Archives of orthopaedic and trauma surgery
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Isolated fracture of the calcaneal apophysis is a rare injury in children and adolescents. In this study, we report on a case of a displaced calcaneal apophyseal avulsion fracture in a child treated with open reduction and internal fixation, as well as a review of the literature. A 9-year-old female child presented to the senior surgeon complaining of acute heel pain after a gymnastic injury. ⋯ A combination of bioabsorbable suture tacks and pins was used to anatomically fix the fragment using the tension band wiring technique. At 2 years and 6 months follow-up, she had full range of motion, complete return of strength. We report here on the successful surgical treatment and the first case evaluated by MRI of an avulsion fracture of the calcaneal apophysis in a child.
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Arch Orthop Trauma Surg · May 2007
Case ReportsConservative treatment of an acute compartment syndrome of the thigh.
Compartment syndromes of the thigh after blunt trauma without any fracture are rare. Most surgeons recommend operative treatment. There are different rules for compartment syndromes of the thigh in young athletes after blunt trauma compared to compartment syndromes at other locations [(1) the large volume of the quadriceps muscle, (2) its relatively elastic fascia, (3) the direct proximal contact to the hip muscles which allows extravasation of fluid out of the compartment)]. ⋯ Depending on the severity the diagnosis and follow-up with ICP measurements and MRI is necessary. There is a very good chance for excellent outcome without any risk of surgery. However, a long healing time is possible.
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Arch Orthop Trauma Surg · May 2007
Randomized Controlled Trial Comparative StudyPre- versus postoperative intraarticular application of local anesthetics and opioids versus femoral nerve block in anterior cruciate ligament repair.
Often anterior cruciate ligament (ACL) reconstruction is performed as outpatient surgery. This requires a patient friendly postoperative pain management. Three common procedures were compared in this trial. ⋯ Our data show that in anterior cruciate ligament reconstruction preoperative intraarticular analgesia with Bupivacain/Fentanyl is satisfactory and equal to the femoralis 3-in-1 nerve block with Bupivacain.
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Arch Orthop Trauma Surg · Apr 2007
Use of the AO hook-plate for treatment of unstable fractures of the distal clavicle.
We used a new internal fixative implant, the AO clavicle hook-plate, for treatment of unstable fractures of the distal clavicle. This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and problems encountered. ⋯ AO clavicle hook-plates are useful fixative implants for unstable fractures of the distal clavicle. Static fixation was achieved and physiotherapy can be started immediately after surgery. Early removal of the implant is recommended however because hooks inserted under the acromion migrated into the bone in most cases.
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Arch Orthop Trauma Surg · Jan 2007
Controlled Clinical TrialFixation of nondisplaced scaphoid fractures: making treatment cost effective. Prospective controlled trial.
Nondisplaced scaphoid waist fractures treated with prolonged plaster immobilisation often lead in transient joint stiffness and to a delay in return to sport and work activity. The long time off work increases the work off compensation costs. Internal fixation of scaphoid fractures has resulted in a shorter time to union and to return to work and sports. This prospective study compares cast immobilisation with screw fixation and the direct cost with indirect cost of conservative and minimally invasive treatment of undisplaced scaphoid fractures. ⋯ Internal screw fixation of nondisplaced scaphoid fractures had a shorter time to bony union and the patients returned earlier to work compared with cast immobilisation. Although it is assumed that operative treatment is more expensive, in this study the cost was not found to be higher.