The American journal of orthopedics
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Neurologic injuries are a potentially devastating complication of total hip arthroplasty (THA). Review of the literature reveals that these injuries are uncommon. The reported incidence ranges from 0.08% to 7.6%. ⋯ Reported etiologies include intraoperative direct nerve injury, significant leg lengthening, improper retractor placement, cement extravasation, cement-related thermal damage, patient positioning, manipulation, and postoperative hematoma. Risk factors include developmental dysplasia of the hip, the female sex, posttraumatic arthritis, and revision surgery. However, no single risk factor has been consistently reported to be significant, and many patients with no known risk factors incur neurologic injuries.
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Segmental forearm fractures are rare in children, and management is controversial. Epiphyseal injuries further complicate matters. ⋯ The patient underwent immediate internal fixation of the forearm fractures and delayed fixation of the scaphocapitate fractures. Results at 12 months showed excellent functional outcome.
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Open periarticular shoulder fractures present a tremendous challenge for orthopedic surgeons. These injuries, albeit rare, are typically caused by high-energy mechanisms and are associated with insult to multiple organ systems resulting in high morbidity and mortality. Although the civilian trauma literature includes several articles on outcomes of closed periarticular shoulder fractures, only 1 peer-reviewed article has focused on this specific open injury pattern. ⋯ Meticulous surgical débridement is essential in managing these severely comminuted and contaminated open fractures. In cases in which internal fixation is used, careful timing and patient selection are required to minimize risk for osteomyelitis. Data collection is being continued in this patient cohort to allow for eventual reporting of functional outcomes.