1/5. Nasoethmoid orbital fractures: diagnosis and management.BACKGROUND AND OBJECTIVES: Trauma to the central midface may result in complex nasoethmoid orbital fractures. Due to the intricate anatomy of the region, these challenging fractures may often be misdiagnosed or inadequately treated. The purpose of this article is to aid in determining the appropriate exposure and method of fixation. methods AND MATERIALS: This article presents an organized approach to the management of nasoethmoid orbital fractures that emphasizes early diagnosis and identifies the extent and type of fracture pattern. It reviews the anatomy and diagnostic procedures and presents a classification system. The diagnosis of a nasoethmoid orbital fracture is confirmed by physical examination and CT scans. Fractures without any movement on examination or displacement of the NOE complex on the CT scan do not require surgical repair. Four clinical cases serve to illustrate the surgical management of nasoethmoid fractures. RESULTS AND/OR CONCLUSIONS: Early treatment using aggressive techniques of craniofacial surgery, including reduction of the soft tissue in the medial canthal area and restoration of normal nasal contour, will optimize results and minimize the late post-traumatic deformity. A high index of suspicion in all patients with midfacial trauma avoids delays in diagnosis.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
2/5. Early proximal row carpectomy after severe carpal trauma.Complex fracture dislocations of the wrist often result in post-traumatic arthrosis. In these cases, patients can experience severe pain and loss of function of the wrist and as a result many of them end up having a total arthrodesis. In trying to avoid the disadvantages of a total arthrodesis, alternative treatment strategies have been investigated, amongst which proximal row carpectomy (PRC). Basic conditions for a good outcome of PRC are an intact cartilage of the lunate fossa of the distal radius and an intact surface of the head of the capitate for the new radiocapitate joint (, schematic drawing post-PRC). Also, an intact (volar) radioscaphocapitate (RSC) ligament is necessary because it plays an essential role in stabilizing the new joint and preventing volar dislocation and ulnar translocation of the distal carpal row. Acute post-traumatic PRC can be indicated, but is rarely reported in literature. In this article, we present four patients whom we have treated with early PRC after severe trauma of the wrist. Three patients had a good outcome. In the patient with the bad outcome, the before-mentioned prerequisites were not met, which is discussed.- - - - - - - - - - ranking = 2keywords = post-traumatic (Clic here for more details about this article) |
3/5. Osteoarticular allograft reconstruction for recurrent post-traumatic dislocation of the hip.A patient with post-traumatic mechanical instability associated with a significant posterior acetabular deficiency in the presence of an otherwise good articular surface was treated with an allograft reconstruction. The short-term result was good; at 10-month follow-up there was full range of motion with no clinical evidence of instability. This procedure may be indicated in rare instances of post-traumatic mechanical instability where insufficiency of the posterior acetabular wall is felt to be a significant factor.- - - - - - - - - - ranking = 6keywords = post-traumatic (Clic here for more details about this article) |
4/5. Post-traumatic first metatarsal reconstruction using coralline hydroxyapatite.Autogenous bone grafting has been the standard approach to reconstruction of trauma-induced metatarsal defects. However, this treatment has well-known disadvantages related to the harvesting, size, shape, and availability of autografts. The authors used a synthetic hydroxyapatite bone-graft substitute manufactured from a marine coral with a morphology similar to that of cancellous bone in the reconstruction of a large, post-traumatic first metatarsal defect. The authors found grafting with coralline hydroxyapatite to be a safe and effective substitute for autogenous bone grafting in the post-traumatic setting.- - - - - - - - - - ranking = 2keywords = post-traumatic (Clic here for more details about this article) |
5/5. Correction of post-traumatic asymmetry by mandibular angle reduction: report of two cases.We present two patients with post-traumatic mandibular asymmetry, caused by flaring of a fragment containing the mandibular angle in between two fractures. No occlusal disturbance was evident in either case. Instead of refracturing or ramus osteotomies, the asymmetry was corrected by transoral ostectomy of the mandibular angle with good aesthetic results.- - - - - - - - - - ranking = 5keywords = post-traumatic (Clic here for more details about this article) |