Cases reported "Ulna Fractures"

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1/260. Sideswipe elbow fractures.

    A retrospective review of all cases of sideswipe elbow fractures (SSEFs) treated at two community hospitals from 1982 to 1992 was conducted to determine the functional outcome of the operative treatment of SSEFs. All five injuries involved the left elbow, and they included open fractures of the olecranon, the radius and ulna, the ulna and humerus, the humerus, and traumatic amputation of the arm. Concomitant injuries included three radial nerve palsies and two injuries each to the median nerve, ulnar nerve, and brachial artery. Treatment included irrigation, debridement (repeated if necessary), open reduction and internal fixation, external fixation (one case), and delayed amputation (one case). An average of 130/-10 degrees elbow flexion/extension, and 60/60 degrees supination/pronation was obtained for the three of four patients with reconstructions who returned for follow-up. ( info)

2/260. Irreducible Galeazzi fracture-dislocation due to an avulsion fracture of the fovea of the ulna.

    We report a rare case of Galeazzi fracture-dislocation with an irreducible distal radioulnar joint. The cause of the irreducibility was entrapment of a fragment avulsed from the fovea of the ulna. The patient was successfully treated with open reduction and internal fixation of the radius, ulnar styloid process and avulsed fracture at the fovea of the ulna. ( info)

3/260. 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. ( info)

4/260. Congenital pseudarthrosis of the forearm treated by free vascularized fibular graft: a report of three cases and a review of the literature.

    Congenital pseudarthrosis of the forearm is a rare condition; approximately 60 cases have been reported in the English literature. We report 3 patients treated by wide excision of the pseudarthrosis and free vascularized fibular grafting. The pseudarthrosis involved the radius in 1 patient and the ulna in 2. Neurofibromatosis was present in 2 patients. The technical problems encountered during the procedures included preservation of the distal epiphysis and attaining stable fixation of the fibular graft without damaging its vascular supply. A review of 15 previously reported patients treated by free vascularized fibular grafting showed that this procedure is excellent in the treatment of congenital pseudarthrosis of the forearm and that the result is consistently reproducible. ( info)

5/260. Complete transection of the median and radial nerves during arthroscopic release of post-traumatic elbow contracture.

    Arthroscopic debridement and capsular release was performed in a 57-year-old woman because of post-traumatic stiffness in the dominant right elbow joint. During this procedure, the median and radial nerves were completely transected. A few recent reports of small series have described encouraging results after arthroscopic capsular release of post-traumatic elbow contracture, but the present case demonstrates the inherent risk of damage to neurovascular structures. ( info)

6/260. 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. ( info)

7/260. 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. ( info)

8/260. A new fracture of the forearm adjacent to a healing fracture.

    A 10-year-old girl sustained closed fractures of the distal radius and ulna. This was manipulated and she was treated in an above-elbow plaster for 4 weeks. Two weeks later she was discharged, only to have a second injury to the same forearm. X-ray showed a new fracture distal to undisrupted callus. ( info)

9/260. 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. ( info)

10/260. Consequences of a fracture through a minimally ossified apophysis of the olecranon.

    The case of a 12-year old boy with a missed olecranon fracture after an elbow trauma is presented. knowledge of the ossification patterns around the elbow is essential in evaluating elbow trauma in children. Certain fractures of the immature elbow present diagnostic difficulty, which can lead to missed or delayed diagnosis, with possible permanent functional loss that timely diagnosis and treatment might avoid. This is particularly true for those fractures running through unossified portions of the elbow. Such a case is described. ( info)
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