When a wrist injury is not a Colles' Fracture - abstract

Fractures of the lower radius with anterior displacement of the distal fragment are very uncommon injuries. These injuries, designated Smiths' and Barton's Fractures, tend to be readily confused with and misdiagnosed as the commoner Colles' fracture in which the distal fragment is displaced posteriorly, producing the well-known clinical "Dinner Fork Deformity". Between January 1977 and October 1984, 12 fractures of the distal radius with anterior displacement were seen and treated at the Queen Elizabeth Hospital. The case notes and radiographs of these 12 patients were studied, and nine were available for interview and examination. The injuries arose from falls (5), cycle accidents (6), and blows to the back of the hand (1). Two fractures were in children. In ten of the 12 cases the initial diagnosis was incorrect. On average presentation was late, 3 to 4 days, with one patient presenting one month after injury. Most fractures were treated by open reduction and fixation; three, including two children, were treated by manipulation and Plaster-of-Paris (AU)

Supracondylar fracture of the humerus in children in Guyana

The management of 109 children with supracondylar fractures of the humerus at the Georgetown Hospital, Guyana over a 5-year period has ben described. The condition was seen more commonly in East Indians than in Africans. The treatment of choice was closed reduction which was performed in flexion and held in pronation. Open reduction when necessary was done early. Cubitus varus deformity was more common in the group which had closed reduction and was due to inadequate correction of the medial angulation of the distal fragment. Volkmann's ischaemia, as a complication, was not observed in this series (AU)