Der Unfallchirurg
-
Antegrade or retrograde intramedullary nailing is a common and well established procedure for the treatment of femoral shaft fractures. One drawback of this technique is the high incidence of clinically relevant malalignment. Despite intra-operative and radiological improvements this problem has not yet been solved efficiently. The aim of this study was the evaluation of the mechanical influence on the antetorsion angle of intramedullary nails during and after interlocking in femoral shaft fractures. ⋯ It could be shown that mechanical stability as well as the interlocking itself of femoral nails have a relevant impact on the antetorsional angle of the femur. Potential sources of error of the femoral antetorsion angle can be caused by the interlocking process as well as by forced rotation of the femur after interlocking. Clinical studies are needed to improve our findings, while the observed effects might have an essential influence on the incidence of femoral malalignment after osteosynthesis by intramedullary nailing of the femur.
-
A baby was brought into the accident and emergency department with X-ray pictures and with a plaster cast in place because of a pain reaction in the right arm. The pictures showed destruction of the epiphyseal region and double periosteal contours. ⋯ No traumatological/orthopedic treatment was given, and the plaster cast was removed. Following recognition of the signs described a complete cure was possible.