Cases reported "Ulna Fractures"

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1/83. An open fracture of the ulna with bone loss, treated by bone transport.

    We report a Gustilo and Anderson IIIc fracture of the ulna with 8 cm of bone loss which was reconstructed primarily by the technique of external fixation and bone transport. Five operations were performed over a period of 14 months (treatment index = 52.5 days/cm). A satisfactory functional result was achieved, demonstrating the efficacy of this technique for difficult forearm reconstructions and comparing favourably with other methods of managing large bone and soft tissue defects.
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2/83. Transcranial doppler detection of fat emboli.

    BACKGROUND AND PURPOSE: The fat embolism syndrome (FES) is characterized by the simultaneous occurrence of pulmonary and neurological symptoms as well as skin and mucosal petechiae in the setting of long-bone fractures or their surgical repair. Its pathophysiology is poorly understood, and effective treatments are lacking. We present 5 patients with long-bone fractures in whom in vivo microembolism was detected by transcranial Doppler. methods: Five patients with long-bone fractures were monitored with transcranial Doppler for microembolic signals (MESs) after trauma. Two patients also had intraoperative monitoring. A TC-2020 instrument equipped with MES detection software was used. Detected signals were saved for subsequent review. Selected signals satisfied criteria defined previously and were categorized as large or small. RESULTS: Cerebral microembolism was detected in all 5 patients and was transient, resolving within 4 days of injury. Intraoperative monitoring revealed an increase in MESs during intramedullary nail insertion. The characteristics of MESs after injury varied among patients, with large signals being more frequent in the only patient with a patent foramen ovale. CONCLUSIONS: Cerebral microembolism after long-bone fractures can be detected in vivo and monitored over time. These findings may have potential diagnostic and therapeutic implications.
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keywords = bone
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3/83. Entrapment of the median nerve in a greenstick forearm fracture. A case report and review of the literature.

    We report a case of low median nerve palsy occurring as a complication of a closed both-bone forearm fracture in a child. Following delayed diagnosis, surgical exploration was performed and it was observed that the median nerve was entrapped in the callus of the radius fracture.
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4/83. Entrapment of the index flexor digitorum profundus tendon after fracture of both forearm bones in a child.

    Entrapment of the index FDP tendon in a radius fracture callus occurred after fracture of both forearm bones in a 4-year-old boy. Surgical release of the FDP tendon, three months after fracture, resulted in normal index finger motion. This clinical problem can be avoided by a detailed physical examination of children with forearm fractures, verifying full passive range-of-motion of the hand after cast immobilization. Prompt supervised active range-of-motion should be done to prevent adhesions at the fracture site.
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5/83. Transient posttraumatic cystlike lesions of bone.

    Cystlike cortical defects appearing after minor greenstick fractures in children have occasionally been described. These lesions are typically asymptomatic and appear just proximal to the fracture line within the area of subperiosteal new bone formation. Although the pathogenesis of these lesions remains in doubt, complete resolution is the rule, with no adverse effect on fracture healing. Only 18 cases of these transient postfracture cysts have previously been reported in the English-language literature. We present two additional cases of cyst formation after greenstick fracture of the distal radius in children aged 2.5 and 5.5 years. The natural history of such lesions is discussed and the current theories on their pathogenesis are reviewed.
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6/83. One-bone forearm formation using vascularized fibula graft for massive bone defect of the forearm with infection: case report.

    Massive long-bone defects of greater than 6 cm are difficult to treat with conventional bone grafts, and other methods are sometimes recommended, such as vascularized bone grafts or bone transport using the Ilizarov external fixator. The combination of local infection with a massive bone defect exacerbates the problem, and provides an even more negative prognosis. The authors treated a large bone defect of the forearm with local infection, using a one-bone forearm formation with a large vascularized fibula graft. They attached an adequate amount of muscle fascia to the vascularized fibula, which was useful not only for coverage of the skin defect, but also for treatment of the local infection. Twenty months after surgery, elbow and hand functions were maintained, and the patient had no disturbance of hand function in daily activities, although rotation of the forearm was sacrificed.
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ranking = 1.3636363636364
keywords = bone
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7/83. Spontaneous fracture healing in plasma cell malignancy of bone.

    This report describes a patient in whom sequential pathological fractures occurred at sites of plasma cell malignant bony deposits, but in which clinical and radiological healing occurred without treatment at the site of the initial deposit.
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8/83. Entrapment and transection of the median nerve associated with minimally displaced fractures of the forearm: case report and review of the literature.

    Complete transection of the median nerve associated with minimally displaced fractures of forearm bones is described in a 20-year-old woman. An end-to-end epineural repair was performed. There was good sensory and motor recovery of the median nerve in the hand.
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ranking = 0.090909090909091
keywords = bone
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9/83. growth arrest of the distal radius following a metaphyseal fracture: case report and review of the literature.

    We report a 12-year-old girl who developed growth arrest of the distal radius physis 9 months after sustaining a complete fracture of the distal radial and ulnar metaphysis with no involvement of the physis evident at time of injury. The girl sustained a fracture of the metaphysis of her right distal radius and ulna after a fall. Anterior-posterior, lateral and oblique radiographs at injury, and during subsequent healing show no evidence of the fracture involving the physis. She was treated with closed reduction and casting for 6 weeks and healed uneventfully. She returned 4 month later concerned about distal ulnar prominence. Radiographs revealed a loss of radial tilt and with suspicion of a physeal bar. magnetic resonance imaging confirmed a physeal bar located in the dorsal radial region. A literature search of the medline database was used to obtain prior case reports for review purpose. The patient underwent an epiphysiodesis of the distal radius and ulna along with an opening wedge osteotomy and bone grafting of the distal radius to restore radial height and inclination. She healed without complication and with restoration of the normal relationship of the distal radius and ulna. A review of the literature reveals five reported case of distal radial metaphyseal fractures not invloving the physis leading to growth arrest. By comparison, there are 31 reported cases of distal radius physeal arrest following fractures involving the physis. The physician should be aware that common distal radius metaphyseal fractures may rarely lead to growth arrest.
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10/83. Limb conservation using non vascularised fibular grafts.

    This paper highlights the use of non-vascularised fibular graft in limb reconstruction from bone loss due to trauma and infection. Bone loss can occur from severe high velocity injuries due to road traffic accidents, severe neglected infections, and osteolytic tumours. In majority of cases, the surgeon is left with the only option of an amputation especially where there is no access to microvascular surgery and microvascular bone grafting devices. This is a major problem in the West African subregion hence the need for this article. We present illustrative cases of limb conservation in an adult involved in a high velocity trauma and a child with a destructive osteolytic infection culminating in bone loss. The patients are still been followed up in our surgical outpatient clinics.
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