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At least 19 recordsLinked to original sources

The operative treatment of intra-articular fractures of the lower end of the tibia.

Intra-articular fractures of the lower end of the tibia are an interesting challenge. The best functional results in the past series were observed in patients treated according to the following 4 sequential principles: (1) reconstruction of the correct length of the fibula; (2) anatomical reconstruction of the articular surface of the tibia; (3) insertion of a cancellous autograft to fill gaps left by impaction and comminution; (4) stable internal fixation of the fragments by a plate placed on the medial aspect of the tibia. Seventy-five cases had a good or excellent late result (on average 6 years postoperatively) in 70% as compared to 43% to 55% in cases treated by closed and/or open methods.

Adult↗

The incidence and descriptive factors of calcaneal malunion after surgical fixation of intra-articular calcaneal fractures using the sinus tarsi approach: A retrospective cohort study with binary logistic regression analysis.

BACKGROUND: This study evaluated the incidence of calcaneal malunion after minimally invasive sinus tarsi approach (MIS-STA) in displaced intra-articular calcaneal fractures (I-ACFs) and identified related descriptive factors of calcaneal malunion. METHODS: A retrospective review of 99 displaced I-ACFs treated with MIS-STA was conducted. Demographic data, pre-operative radiographs, and operative details were analyzed. Outcomes included numerical rating scale (NRS) pain scores at rest and during activities of daily living (ADL), Foot and Ankle Ability Measure (FAAM) for ADL and radiographic parameters. Logistic regression was used to identify descriptive factors associated with malunion. RESULTS: Malunion occurred in 33/99 cases (33.3%). The significant descriptive factors were the initial B&#xf6;hler angle <&#x202f;0.5 &#xb0;, time to surgery >&#x202f;12.5 days, and Sanders type &#x2265;&#x202f;III. Malunion patients had significantly worse NRS and FAAM scores (p&#x202f;&#x2264;&#x202f;0.001). CONCLUSION: Calcaneal malunion after MIS-STA occurred in one-third of cases, with three descriptive factors identified and poorer outcomes observed. LEVEL OF EVIDENCE: III, Comparative retrospective study with binary logistic regression analysis.

Humans↗

Fractures at the base of the thumb: treatment with oblique traction.

Oblique traction on the thumb metacarpal, originally described for the treatment of Bennett's fracture, has been applied to comminuted intra-articular fractures of the thumb metacarpal to counter the forces that cause shortening and varus angulation. It also has been applied to fractures of the trapezium to restore congruity of the trapeziometacarpal joint. It was successful in achieving and maintaining a satisfactory reduction in eight patients with these three types of fractures.

Evaluation Studies as Topic↗

[Long-term radiological and clinical observations following surgery for tibio-fibular syndesmosis after fractures of the upper ankle joint (author's transl)].

Forty-two patients treated surgically for tibio-fibular syndesmosis were observed radiologically and clinically for a period of five years; the lesions followed fracture-dislocations type B, type C and following intra-articular fractures. Surgery consisted, as usual, of bone reconstruction and, where necessary, of transfixation of the syndesmosis with a horizontal screw introduced 2 cm. above the syndesmosis at a 30 degree angle to the frontal plane (15 cases). A new classification of the severity of subsequent arthrosis, as seen radiologically, was introduced and its correlation with clinical findings were determined. There was good agreement between the degree of arthrosis and functional results. The earliest signs of posttraumatic arthrosis following an incompletely treated lesion can be seen within the first year following the injury. An arthrosis of severity O due to sclerosis is of no, or only little, significance; it does not share the poor prognosis of severity grades I to III which, once they have developed, always show further deterioration.

Ankle Injuries↗

Internal fixation of fractures of the third phalanx in three horses.

The technique of internal fixation of intra-articular fractures of the third phalanx using lag screw interfragmentary compression is described. Three cases are discussed and the successful treatment of infection and osteomyelitis described in one of them. Despite this potential complication internal fixation offers a better prognosis and also a more rapid return to work than non-operative treatments.

Animals↗

The acute carpal tunnel syndrome: nine case reports.

Nine cases of acute carpal tunnel syndrome are reported. Etiologies include: bleeding secondary to chronic lymphatic leukemia; Colles' fracture of the wrist (2 cases); Epiphyseal fracture (Salter II) of the distal radius; Bleeding secondary to giant cell tumor of the tendon sheath; Unstable distal radio-ulnar joint; Displaced intra-articular fracture of the distal radius; Rheumatoid synovitis and vasculitis; Trans-scaphoid, perilunar fracture dislocation of the wrist. Early recognition of median nerve compression in the carpal tunnel is vital. The signs of median nerve compression should be looked for in all cases of wrist trauma. In our opinion, immediate surgical decompression is frequently indicated.

Acute Disease↗

Fractures of the distal tibial metaphysis with intra-articular extension--the distal tibial explosion fracture.

In a study of 26 distal tibial explosion fractures in 24 patients two fracture patterns were identified: Type A, a rotational pattern; and Type B, a compressive fracture pattern. The rotational pattern was found to be less common than the compressive fracture and to have a substantially better prognosis. Operative treatment of the Type A pattern led to an overall acceptable result of 84%, while the Type B patients had 53% acceptable results. The results of operative treatment were however, superior to the results of nonoperative treatment in both fracture groups. Adequate treatment consists of anatomic reconstruction of the distal tibia, rigid internal fixation, early active motion, and nonweight bearing in 3 to 5 months.

Ankle↗

Internal fixation of fractures: evolution of concepts.

The recognized goal of any fracture treatment is the restoration of normal function to the injured part(s). Historically, this was first achieved with non-operative techniques and more recently with operative fixation of fractures. Newer systems utilizing the principles of rigid internal fixation and a sophisticated armamentarium have proved useful in fractures of both bones of the forearm, major intra-articular joint fractures and the multiply injured patient. With these methods "fracture disease" (i.e. muscle atrophy, joint stiffness and bony demineralization) is decreased by early mobilization without external support. The penalties for inadequate surgery are nonrigid fixation and/or infection, emphasizing that the operative treatment of fractures is a technique to be mastered.

Europe↗

Management of hand injuries in a professional football team. Review of 15 years of experience with one team.

Thirty-eight players from one professional football team suffered 46 major hand and wrist injuries during a 15-year period. Twenty-one of the injuries occurred in offensive players and 25 occurred in defensive players. The injuries included fractures, dislocations, fracture dislocations, and soft tissue injuries of the phalanges, metacarpals, carpals (particularly the navicular), and distal radius/ulna, including intra-articular injuries. Twelve surgical procedures were performed. Open reduction, internal fixation, and Lightcast immobilization devices (3M Company, Atlanta, Georgia) allowed the players to return to active participation with a minimum loss of practice time and virtually no loss of Sunday game availability. Early aggressive surgery for intra-articular and certain metacarpal fractures is the correct course of treatment, according to our analysis, in order to achieve the best possible functional results.

Athletic Injuries↗

Multiple loose bodies in rheumatoid arthritis.

Intra-articular loose bodies are usually secondary to osteochondral fractures, osteochondritis dissecans, synovial osteochondromatosis, and degenerative arthritis. The authors report four patients with longstanding rheumatoid arthritis and multiple loose bodies in a variety of joints. All patients have remained active despite their disease, suggesting that the loose body production was secondary to trauma of continued activity superimposed on joints containing pannus and eroded cartilage.

Ankle Joint↗