Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Case Reports Comparative StudyEvaluation of isolated fractures of the greater trochanter with magnetic resonance imaging.
The diagnosis of an isolated fracture of the greater trochanter can be done on routine radiographs, but this may not be the whole story. We evaluated fractures of the greater trochanter of the femur by magnetic resonance imaging (MRI). MR images were obtained within 5 days of the time of clinical presentation. ⋯ MRI showed that in seven of the eight cases, the fracture line was observed leading from the greater trochanter towards other trochanter regions. In only one case was the fracture limited to the greater trochanter and corresponded to the line observed on the standard radiographs. We suggest that in cases of greater trochanter fracture with somewhat severe symptoms, MRI should be performed in order to discover the appropriate diagnosis and treatment.
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Arch Orthop Trauma Surg · Jan 2000
Case ReportsSimultaneous anterior and posterior traumatic dislocation of the hip. A case report with review of the literature.
The presence of anterior dislocation of the hip along with contralateral posterior dislocation of the hip in the absence of other major trauma is a distinctly rare injury pattern. We report such a case resulting from a motor vehicle striking a pedestrian, along with a review of previous cases. The patient was managed nonoperatively within 6 hours of trauma with an excellent final outcome and no posttraumatic complications over a 3-year follow-up. The possible mechanism of this injury is discussed.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyTibial shaft malunion treated with reamed intramedullary nailing: a revised technique.
Thirty-seven consecutive adult tibial shaft malunions which had not undergone surgical treatment were prospectively treated with reamed intramedullary nailing. Indications for this treatment modality included a malunion of a tibial shaft which had only been conservatively treated, lesion level fitting for traditional or locked reamed intramedullary nail fixation, less than 2 cm shortening, and without evidence of deep infection at present. The malunions were treated with fibulotomy, closed wedge tibial osteotomy, open reaming of the marrow cavity, stable reamed intramedullary nail stabilization with or without supplementation, and cancellous bone grafting. ⋯ Good exposure of the bony segments to ream the marrow cavity precisely can avoid cortical perforation. Gentle dissection of the soft tissues may lower the infection rate. Concomitant cancellous bone grafting can improve the union rate.
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We report a case of a nerve sheath ganglion of the ulnar nerve at the canal of Guyon. This case involved a ganglion which was confined to the epineurium of the ulnar nerve. and it was completely excised without any damage to the nerve fiber. A nerve-sheath ganglion is rare, but it should be considered in the differential diagnosis of any tumor which is causing neural disturbance.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyThe pelvic external fixation: the mid-term results of 41 patients treated with a newly designed fixator.
The purpose of this study was to evaluate the clinical and radiological results of unstable pelvic fractures treated with a new external fixation device. Between May 1992 and May 1998, 43 patients with unstable pelvic fractures were treated with a new anterior pelvic external fixator. Two died, and therefore 41 patients' results were evaluated. ⋯ The fixator can be used alone in patients with type B pelvic injuries such as open book and lateral compression. However, it does not provide sufficient stability for severely displaced type C injuries when applied alone. Nevertheless, it may be helpful for fixing type C injuries like a posterior iliac fracture without dislocation of the sacroiliac joint.