1/340. Hang gliding injuries.Two fatal and 42 non-fatal hang gliding accidents are reported. The commonest cause was stalling the craft, either owing to adverse winds or to pilot inexperience. The most frequent injuries were fractures of the wrist, humerus and spine. Inexperienced pilots were involved in most of the accidents, so that the training and supervision of novices is of fundamental importance if the accident rate of the sport is to be reduced.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/340. Complete rotational burst fracture of the third lumbar vertebra managed by posterior surgery. A case report.STUDY DESIGN: Case report of a young man with rotational burst fracture of the third lumbar vertebra, treated by posterior surgery. OBJECTIVES: To describe the management of a rotational burst fracture of the third lumbar vertebra by posterior surgery consisting of reduction, decompression, fusion, and transpedicular instrumentation. SUMMARY OF BACKGROUND DATA: Surgery is the generally recommended means of managing lumbar burst fractures with neurologic deficit. Some surgeons recommend anterior decompression, fusion, and instrumentation. Posterior surgery with decompression through laminectomy, spongioplasty of the vertebral body, interbody fusion of damaged discs, posterolateral fusion, and transpedicular fixation is also a safe and successful management technique. The combined approach consists of posterior decompression, fusion, transpedicular fixation, and anterior fusion using pelvic autografts. The optimum method of management remains in question. METHOD: An 18-year-old man with complete rotational burst fracture of the third lumbar vertebra was treated by posterior surgery. This surgery consisted of reduction, laminectomy, decompression, structure of dural sac tears, spongioplasty of the vertebral body, interbody fusion of both damaged discs, and the implantation of a transpedicular Socon fixator (Aesculap, Tuttlingen, germany), including a transverse connector. The case was documented by radiographs and computed tomography scans before surgery and after fixator removal 19 months after surgery. RESULTS: The patient healed solidly with no instrumentation failure. The neurologic deficit Frankel Grade B improved to Frankel Grade D. CONCLUSION: Surgery to manage lumbar burst fracture must include reduction, decompression, restoration and fusion of anterior and posterior elements by using autologous pelvic spongious autografts, and anterior or posterior instrumentation. Posterior surgery including suturing of dural sac tears, fusion of damaged structures, and transpedicular fixation is successful in young patients and patients with good bone quality.- - - - - - - - - - ranking = 9.0225704828608keywords = fracture, compression (Clic here for more details about this article) |
3/340. Femoral neck stress fracture presenting as gluteal pain in a marathon runner: case report.A case is described of a 50-year-old man with a femoral neck stress fracture presenting as gluteal pain. An operative pinning procedure of the femoral neck was performed for stabilization. Femoral neck stress fractures are often misdiagnosed early in their presentation. The signs and symptoms can mimic those of more commonly seen disorders. Appropriate physiatric history and physical examination, along with indicated studies, will help prevent misdiagnosis and potentially serious complications associated with musculoskeletal pathology.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
4/340. Fracture of the sternum--an unusual case.Stress fracture of the sternum is a rare injury and can occur in young athletes due to repeated stress and in elderly with osteoporotic bones or other pathological conditions under normal stress. A case of a 14-year-old boy is reported who sustained fracture of the sternum without any history of significant trauma when he simply tried to lift his whole body over his arms and felt pain in front of the chest.- - - - - - - - - - ranking = 2keywords = fracture (Clic here for more details about this article) |
5/340. An aneurysm involving the axillary artery and its branch vessels in a major league baseball pitcher. A case report and review of the literature.baseball pitchers appear to be prone to aneurysms of the axillary artery and its branches. The cause is probably related to repetitive compression of or tension on the vessels at the level of the pectoralis minor muscle and the humeral head, which is exacerbated by the pitching motion. The incidence of aneurysms of the axillary artery and its branches among pitchers and other athletes is not known, nor is it clear whether pitchers who are at high risk of vascular injury can be identified before irreversible damage to the vessels has occurred. Perhaps patients who have documented compression or occlusion of the vessel with the arm in the abducted, externally rotated position are at higher risk. Screening pitchers to identify those with axillary artery compression, aneurysm, or thrombosis has also not been shown to be effective. Certainly, many pitchers will have some level of compression of the axillary artery with their arm in the pitching position but will never develop any clinical abnormality requiring treatment. Screening would therefore probably lead to a high false-positive rate. It is clear, however, that pitchers who complain of ischemia-type symptoms such as early fatigue or who have evidence of emboli require a complete evaluation to rule out any abnormality of the axillary artery or one of its branches. Orthopaedic surgeons who see pitchers and other athletes involved in repetitive overhead motions need to be aware of this disorder so that they order the appropriate tests and obtain a vascular consultation--and make a prompt diagnosis. Treatment will vary depending on the type of lesion and on which vessel or vessels are involved, and should be decided on by the team of surgeons treating the patient.- - - - - - - - - - ranking = 0.015046988573846keywords = compression (Clic here for more details about this article) |
