immobilization of comminuted fractures of the zygomatic arch].

The authors suggest a method for the reduction and immobilisation comminutive fractures in varus of the zygomatic arch. This procedure consists of the introduction of a Franchebois balloon filled with physiological saline into the external space of the manducatory sysarcoses, thereby maintaining the calibe of the zygomato-temporo-malar canal. The procedure falls within the context of the functional treatment of fractures of the facial skeleton.

Fracture Fixation↗
PubMed1982

[Comminuted fractures of the lower end of the radius. Treatment by traction-suspension].

Treatment of comminuted fractures of the distal radius bone by the traction-suspension technique is both simple and innocuous. The authors describe this old and satisfactory technique, slightly modified: a transmetacarpal pin is introduced and suspended to a giving set stand, and a counter-traction of 3 to 4 kg is exerted by means of a transulnar pin. After remodelling of the bone under general anaesthesia and radiographic control, the pins are sunk in plaster to be removed 6 to 8 weeks later. Excellent, often unexpected clinical and radiological results can be obtained, and complex traumatic problems can be solved by this technique which can be performed by non-orthopedic surgeons, even with little experience.

Anesthesia, General↗
PubMed1993

[Experience with the endoprosthesis in comminuted fractures of the humeral head].

Surgical treatment is difficult in elderly patients who have suffered a comminuted fracture of the head of the humerus, often associated with dislocation. We performed follow-up examinations in our hospital in 11 patients after implantation of 12 endoprostheses since July 1990. Very good results were confirmed in respect of regained freedom of movement and overall high personal satisfaction on the part of the patients. Endoprosthesis appears to us as the treatment of choice in complex fractures of the head of the humerus in patients of advanced age.

Aged↗
PubMedDate not supplied

Functional evaluation of intraarticular severely comminuted fractures of the calcaneus with gait analysis.

Twenty-one patients (23 feet) treated nonsurgically for severely comminuted intraarticular fractures of the calcaneus were evaluated prospectively with a clinical scoring scale and computerized gait analysis. All patients had Sanders type III and type IV fractures. The treatment protocol consisted of no closed reduction, immobilization in removable splint, physiotherapy after edema subsided, and weightbearing after 8 weeks. All patients had a minimum follow-up of 2 years (mean, 38 months). Clinical results were good in 2 patients, fair in 3 patients, and poor in 16 patients. Gait analysis showed that patients were at high risk of gastrocnemius weakness and ankle and knee instability. These results may be useful for comparison with the results of other methods, such as open reduction and internal fixation, nonsurgical closed reduction, and arthrodesis.

Adolescent↗
PubMed1988

Management of a severely comminuted fracture of the third metacarpal bone in a horse.

A 4-year-old Standardbred stallion sustained a severely comminuted fracture involving the second, third, and fourth metacarpal bones. The fracture was repaired using two 14-hole broad dynamic compression plates positioned at 90 degrees to one another, allowing one plate to protect the other in the bending mode. An autologous cancellous bone graft obtained from the tuber coxae was added at the site of the defect in the mid- to upper third of the third metacarpal bone. Complications associated with the fixation included a Staphylococcus aureus infection 5 months after surgery, laminitis that developed in the opposite forelimb 6 months after the fracture, and septic tenosynovitis in the contralateral hind limb. The septic tenosynovitis prolonged hospitalization for a total of 20 months. Both postoperative problems resolved when the stallion returned to breeding use.

Animals↗
PubMed1991

Comminuted fractures of the basilar joint of the thumb: combined treatment by external fixation, limited internal fixation, and bone grafting.

Displaced, comminuted fractures of the thumb carpometacarpal joint were treated by intermetacarpal external fixation, anatomic reduction of the joint surfaces, bone grafting and adjunctive internal fixation in thirteen patients. Retrospectively, at an average follow-up time of 35 months, nine patients showed a good result and one patient had a fair result. All fractures had united without secondary displacement, but focal irregularities of the joint surface were commonly seen. As compared with the uninvolved side, axial rotation averaged 79%, radial abduction 89%, key pinch 88%, and grip strength 81%.

Adolescent↗
PubMed1987

[Results of treatment of multifragment and comminuted fractures of the femoral shaft in adulthood. Results of a community study].

Progress in osteosynthesis techniques has enabled successful surgical stabilisation of femur fractures with multifragment and comminuted zones. Support plating, intramedullary nailing combined with cerclage wires, and interlocked nailing have proved to stand out as osteosynthesis methods for high stability. A retrospective study was conducted into 73 medical centres throughout the GDR to analyse the effectiveness of several variants of osteosynthesis in 939 adult patients who had received surgical treatment for femur fractures with severe traumatisation of the bone. Interlocked nailing proved to be unambiguously superior to other techniques for good results and low rates of complications. This analysis is likely to support current recommendations to the effect that interlocked nailing should be definitely preferred to cope with multifragment and comminuted femur fractures.

