Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2007
Rupture of the distal biceps brachii tendon: conservative treatment versus anatomic reinsertion--clinical and radiological evaluation after 2 years.
Distal biceps tendon rupture is a relatively rare injury. It commonly occurs in the dominant extremity of middle-aged men during an excessive eccentric tension as the arm is forced from a flexed position, while it is rarely observed during sport activities. Many techniques, including non-operative and surgical option, have been described for the treatment of a ruptured distal biceps tendon, but there is still considerable controversy about the management of choice. ⋯ Our findings confirm the view that anatomic repair of distal biceps tendon rupture provides consistently good results and early anatomic reconstruction can restore strength and endurance for the elbow.
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Arch Orthop Trauma Surg · Oct 2007
Case ReportsA case report of firearm bullet settling into the thoracic spinal canal without causing neurological deficit or vertebral bone destruction.
The main objective of this study was to present a case of gunshot injury in which a bullet particle settled into the inferior-thoracic epidural canal, which was neurologically intact, without causing any vertebral bone destruction. There has been no previous report in the literature regarding a foreign body settling into the vertebral canal following gunshot injury without causing any bony destruction. ⋯ We prefer removal of firearm particles settling into the spinal canal in view of possible later complications such as infection and the toxic effect of the metallic particles, unless there appears any risk of neurological detriment to the patient.
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Arch Orthop Trauma Surg · Oct 2007
Proximal oblique-domed osteotomy of the first metatarsal for the treatment of hallux valgus associate with flat foot: effect to the correction of the longitudinal arch of the foot.
Flat foot and/or metatarsal primus varus are the major causes of hallux valgus, and it is important to correct these deformities in order to prevent the recurrence of this condition. We demonstrate the clinical and radiological assessment of the correction of hallux valgus, metatarsal primus varus, and flat foot after proximal oblique-domed osteotomy of the metatarsus with distal soft tissue reconstruction. ⋯ This study suggest that proximal oblique-domed osteotomy of the metatarsal as a surgical procedure for the treatment of moderate or severe hallux valgus with flat foot can be recommended to correct the longitudinal arch of the foot and the first-second intermetatarsal angle.
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Arch Orthop Trauma Surg · Sep 2007
Retention of flexible intramedullary nails following treatment of pediatric femur fractures.
Flexible intramedullary nails are commonly used for the treatment of diaphyseal femur fractures in children. Although, their removal after fracture healing is advocated by some, there are no definitive studies to support the routine removal of these implants. The purpose of this study is to determine the natural history of children with diaphyseal fractures of the femur treated with flexible intramedullary nails and no scheduled nail removal. ⋯ Among children with femur fractures treated with flexible intramedullary nailing without scheduled implant removal, about a quarter may ultimately require a second procedure for nail removal due to persistent discomfort. Moreover, up to half of patients can have residual non-debilitating pain at 2-5 years post-injury regardless of presence or absence of the implant. Whether this is a previously unrecognized adverse outcome of this injury or treatment approach, or due to routinely leaving nails in will have to be assessed in future controlled trials.
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Arch Orthop Trauma Surg · Sep 2007
Comparative StudyInternal fixation of proximal humerus fractures using the Polarus intramedullary nail.
It has been stated that proximal humeral fractures are the last unsolved fractures in orthopedics. In this study, we evaluate the results of the Polarus nail, in order to constitute to the controversial problem of the treatment of proximal humerus fractures. ⋯ The Polarus nail is designed to provide stable fixation with a straightforward insertion and targeting procedure. The fact that 77.78% of the patients had an excellent or satisfactory clinical outcome, suggest that Polarus humeral rod system can be a worthy alternative to traditional operative methods for displaced proximal fractures of the humerus.