1/116. The spiral compression plate for proximal humeral shaft nonunion: a case report and description of a new technique.We present a case of humeral nonunion managed with a dynamic compression plate (DCP) contoured in a spiral fashion to preserve the deltoid muscle insertion. A forty-one-year-old woman sustained a closed proximal third humeral shaft fracture with an associated supraclavicular brachial plexus injury. She presented five months later with an atrophic nonunion of the proximal humeral shaft, inferior subluxation of the humeral head, and a resolving brachial plexopathy. Autogenous cancellous bone grafting and open reduction and internal fixation with a narrow DCP was performed. The deltoid muscle insertion was preserved by contouring the plate to fix the proximal humerus laterally over the greater tuberosity and anteriorly over the mid-humeral shaft. During the postoperative period, the humeral head reduced spontaneously. Five months after surgery, the fracture healed, and an excellent clinical result was achieved. We recommend the use of the spiral DCP for proximal shaft fractures and nonunions when preservation of the deltoid insertion is desirable.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/116. Severance of the radial nerve complicating transverse fracture of the mid-shaft of the humerus.A case of radial nerve injury associated with a transverse fracture of the middle third of the humerus is reported. The radial nerve was found to be completely severed at the fracture site. Early exploration of the nerve and internal fixation of the fracture gave a satisfactory result.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
3/116. Nonunion of a pediatric lateral condyle fracture without ulnar nerve palsy: sixty-year follow-up.Displaced lateral condyle fractures in the pediatric population are usually treated with open reduction and internal fixation. Significant complications associated with the nonoperative management include nonunion, malunion, deformity, and tardy ulnar nerve palsy. However, few cases of nonunion of the lateral condyle and tardy ulnar nerve palsy with long-term follow-up have been reported. We present a radiographically documented case of a pediatric lateral condyle fracture and subsequent nonunion with significant cubitus valgus deformity without ulnar nerve palsy sixty years following injury.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
4/116. Pediatric elbow dislocation associated with a milch type I lateral condyle fracture of the humerus.A Milch Type I lateral condyle fracture associated with a posterior elbow dislocation is described in a pediatric patient. Previously, Milch Type I fractures were thought to be stable injuries due to maintenance of the lateral trochlear rim. Prompt recognition and treatment are essential to avoid complications of this injury and to ensure a good functional result.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
5/116. Aortic dissection: A "humerus" case.Aortic dissection usually presents with acute onset of severe chest pain. Classically there is a pressure differential between the 2 arms and widening of the mediastinum. echocardiography is considered the investigation of choice in many institutions. A case is presented in which the presentation and clinical signs are classical for dissection. Transthoracic echocardiography demonstrated "enlargement" of the descending aorta and a "flap." A surprise diagnosis was made by transesophageal echocardiography. Other vascular structures in the para-aortic regions should be considered when the diagnosis of aortic dissection is entertained.- - - - - - - - - - ranking = 0.00031572581477189keywords = chest (Clic here for more details about this article) |
6/116. radial nerve entrapment by the lateral intermuscular septum after trauma.radial nerve palsy is associated with humeral shaft fractures, usually occurring at the time of injury but sometimes occurring later. We report on a case in which a progressive radial nerve palsy occurred three months after a fracture; on exploration, the nerve was found to be trapped by the lateral intermuscular septum. It is important to recognize progressive radial nerve palsies or late presentations, because they often represent chronic compression and a delay in exploration may be detrimental to the return of nerve function.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
7/116. The application of arthroscopic principles to bone grafting of delayed union of long bone fractures.The purpose of this study was to explore the potential of applying arthroscopic techniques to autogenous bone grafting of long bone fracture delayed union. There were 9 patients in this initial series, including 4 patients (average age, 37 years) with humeral lesions and 5 patients (average age, 25 years) with tibial fractures. There were 6 men and 3 women. Techniques customarily employed in arthroscopy were used to visualize, expose, and deliver the onlay cancellous bone grafts. Bony union occurred in all but 1 patient in an average of 4 months. This patient had a fibrous union and sustained a reinjury that led to successful repeat open bone graft surgery. The arthroscopic approach for bone grafting of certain long bone delayed union appears to be a safe and effective procedure. The procedure is best suited for patients with mechanically stabilized fragments, and it lends itself to those with overlying skin or soft tissue compromise. There are some relative contraindications: grossly unstable fragments, severe malunion, and/or infection.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
8/116. Iatrogenic ulnar nerve injury after percutaneous cross-pinning of supracondylar fracture in a child.Supracondylar fracture of the humerus is the most common fracture of the elbow in children and has been treated by a variety of methods. Recently, stabilization of reduced fractures with percutaneous pin fixation has become the accepted method of treatment. ulnar nerve injury is a complication of percutaneous pinning of supracondylar fractures, although many authors have reported that it resolves spontaneously after removal of the pin.- - - - - - - - - - ranking = 5keywords = injury (Clic here for more details about this article) |
9/116. Broken arm wrestler.An unusual injury following an arm wrestle is presented, that of a fractured humerus.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
10/116. Fishtail deformity following fracture of the distal humerus in children: historical review, case presentations, discussion of etiology, and thoughts on treatment.Fishtail deformity is an uncommon complication of distal humeral fractures in children. This article reports four cases accompanied by premature closure of a portion of the distal humeral physis with resultant deformity, length retardation, decreased elbow motion, and functional impairment. The ages of the patients at time of injury ranged from 4 years 2 months to 6 years 1 month (average 5 years 4 months). The average length of follow-up was 9 years 9 months (range, 3 years 5 months to 18 years 10 months). The cause of the arrest is multifactorial and may be due to a gap in reduction of an intracondylar fracture, avascular necrosis of the epiphysis, or central premature physeal arrest (bar formation) without a fracture gap or avascular necrosis. If identified in a young child, surgical closure of the medial and lateral portion of the physis may prevent the deformity from progressing and would not cause significant additional humeral length discrepancy.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
| | Next -> |