11/634. Complications of Kuntscher intramedullary nailing in a child: a case report.A fracture of the femur in a 7-year-old boy who was treated with retrograde Kuntscher nailing is described. The follow-up period was 8 1/2 years. Deep infection, physeal injury of the femoral head, and trochanteric epiphysiodesis were serious consequences of the surgery.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
12/634. Use of the fork plate for internal fixation of periprosthetic fractures and osteotomies in connection with total knee replacement.Six cases of periprosthetic fractures of the distal femur following total knee arthroplasty were treated with a newly developed fork plate. Instead of the blade of the condylar plate, this implant features two prongs that are adaptable in length. Because of the space between the prongs, the distal femoral fragment surrounds the anchorage pegs of the prosthesis and can be gripped near the joint line. The average patient age was 74 years. Follow-up ranged between 2 and 54 months. All patients were mobilized immediately postoperatively. Full weight bearing and bone consolidation was achieved by 9 weeks postoperatively.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
13/634. Intraarticular heterotopic ossification in the knee following intramedullary nailing of the fractured femur using a retrograde method.The cases of a forty-five-year-old woman and a twenty-year-old man who developed severe intraarticular and periarticular heterotopic ossification around the knee following intramedullary nailing of a femur fracture using a retrograde technique. The association of musculoskeletal heterotopic ossification with closed head injuries seems well established and can occur in and around the knee following retrograde intramedullary nailing. This complication may occur more often than has been reported.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
14/634. Repair of supracondylar femur fracture and unilateral knee replacement at the same surgery.In patients who are candidates for a total knee arthroplasty and suffer a periarticular fracture of the femur, the arthroplasty may be performed after bony union of the fracture or immediately, in conjunction with the fracture repair. Herein we present the case of a sixty-year-old female with rheumatoid arthritis and a supracondylar fracture of the right femur in whom total knee arthroplasty and retrograde nail insertion were addressed at one surgery; the outcome was favorable. The transverse extraarticular fracture pattern in this patient was advantageous for simultaneous procedures; had the fracture been more comminuted or intraarticular, it might not have been possible to perform both procedures at the same time.- - - - - - - - - - ranking = 10keywords = fracture (Clic here for more details about this article) |
15/634. Lower limb exsanguination and embolism.We report a case of fatal pulmonary embolism during lower limb exsanguination in orthopaedic surgery. A 76-year-old woman underwent an open fixation of an external femoral condyle fracture one day after injury. Subarachnoidal anaesthesia was performed and Esmarch compression bandages were applied in preparation for tourniquet ischaemia. At this time, the patient lost consciousness, became apneic and collapsed. resuscitation procedures were instituted and transoesophageal echocardiography revealed pulmonary embolism. In spite of haemodynamic support and thrombolytic therapy, the patient died. Postmortem examination revealed multiple thromboemboli of recent origin in the right heart cavities, in the pulmonary arteries and in the popliteal and tibial veins of the injured leg. Preventive, diagnostic and therapeutic options of this catastrophic event and indications of pulmonary embolectomy are discussed.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
16/634. Spontaneous healing of an atrophic pseudoarthrosis during femoral lengthening. A case report with six-year follow-up.A seven-year old girl developed an atrophic pseudoarthrosis at the midshaft of the femur with 8.5 cm of femoral shortening after an open type II fracture. During a femoral lengthening procedure, the pseudoarthrosis filled with spontaneous callus formation and bone union was obtained.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
17/634. Pulmonary fat embolism: a complication of fracture.Medical personnel must be aware of the possibility of fat embolism as a complicating factor of fractures. Ambulance, emergency room, orthopedic, and intensive-care personnel may frequently be involved in the care of these patients. Fat embolism should be suspected any time a patient exhibits bizarre mental, pulmonary, or circulatory symptoms following a fracture. Prevention may be achieved by as near immobilization of a fracture as possible. When fat embolism does occur, the course of the illness may or may not be complex. The treatment is supportive and the patient should be made as comfortable as possible.- - - - - - - - - - ranking = 7keywords = fracture (Clic here for more details about this article) |
18/634. Implant failure of the gamma nail.The gamma nail is a temporary implant characterised by a limited life expectancy under continuous dynamic stress. We reviewed a series of 839 patients with gamma nail stabilisation and found two fatigue fractures (0.2%) at the aperture of the distal locking holes. This complication has not been described in the literature. Metallurgic and scanning electron microscopic examinations proved that the fatigue zones occurred at the clover-leaf grooves, which is where the diameter of the gamma nail is reduced. The clover-leaf diameter is of no biomechanical use in gamma nail stabilisation. We suggested product modification of the gamma nail to produce implants with a round diameter instead of a clover-leaf shape. A modified implant is already in use at our institution.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
19/634. Broken Ender nails after fixation of concomitant ipsilateral fractures of the femoral neck and shaft.Concomitant ipsilateral fractures of the upper part and shaft of the femur are uncommon injuries. Because of the small number of cases reported and the diversity of devices used, no single type of internal fixation stands out as the best treatment for both of these fractures. This report describes a case of concomitant ipsilateral fractures of the femoral neck and shaft that is further distinguished by a rare complication: breakage of Ender nails after fixation.- - - - - - - - - - ranking = 7keywords = fracture (Clic here for more details about this article) |
20/634. Spinal muscular atrophy variant with congenital fractures.A single report of brothers born to first-cousin parents with a form of acute spinal muscular atrophy (SMA) and congenital fractures suggested that this combination represented a distinct form of autosomal recessive SMA. We describe a boy with hypotonia and congenital fractures whose sural nerve and muscle biopsies were consistent with a form of spinal muscular atrophy. Molecular studies identified no abnormality of the SMN(T) gene on chromosome 5. This case serves to validate the suggestion of a distinct and rare form of spinal muscular atrophy while not excluding possible X-linked inheritance.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
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