Injury
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Comparative Study
Fracture of the distal radius with radial artery injury: injury description and outcome of vascular repair.
The ideal treatment of an isolated radial artery injury that is associated with a fracture of the distal radius is unknown. Our purposes were to assess the incidence of this injury pattern and to describe the outcomes of our treatment protocol. We hypothesised that combined routine repair of the artery during operative treatment results in a satisfactory outcome. ⋯ Our protocol resulted in adequate outcomes, a 71% patency rate (five of seven fractures with adequate vascular follow-up) and no evidence of symptoms related to a poorly perfused hand.
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Hand/finger amputations though rare account for significant disability and health-related costs; yet, information on underlying causes, springing mostly from physicians' reports, is rather anecdotal. We sought to draw attention to the high preventable fraction of hand/finger amputations among adults in Greece. ⋯ Increased management of safety in the workplace could play a role in reduction in hand amputations.
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Comparative Study
A prospective analysis of the functional and radiological outcomes of minimally invasive plating in proximal humerus fractures.
Locking-plate osteosynthesis is a well-established treatment option for proximal humerus fractures. The standard approach is delta-pectoral, but few data using the minimally invasive antero-lateral delta-split approach exist. The aim of the study was to prospectively evaluate shoulder function and radiological outcome after a minimally invasive antero-lateral delta-split approach. ⋯ Level IIb, monocentric prospective cohort study.
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Reconstruction of shoulder abduction by multiple nerve fascicle transfer through posterior approach.
To evaluate the feasibility and clinical efficacy of multiple nerve fascicle transfer through posterior approach for reconstruction of shoulder abduction in patients with C5 or upper brachial plexus injury. ⋯ It is feasible to carry out multiple nerve fascicle transfers for early reconstruction of shoulder abduction by posterior approach. Patients who received this procedure achieved good functional recovery and their donor site morbidity/injury was minimal.
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The aim of our study is to analyse the results of our surgical technique for the treatment of proximal humeral fractures and fracture dislocations using locking plates in conjunction with calcium sulphate bone-substitute augmentation and tuberosity repair using high-strength sutures. We used the extended deltoid-splitting approach for fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations. Optimal surgical management of proximal humeral fractures remains controversial. Locking plates have become a popular method of fixation. However, failure of fixation may occur if they are used as the sole method of fixation in comminuted fractures, especially in osteopenic bone. ⋯ In our experience, we have found the use of locking plates, calcium sulphate bone substitute and tuberosity repair with high-strength sutures to be a safe and reliable method of internal fixation for complex proximal humeral fractures and fracture-dislocations. Furthermore, we have also found the use of the extended deltoid-splitting approach to be safe and to provide excellent exposure facilitating accurate reduction for fixation of the fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations.