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[Treatment of wrist fractures by external fixation. Indications and early results].
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A new device for the internal fixation of wrist fractures: preliminary communication.
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Prevalence, pathogenesis and treatment of post-menopausal osteoporosis.
About 11% of post-menopausal women with wrist fractures have spinal osteoporosis with compressed vertebrae, and about 25% of postmenopausal osteoporosis patients have had a wrist fracture. The estimated prevalence of post-menopausal spinal osteoporosis is 4% of the female population at age 60 and about 8% at age 80. Osteoporotic patients have lower plasma oestrone and androstenedione levels, lower calcium absorption and higher urinary hydroxyproline than matched controls. Of six treatments tested in three different ways, the least successful were vitamin D2 and 1 alpha-OHD3 and the most successful were hormones with or without 1 alpha-(OH)2D3 and calcium supplements. Calcium and vitamin D given in combination occupied an intermediate position.
Bone mineral content in the forearm after fracture of the upper limb.
The bone mineral content was measured by gamma absorptiometry in patients who had sustained fractures of the upper limb. Measurements were taken on the shafts of the forearm and in the trabecular bone immediately proximal to the wrist. Fractures of the surgical neck of the humerus and fractures of the shaft of the humerus did not significantly influence the bone mineral content of the ipsilateral forearm. Fracture of the radius and the ulna, however, caused a 15% loss of the bone mineral content in the trabecular bone proximal to the wrist, whereas the mineral content on the shafts of the fractured forearms increased or decreased depending on the fracture site. The findings suggest that measurements of bone mineral content of the forearm are not necessarily invalidated if there has been a fracture of the same limb. Only if the forearm itself is fractured should measurements on this site be avoided.
Acute ulnar neuropathy with fractures at the wrist.
Injury to the ulnar nerve associated with or following a fracture at the wrist is unusual. Three cases of this association are presented. Previously reported cases have been reviewed. The associated lesions tend to occur in young adults after higher-energy trauma and more dorsal displacement of the distal radial fragment than are generally seen in patients with Colles fractures. The return of function in the three wrists was related to the promptness and accuracy of reduction of the fracture and to the decompression of the ulnar nerve in Guyon's canal. We present a regimen for treatment of this injury stressing accurate reduction of the fracture and early surgical decompression when necessary.
Linear tomography and the injured wrist.
Linear tomography was used in the investigation of recent wrist injuries. By providing greater bony detail than conventional radiographs it proved a useful aid in the study of the suspected wrist fracture, and in the differentiation of the old from the recent fracture of the scaphoid. Such additional information may affect the clinical management of the injury, for instance when an injury is shown to be longstanding.
Radiographic measurements on the radio-carpal joint in distal radial fractures.
Radiography of 40 wrists with fractures in the distal part of radius was performed. In the lateral view the inclination of the radial joint surface was analysed in different degrees of pronation and supination. The central ray was directed 15 degrees proximally and the results were compared with those obtained with a perpendicular central ray. In the perpendicular projections even moderate differences in pronation or supination between two examinations could seriously alter the measured inclination of the joint surface of the radius. The projection with the central ray directed 15 degrees proximally highly significantly decreased the errors between the measurements when compared to the perpendicular projection. The joint surface was depicted more dorsally inclined than in the perpendicular projection.
[The limits of tolerance of treatment of fractures of the wrist (author's transl)].
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Barton's fracture-dislocation of the wrist.
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[Problem of classification of open fractures of the wrist].
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[Perilunar, transscaphoid, transcapital, transstyloid fracture-dislocation of the wrist. Operative reconstruction].
Report of a new type of fracture dislocation of the wrist and the intercarpal joints, which has not been published until now. A perilunar dislocation was associated with fractures of the scaphoid and capitate bones as well as a fracture of the radialstyloid. Open reduction and internal fixation was followed by fracture healing and slight posttraumatic arthritis. Loss of function was minimal and working capacity not reduced.
[Pseudarthrosis following radial fracture close to the wrist joint - a therapeutic error?].
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The wrist extension cast: for fractures of the metacarpals and phalanges.
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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.
Fractures of the forearm and wrist.
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[Bilateral perilunar dislocation of the wrist].
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An unusual cause of ulnar nerve palsy associated with Colles's fracture.
An unusual case of traumatic neuritis of ulnar nerve associated with Colles's fracture is described. The ulnar nerve had the abnormal course in the lower forearm and wrist. The fracture of the styloid process of the ulna was responsible for the traumatic neuritis of the ulnar nerve.