Cases reported "Fractures, Malunited"

Filter by keywords:



Filtering documents. Please wait...

1/11. osteotomy for malunion of a talar neck fracture: a case report.

    A malunion of the talar neck after a Hawkins type II fracture/dislocation of the talar neck occurred in a 34-year-old man after nonoperative treatment. Rigid varus deformity of the forefoot was a source of severe pain and disability in this patient. We describe our surgical technique for osteotomy of the talar neck with insertion of a tricortical iliac crest bone graft to correct the deformity. At follow-up (56 months), the patient had consistent relief of pain and was employed at his preinjury job doing heavy labor. The score on the American Orthopaedic foot and ankle Society ankle-Hindfoot Scale improved from 11 points, preoperatively, to 85 points, postoperatively. Radiographs showed maintenance in the position of the osteotomy and no evidence of avascular necrosis in the talar body. Evidence of arthrosis of the talonavicular joint was apparent radiographically, but the patient did not complain of symptoms referable to this area.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/11. Articular impingement in malunited fracture of the humeral head.

    We report on the case of a fracture of the humeral metaepiphysis, surgical neck, and greater tuberosity treated conservatively. Malunion of a fracture of the greater tuberosity developed an impingement on the glenoid surface, causing an articular locking in internal rotation that resolved with slight pressure and a painful "click." The impinging bone was removed arthroscopically. Its extreme posterior position required opening a second, novel portal close to the posterior edge of the acromion for instrument access. Complete removal of the impinging bone restored free internal rotation without signs of impingement on the glenoid surface. Passive motion was initiated immediately postoperatively, and active motion in a water pool was initiated after 2 weeks. After 1 year, the patient has no pain, has maintained complete range of motion, and experiences no limitations in daily or sports activities. The peculiar features of this case are the absence of soft tissue scar stiffness and deficiency of the rotator cuff, because malunion of the bone fragment to the posterior edge of the humeral head produced a mechanical block of internal rotation, and the arthroscopic treatment of the impingement through an atypical superoposterior portal, which has not been described in the literature before.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = operative
(Clic here for more details about this article)

3/11. Malunion of femoral head fractures treated by partial ostectomy: three case reports.

    Malunion of femoral head fractures has been rarely reported. We report on three cases of malunion of the femoral head, which were treated by partial ostectomy. All patients were involved in traffic accidents and had a posterior fracture-dislocation of the hip. The types of femoral head fractures were Pipkin type I with inferomedial fracture fragment in all cases. Initially, they were treated by closed reduction and skeletal traction for between 6 and 8 weeks. The patients were then transferred to our hospital; the chief complaint was of limited hip motion. A protruding bony mass limiting the hip motion was resected in all cases. The Smith-Petersen approach was used in all cases. The malunion sites were located distally to the original fracture site in all cases. Full weight bearing was permitted, and a range of motion exercises was started postoperatively. Excellent results were obtained with almost complete restoration of hip motion without pain. In the follow-up radiographs, there were no cases of avascular necrosis.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = operative
(Clic here for more details about this article)

4/11. Neglected femoral diaphyseal fracture.

    Femoral diaphyseal fractures usually result after trauma of high magnitude and because of this, can be life-threatening injuries or may result in considerable physical disability if not treated with care and caution. Nonoperative treatment of these fractures continues to be popular among the patient population in the Indian subcontinent, which in majority of cases, leads to healing in malalignment, shortening of the limb, chondromalacia patellae, and loss of knee motion. Although the majority of these fractures are being treated by operative methods today, success of the treatment depends largely on the surgeon's familiarity with the procedure or the type of fracture pattern (comminuted or segmental) particularly in a polytraumatized patient. Delayed union and nonunion of femoral-diaphyseal fractures and implant failures usually result after these procedures or the type of injury. The purpose of this study is to discuss various types of neglected femoral diaphyseal fractures and to review the literature on their treatment.
- - - - - - - - - -
ranking = 0.66666666666667
keywords = operative
(Clic here for more details about this article)

5/11. Obstructive sleep apnea uncovered after high spinal anesthesia: a case report.

    PURPOSE: To illustrate how a patient's previously undiagnosed obstructive sleep apnea was uncovered after administration of a spinal anesthetic with a high sensory blockade, and to discuss possible explanations for this occurrence and anesthetic implications. CLINICAL FEATURES: A 55-yr-old male presented for osteotomy and open reduction and internal fixation of his left femur secondary to malunion from a previous fracture. Past medical history consisted of hypertension, hypercholesterolemia, bipolar disorder, gastroesophageal reflux disease, and cluster headaches. A combined spinal-epidural technique was chosen. Isobaric bupivacaine 0.5% (15 mg), was provided for the spinal anesthetic, along with 1 mg iv midazolam for procedural sedation and 0.5 mg iv droperidol for mild nausea. Throughout the operation, many apneic events were noted, often with respiratory efforts. The patient was easily arousable during each event and would breathe normally until the next episode. vital signs remained stable throughout. Postoperative respirology consultation was requested, and a sleep study revealed severe obstructive sleep apnea. The patient was subsequently started on continuous positive airway pressure with marked improvement in symptoms, including the cluster headaches. CONCLUSION: Recent literature suggests that high spinal blockade can result in altered levels of arousal by producing a de-afferentation of peripheral proprioceptive and sensory stimuli necessary for maintaining an awake state. In patients predisposed to upper airway obstruction, decreasing the level of consciousness can result in airway obstruction as occurs during sleep in these patients. This serves to underline the importance of considering capnography for all cases utilizing a neuraxial anesthetic technique.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = operative
(Clic here for more details about this article)

6/11. absorbable implants in surgical correction of a capitellar malunion in an 11-year-old: a case report.