Femoral Fractures↗
PubMed2006

Open reduction and palmar plate-osteosynthesis in combination with a nanocrystalline hydroxyapatite spacer in the treatment of comminuted fractures of the distal radius.

In a prospective study, we used the nanocrystalline hydroxyapatite paste Ostim (Osartis, Obernburg, Germany) in combination with a palmar plate to treat comminuted radius fractures with a metaphyseal and articular component in order to examine the clinical use of Ostim as a bone substitute. Twenty-one patients with 22 radius fractures of AO types C2 and C3 were included in the study. The measurements, taken 10.2+/-1.3 months after the initial treatment, revealed a dorsopalmar tilt of 8.8+/-3.7 degrees , a radioulnar inclination of 18.8+/-2.8 degrees and an ulnar variance of 0.8+/-1.8mm. According to the Gartland and Werley evaluation, eight of the treated fractures attained an excellent, 11 a good and the remaining three a fair result. The study demonstrates that Ostim, in combination with angularly stable osteosynthesis, can be used as an acceptable bone substitute for the treatment of type C2 and C3 radial fractures.

Adult↗
PubMed1975

[Treatment of comminuted fractures of the distal end of the radius by traction using transfixing Kirschner's wires and plaster cast].

Based on the analysis of 45 cases of comminuted fractures of the lower extremity of the radius, this study points out the insufficiency of conventional treatments. The authors advocate a technique using a Kirschner's wire passed through the metacarpal bones and another one through the ulna, both beind embeded in plaster cast. This method was tested on 19 cases with encouraging results. The technique was precisely described and the authors think that it should be used in fractures incorrectly reduced by conventional methods.

Adolescent↗
PubMed2002

[Results of excision of the radial head in comminuted fractures].

OBJECTIVES: To evaluate the results of radial head excision in the treatment of comminuted radial head fractures. METHODS: The study included 20 patients (14 men, 6 women; mean age 34 years; range 21 to 55 years) who underwent radial head excision for comminuted, closed fractures. Sixteen patients had Mason type 3 and four patients had type 4 fractures. Surgery was performed at a mean of eight days after trauma (range 1 to 30 days). Patients were assessed with regard to whether they were able to return their former activities and work, and whether they had pain, limitation, loss of strength, and instability. The results were evaluated by the Radin and Riseborough's classification. The mean follow-up period was seven years (range 2 to 12 years). RESULTS: Sixteen patients (80%) re-gained their previous activities or work. Nine patients became asymptomatic. Five patients complained of loss of strength in the arm. Pain associated with weight bearing was observed in two patients in the wrist and elbow, respectively, and in both in two patients. Two patients had limitation of more than 30 degrees in at least one of extension, flexion, supination, or pronation. Five patients had mediolateral instability. The mean elbow flexion was 125 degrees (range 100 to 140 degrees). Proximal migration of the radius was detected in five patients (1 mm), two patients (3 mm), and in three patients (5 mm). According to the Radin and Riseboroughs classification, nine (45%), seven (35%), and four (20%) patients had good, fair, and poor results, respectively. CONCLUSION: Despite its relevance in elbow kinematics, our results seem to justify excision of the radial head in Mason type 3 comminuted radial head fractures where internal fixation presents severe difficulties.

Adult↗
PubMed1987

External fixation of open comminuted fractures of the proximal phalanx.

External fixation is an accepted method of treatment for many injuries, however, only a limited number of reports concern its use in open, comminuted fractures of the hand. Ten patients with eleven fractures of the proximal phalanx were treated using the AO/ASIF small external fixator. Five fractures involved the interphalangeal joint (IPJ), two the metacarpophalangeal joint (MPJ), and four the shaft. Nine fractures were caused by small caliber gunshot wounds, one was due to a power saw injury, and one occurred during a three wheeler accident. The patients with interphalangeal joint involvement all had extensive involvement of one or both of the joint surfaces. The fixator was placed across the joint and a stable ankylosis allowed to occur with the IPJ in 30 degrees to 40 degrees of flexion. MPJ motion averaged 75 degrees in these patients while distal interphalangeal joint (DIPJ) motion averaged 20 degrees. The four patients with shaft fractures all healed, but three required bone grafting. These patients averaged 85 degrees of MPJ motion, 25 degrees of proximal interphalangeal joint (PIPJ) motion, and 30 degrees of DIPJ motion. One patient with metacarpophalangeal joint involvement regained 85 degrees of MPJ motion but had limited motion at the PIPJ and DIPJ. The other patient with MPJ involvement suffered massive bone loss; a ray amputation was eventually performed. Complications included pin tract drainage in three of the eleven fractures and slight loss of reduction in two fractures. The best clinical results occurred when the fixator was used as a digit salvage procedure in interphalangeal joint fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Pneumocephalus secondary to tension pneumothorax associated with comminuted fracture of the thoracic spine.

