Archives of orthopaedic and trauma surgery
-
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.
-
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.
-
Arch Orthop Trauma Surg · Oct 2007
Review Case ReportsOpen grade III "floating ankle" injuries: a report of eight cases with review of literature.
"Floating ankle" injuries result from high-energy trauma and are usually associated with extensive soft tissue damage. Such rare and complex injuries in the acute phase pose therapeutic dilemma to the treating surgeon. When salvage instead of amputation is preferred, a variety of treatment options are available ranging from open reduction along with minimal internal fixation to external fixation. In this retrospective case series study we report eight patients with open "floating ankle" injuries who had been treated with external fixation with or without internal fixation. ⋯ External fixation with or without internal fixation is an option when salvaging rare injuries like open grade III "floating ankle" injuries. Salvaged patients do suffer a cocktail of crippling disease characterized by psycho-socio-economic and physical disability and result in increased hospital costs. We recommend more prospective studies with long-term follow-up of such complex injuries to identify the indications for salvage and also the criteria for a successful salvage.
-
Arch Orthop Trauma Surg · Oct 2007
Randomized Controlled TrialTreatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing.
The aim of this study was to compare the radiographic results and clinical outcome of unreamed tibial nailing (UTN) and Ilizarov external fixation (IEF) for the treatment of type IIIA open fractures of the tibia. ⋯ The results of the current study showed that IEF technique had a notable incidence of pin-tract infection, joint contracture, and shorthening related to treatment of the delayed union. The UTN technique had the disadvantage of a posttraumatic osteomyelitis and delayed union requiring additional surgery. We believe that the decision to use IEF or UTN should be made on a case-by-case basis.
-
Arch Orthop Trauma Surg · Oct 2007
Treatment of the humeral shaft nonunion after surgical failure using the Selfdynamisable internal fixator.
A nonunion of the humeral shaft is not a rare condition and is a complication of both nonoperative and operative treatment of the fracture. Several fixation options were used in the nonunion treatment, including various plate techniques, intramedullary nails and external fixator. We applied our Selfdynamisable internal fixator for the treatment of humeral shaft nonunion after surgical failure and evaluated its clinical outcome. ⋯ Selfdynamisable internal fixator with bone graft for the treatment of recalcitrant humeral shaft nonunion provided successful clinical outcome with minimal complications.