    We present the case of an 11-year-old girl who had a corrective osteotomy reconstruction using absorbable implants for a malunited capitellar fracture 3-1/2 months after a dislocation of her elbow joint. This operative stabilization enabled early joint mobilization and, finally, excellent results in terms of anatomy and function at a 2-year follow-up. We were not able to find any similar report in the English literature dealing with corrective osteotomy reconstruction using absorbable implant fixation for a malunited capitellum in a child.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = operative
(Clic here for more details about this article)

7/11. Remodelling of a displaced phalangeal neck fracture.

    Phalangeal neck fractures are uncommon in children. When these injuries to the proximal and middle phalanges are displaced and not treated operatively the fracture may heal in a malunited position with loss of motion at the IP joint. Remodelling in the area of the phalangeal neck is thought to be reduced because of its distance from the physis. In cases of malunion osteotomy of the phalangeal neck may be required to restore anatomy and motion. A case is described which demonstrates complete remodelling of a displaced middle phalangeal neck fracture in a child and recovery of a normal range of motion without operative intervention.
- - - - - - - - - -
ranking = 0.66666666666667
keywords = operative
(Clic here for more details about this article)

8/11. Reconstruction after malunion and nonunion of intra-articular fractures of the distal humerus. methods and results in 13 adults.

    We reviewed the results of 13 adults of secondary reconstruction of malunited and ununited intraarticular distal humeral fractures. Their average age was 39.7 years, and preoperatively all had pain, loss of motion and functional disability; the average arc of motion was only 43 degrees and the average flexion contracture was 45 degrees. Nine patients had ulnar neuropathy. Elbow reconstruction, at an average of 13.4 months after the original injury, included osteotomy for malunion or debridement for nonunion, realignment with stable fixation and autogenous bone grafts, anterior and posterior capsulectomy and ulnar neurolysis. The elbows were mobilised 24 hours postoperatively. There were no early complications and all nonunions and intra-articular osteotomies healed. After a mean follow-up of 25 months, the average arc of motion was 97 degrees with no progressive radiographic degeneration. ulnar nerve function improved in all cases and clinical assessment using the Morrey score showed two excellent, eight good and three fair results. Reconstruction of intra-articular malunion and nonunion of the distal humerus in young active adults is technically challenging, but can improve function by restoring the intrinsic anatomy of the elbow.
- - - - - - - - - -
ranking = 0.66666666666667
keywords = operative
(Clic here for more details about this article)

9/11. Correction osteotomies of phalanges and metacarpals for rotational and angular malunion: a long-term follow-up and a review of the literature.

    Correction osteotomies of nine phalanges and six metacarpals for rotational and angular malunion were performed in 15 patients ranging from 20 to 75 years of age and followed a mean period of 4.5 years, ranging from 1 to 11 years. Full correction of the preoperative deformity was achieved in 13 of the 15 patients (87%), bony union in 100%, and no loss of preoperative range of motion was observed, except in one patient who underwent additional arthrodesis. A high satisfaction rate was seen among 13 of the 15 patients. These results underline that osteotomies of phalanges and metacarpals for angular and rotational malunion can have significant functional benefits for the well-being of patients.
- - - - - - - - - -
ranking = 0.66666666666667
keywords = operative
(Clic here for more details about this article)

10/11. Corrective osteotomy for scaphoid malunion: technique and long-term follow-up evaluation.

    Five patients with dorsal intercalated segment instability underwent corrective osteotomy for symptomatic scaphoid malunion. Follow-up examination at an average of nearly 9 years after the procedure (range, 1.5-19 years) revealed that all had improvement in range of motion (ROM). Total active ROM improved from a mean of 127 degrees (range, 95 degrees-165 degrees) to a mean of 156 degrees (range, 95 degrees-214 degrees). Grip strength increased from a mean of 16 kg (range, 14-35 kg) to a mean of 32 kg (range, 24-48 kg). The wrist score improved from an average of 19 to 75. The preoperative intrascaphoid and carpal malalignments were reduced, as demonstrated by trispiral tomography. Symptomatically, all patients reported improvement. All osteotomies healed within 5.5 months of the procedure. No case of avascular necrosis was noted. Mild radioscaphoid arthrosis is apparent in four patients and a preexisting midcarpal arthrosis persists in one patient. Corrective osteotomy for scaphoid malunion may have a role in the prevention or slowing of the onset of premature arthritis in young patients with high functional demands. A technique is described.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Fractures, Malunited'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.