The April 2012 Trauma Roundup. 360 . looks at fibula-pro-tibia plating, galeazzi fractures, distal radial fractures in the over 65s, transverse sacral fractures, acute dislocation of the knee, posterior malleolar fractures,
We retrospectively evaluated the clinical and
radiological outcomes of a consecutive cohort of patients aged >
70 years with a displaced fracture of the olecranon, which was treated
non-operatively with early mobilisation. We identified 28 such patients
(27 women) with a mean age of 82 years (71 to 91). The elbow was
initially
1. The bad reputation of fractures of the scaphoid bone is based on a) past disasters caused by inadequate splintage and premature resort to operation; and b) selection of disabling cases for publication. 2. The results obtained in five series comprising over 1,000 fractures suggest that 95 per cent of adequately studied fractures less than a month old unite if properly treated. 3. Sixty cases of established non-union have provided evidence that disability is almost always the result of further injury and that the disability is usually relieved by a short time in plaster. 4. There is no evidence to support the widely held beliefs that a) union by bone can occur only if the fracture is
A protocol for the treatment of subacute haematogenous osteomyelitis has been used and evaluated in 71 children. A group of 26 children with a radiologically "aggressive" lesion had biopsy followed by antibiotics and
Thirty-five patients (28 children and seven adults) were reviewed six months to 22 years after sustaining the common childhood fracture of the intercondylar eminence of the tibia. The aim was to assess both short-term and long-term results and prognosis by clinical and radiological examination and to discover whether conservative treatment was adequate for those severe fractures where a fragment of the tibial crest had been totally displaced. All the less severe fractures and 14 of the 17 severe fractures were treated conservatively. Early improvement occurred in more patients when the knee was
1. The method of treatment of a mallet finger deformity by
Fractures of the hip in children have been associated with a very high rate of serious complications including avascular necrosis (up to 47%) and coxa vara (up to 32%). Over a period of 20 years, we have treated displaced fractures by early anatomical reduction, internal fixation and
Aims. Cubitus varus is the most common late complication of a supracondylar
fracture of the humerus in children. Correction can be performed
using one of a number of techniques of osteotomy but each has disadvantages.
We describe a new technique for correcting post-traumatic cubitus
varus using a lateral closing wedge isosceles triangular osteotomy. Patients and Methods. A lateral closing wedge isosceles triangular osteotomy was performed
in 25 patients (15 male and ten female with a mean age of 9.5 years
(6 to 12)) between May 2010 and April 2013. All patients had cubitus
varus secondary to malunion of a supracondylar fracture, with good
function of the elbow and a full range of movement. The osteotomy
lines were marked on the bone with an isosceles triangular template
made before surgery, after which the osteotomy was performed leaving
the medial cortex intact. Fixation was performed using two lateral
2 mm Kirschner (K)-wires and patients were
Fractures of the forearm (radius or ulna or both)
in children have traditionally been
This paper reports the cost of outpatient venous
thromboembolism (VTE) prophylaxis following 388 injuries of the lower
limb requiring
This paper investigates whether cortical comminution
and intra-articular involvement can predict displacement in distal
radius fractures by using a classification that includes volar comminution
as a separate parameter. A prospective multicentre study involving non-operative treatment
of distal radius fractures in 387 patients aged between 15 and 74
years (398 fractures) was conducted. The presence of cortical comminution
and intra-articular involvement according to the Buttazzoni classification
is described. Minimally displaced fractures were treated with immobilisation
in a cast while displaced fractures underwent closed reduction with
subsequent
We randomly allocated 60 consecutive patients with fractures of the waist of the scaphoid to percutaneous fixation with a cannulated Acutrak screw or
Redisplacement is the most common complication
of
An attempt has been made to describe some of the ways in which the element of rotation, which is so important a part of the function of the normal forearm, has a bearing upon the mechanism and treatment of forearm injuries. In particular, distinction is drawn between those injuries in which the shaft of the radius remains in continuity, and those in which there is a complete fracture of the bone. In the former, rotation of the hand in the reduction will be transmitted to the upper end of the radius, and extremes of rotational movement may safely be used to obtain and hold a reduction. In the latter there is likely to be a rotational deformity between the two radial fragments, and the lower radial fragment must be placed in accurate rotational alignment with the upper. In the first group reduction, and in certain cases
While it is not denied that
Objectives . A rigorous approach to developing, delivering and documenting
rehabilitation within randomised controlled trials of surgical interventions
is required to underpin the generation of reliable and usable evidence.
This article describes the key processes used to ensure provision
of good quality and comparable rehabilitation to all participants
of a multi-centre randomised controlled trial comparing surgery
with conservative treatment of proximal humeral fractures in adults. Methods . These processes included the development of a patient information
leaflet on self-care during sling
Acute fractures of the scaphoid were randomly allocated for conservative treatment in a Colles’-type plaster cast with the wrist
1 . A small series of fractures of the calcaneum with distortion of the subtalar joint has been reviewed. 2. All were treated by subtalar fusion, in most as part of the primary treatment. 3. In all patients the subtalar joint fused by bone without post-operative plaster
We retrospectively reviewed 183 children with a simple fracture of the distal radius, with or without fracture of the ulna, treated by closed reduction and cast
In this review of 106 cases it appears that