Cases reported "Ulna Fractures"

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11/260. Intolerance of osteosynthesis material: evidence of dichromate contact allergy with concomitant oligoclonal T-cell infiltrate and TH1-type cytokine expression in the peri-implantar tissue.

    BACKGROUND: We report on a 37-year-old man without history of previous allergic disease who developed an aseptic intolerance reaction to a chromium-cobalt alloy, with local discomfort, loosening, and absence of fracture healing. Both in vivo and in vitro allergoimmunologic diagnostic tests were performed. methods: Patch testing was done with a European standard series. Specific serum IgE was measured by CAP-FEIA. In addition to immunohistology (APAAP method), peri-implantar tissue was further analyzed by PCR to determine T-cell-receptor-gamma rearrangement and thus the potential clonal (antigen-driven) T-cell repertoire. The actual tissue mRNA expression for IL-4, IL-6, and IFN-gamma was visualized by RT-PCR. RESULTS: skin testing gave a delayed-type reaction to dichromate. Specific serum IgE to natural rubber latex and grass pollen was found--but without clinical symptoms. Immunohistology revealed a monocytic and dense T-cell infiltrate. The latter, instead of being random, showed an oligoclonal T-cell receptor rearrangement. In addition, there was TH1-type mediator expression (IL-6 and IFN-gamma, but not IL-4). CONCLUSIONS: skin test, examination of peri-implantar tissue, and the prompt healing after replacement of the osteosynthesis material suggest an allergic reaction. PCR analysis of peri-implantar tissue can further help to identify and understand allergy-mediated implant intolerance reactions. ( info)

12/260. Metallosis mimicking osteomyelitis from a forearm plate retained for 50 years.

    A forearm plate retained for 50 years was removed because an acute inflammation mimicked chronic infection. The radiographs were very confusing. During the operation metallosis was obvious. Despite the general opinion that forearm plates should be kept in place, this probably should not apply to old "historical" hardware of uncertain chemical composition. ( info)

13/260. An irreducible Salter-Harris type IV distal ulna fracture.

    Epiphyseal fractures of the distal radius are common in children but those involving the distal ulna are rare. Distal ulna epiphyseal injuries are usually Salter-Harris type II and are usually reduced closed and held in plaster to produce good results. In this paper we describe a Salter-Harris type IV injury of the distal ulna epiphysis which required open reduction and internal fixation due to soft tissue interposition. ( info)

14/260. Congenital pseudarthrosis of the ulna treated by free vascularized fibular graft--a case report.

    Congenital pseudarthrosis of the ulna is very rare. We have experienced a case of pseudarthrosis of ulna to be treated with the vascularized fibular graft in a seven-years-and-three-month-old boy. ( info)

15/260. Olecranon stress fracture in a weight lifter: a case report.

    Stress fractures have been reported in the upper limb of sportspeople involved in upper limb dominated events. Olecranon stress fractures have been cited in baseball pitchers, javelin throwers, and gymnasts. The unusual case of a stress fracture of the olecranon in a young weight lifter is reported here. The minimally displaced stress fracture was treated with tension band and two Kirschner wires. The fracture healed in four months and the patient returned to light sports activity after six months. ( info)

16/260. 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. ( info)

17/260. Galeazzi-equivalent fracture in children associated with tendon entrapment--report of two cases.

    INTRODUCTION: This is a report of 2 consecutive cases of the Galeazzi-equivalent fracture in children. CLINICAL PICTURE: In both cases, the mechanism of injury was falls onto the outstretched hand. Radiographs showed fracture of the radius with separation of the distal ulnar physis. TREATMENT: Initial treatment by closed manipulation failed; hence, open reduction and internal fixation was required. The cause of failure of closed manipulation in both cases was interposition of soft tissue into the ulnar fracture site. OUTCOME: Both cases showed good functional outcome after open reduction and internal fixation. CONCLUSION: Recognition of this form of injury is necessary to ensure proper treatment is undertaken to prevent the complications of inadequate reduction and growth retardation. ( info)

18/260. Congenital pseudarthrosis of the ulna and radius in two cases of neurofibromatosis type 1.

    Two children with neurofibromatosis type 1 who presented at birth with congenital pseudarthrosis of the ulna and radius are described. The patients were treated with broad resections. As a consequence, the forearms were reduced in length. The osteotomies were stabilized in one patient first with endomedullary nailing and then with a free vascularized fibular graft. In the second patient the osteotomy was stabilized by external fixation. Using these techniques, rapid and excellent healing and normal function were achieved. In contrast to the lower extremity, reduction of the length of the forearm can be accepted to a certain extent. If necessary, an extension osteotomy can be performed at a later date. ( info)

19/260. 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. ( info)

20/260. Supracondylar fractures of the humerus associated with ipsilateral forearm fractures in children: a report of forty-seven cases.

    Supracondylar fractures of the humerus associated with ipsilateral forearm fractures are uncommon and treatment recommendations are controversial. The purpose of this study was to determine whether pin fixation of both fracture components, humerus and forearm, would improve the outcome. In a two-center trial, 884 children sustaining supracondylar fractures of the humerus were retrospectively reviewed, and 47 (5.3%) showed associated ipsilateral forearm fractures. Of those, 29 underwent Kirschner-wire fixation of the forearm fracture, and 18 of the forearm fractures were treated with casting alone. Three of the 18 forearm fractures with casting alone reangulated. There were no reangulations in the patients who had pin fixation of their fractures. There were no complications due to pin fixation in the humerus or the forearm. In unstable supracondylar humerus and forearm fractures, stabilization with pin fixation to prevent reangulation should be considered. ( info)
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