6/340. Spinous process fractures in a jockey: a case report.Spinous process fractures typically represent avulsion injuries involving the lower cervical spine. This case report describes the clinical and radiographic findings in a patient with spinous process fractures at the T-2, T-3, and T-4 vertebral levels. The fractures, which were obscured on conventional radiographs by overlying osseous and soft-tissue structures, were optimally shown on axial and computer-reconstructed sagittal computed tomographic (CT) images. Although isolated spinous process fractures do not compromise spinal stability, chronic sequelae associated with fracture nonunion may occur if a fracture is not recognized and treated. Because conventional radiographic assessment of the thoracic posterior elements is often limited, cases of clinically suspected spinous process fracture often require CT evaluation to confirm the diagnosis.- - - - - - - - - - ranking = 11keywords = fracture (Clic here for more details about this article) |
7/340. Reconstruction plate fixation with bone graft for mid-shaft clavicular non-union in semi-professional athletes.From 1993 to 1997, 22 semi-professional athletes (14 men and 8 women), aged 18-33 years (mountain bike racers, soccer players, handball players, swimmers, and short distance runners) with a non-union of the middle third of the clavicle were treated operatively by reconstruction plating and bone grafting. Fourteen clavicular non-unions were caused by falls. Eight non-unions were the result of a car, motorcycle, or bicycle accident. There were 19 atrophic and 3 hypertrophic non-unions. In all patients, initially a figure-of-eight strap or a sling was used for immobilization and no radiographic union was documented within 5 months. None of the athletes had gone back to their sports and all had pain and limitation of shoulder function. For open reduction and internal fixation, an AO 3.5-mm seven-hole reconstruction plate was used. The sclerotic bone ends were freshened and a cortical bone transplant or cancellous bone from the iliac crest (depending on the shortening of the clavicle) was packed around the fracture or between the reduced fracture ends. In all athletes, radiographic consolidation was achieved after an average of 14 weeks (range, 11-16 weeks) and the average increase in the Constant and Murley Score was from 79 points preoperatively to 97 points after surgery. No operative or postoperative complications occurred and all athletes returned to their sports.- - - - - - - - - - ranking = 2keywords = fracture (Clic here for more details about this article) |
8/340. Mononeuropathy of the medial branch of the deep peroneal nerve in a scuba diver.Peripheral mononeuropathies occur only rarely in association with decompression illness. The sites previously reported to be affected are areas of potential entrapment in which a peripheral nerve traverses a confined area. In these instances, the pathophysiology has been presumed to be mechanical pressure in an enclosed space by a gas bubble. A rare case is now presented of a peripheral mononeuropathy of the medial branch of the deep peroneal nerve in a scuba diver following surfacing from a 195 foot dive. This case differs from prior reports of mononeuropathy in association with decompression illness in that the affected nerve does not traverse a confined site in which mechanical compression by a gas bubble is likely. The mechanism of injury is hypothesized to be a manifestation of decompression illness with a gas bubble causing blood flow obstruction and an ischemic infarct.- - - - - - - - - - ranking = 0.015046988573846keywords = compression (Clic here for more details about this article) |
9/340. magnetic resonance imaging in the diagnosis of sacral stress fracture.Low back and buttock pain in athletes can be a source of frustration for the athlete and a diagnostic dilemma for the doctor. Sacral stress fractures have been increasingly recognised as a potential cause of these symptoms. As plain radiographs are often normal and the radiation load of an isotope bone scan is substantial, the alternative use of magnetic resonance imaging in the diagnosis of a sacral stress fracture is highlighted in this case report.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
10/340. Arthroscopic treatment of acute traumatic anterior glenohumeral dislocation and greater tuberosity fracture.We present a case and a description of treatment of an anterior dislocation of the shoulder with a greater tuberosity fracture. Both the Bankart lesion and the tuberosity fracture were repaired using arthroscopic techniques.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
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