We present an unusual case of pneumocephalus secondary to a tension pneumothorax associated with fracture of the thoracic spine. Air from a pneumothorax entered the thoracic intraspinal compartment and the intracranial cavity through a comminuted fracture of the spine. The pneumocephalus and the pneumothorax resolved after aspiration of the intrathoracic air via an intercostal catheter. Diagnosis, therapeutic modalities, and potential complications of a pneumocephalus and of a communication between the thoracic cavity and the spinal dural space are discussed.

Adult↗
PubMed1982

Treatment of grossly comminuted fractures of the olecranon by excision.

Operative reduction with internal fixation for the fractured olecranon is generally considered to be the treatment of choice whenever there is separation of the fragments. In grossly comminuted fractures, however, anatomical reconstruction often cannot be achieved satisfactorily. In such cases excision of the loose fragments of the olecranon and re-attachment of the triceps tendon to the shaft of the ulna offers a better solution when the fracture is proximal to the coronoid process.

Adult↗
PubMed1988

Comminuted fractures of the proximal humerus.

Difficulty in fully defining the injury, patient characteristics, osteoporosis, technically difficult surgery, the need for carefully supervised physiotherapy, and the realization that a poor initial result is very difficult to reconstruct make the comminuted fracture of the proximal humerus a problem fracture. The literature on this fracture is also incomplete and confusing. The solutions are many and complex: use adequate roentgenograms to understand the traumatic lesion, be careful to avoid denying older patients effective surgical treatment, use a safe and simple surgical approach, know the options for internal fixation, recognize the values of prosthetic replacement, avoid technical pitfalls, and thoughtfully supervise the postoperative patient care.

Fracture Fixation, Internal↗
PubMed2003

Internal fixation versus arthroplasty of comminuted fractures of the distal humerus.

BACKGROUND: A comminuted distal humerus fracture in an older patient is a difficult clinical problem. Open reduction internal fixation (ORIF) carries the risks of nonunion, loss of fixation, infection, and stiffness. Arthroplasty carries the risks of loosening, infection, and periprosthetic fracture. Both procedures are technically challenging, and complications following these procedures are frequent. OBJECTIVE: To evaluate best available evidence to assist in guiding clinical decision making for ORIF versus arthroplasty of intraarticular distal humeral fractures in elderly patients. HIGHEST AVAILABLE EVIDENCE: 1. Case series of internal fixation or arthroplasty of acute interarticular distal humerus fractures in the elderly (level IV). 2. Review of expert opinion without explicit critical appraisal or controlled research (level V). STUDY IDENTIFICATION: 1. Computerized data search 1969-2003, Cochrane Database, OVID Search Engine. 2. Reviews of bibliographies of selected articles.

Aged↗
PubMed1987

Cerclage wiring in the management of comminuted fractures of the femoral shaft.

A retrospective series of 20 patients is presented, comprising 21 fractures of the femoral shaft treated by open reduction and internal fixation (usually by medullary nailing) combined with cerclage wiring. Most of the patients were young with comminuted fractures of the femoral shaft, many with multiple injuries. The aims of stable reduction and early sound union of the fracture in anatomical position were achieved in all cases and that of early mobilization of the knee to a good ultimate range of flexion in almost all cases.

Accidental Falls↗
PubMed1998

Treatment of a chronic comminuted fracture of the fibula in a horse.

A four-year-old Standardbred gelding was examined because of vague right hind limb lameness of 3 to 4 months' duration. Results of physical examination, radiography, and scintigraphy were indicative of a chronic comminuted fracture of the proximal portion of the right fibula. A cancellous bone graft was placed in the fracture site, and 3 months later, the fracture appeared to be healed radiographically. Fractures of the fibula are rare in horses and should not be confused with normal anatomic discontinuities that result in a bi- or tripartite appearance of the fibula on radiographs. Because the fibula is a non-weight-bearing bone in horses, lameness associated with fibular fractures may be vague.

Animals↗