RESUMO
Thirty-seven patients were treated over a 7-year period using the "S" Quattro dynamic external fixator. There were 30 intra-articular and nine extra-articular fractures. Patients were reviewed at an average of 22.5 months. The average total range of motion for the affected digit at follow-up was 232 degrees for intra-articular and 241 degrees for extra-articular fractures. We believe that this device is a simple, reliable technique in the treatment of these difficult fractures.
Assuntos
Fixadores Externos , Traumatismos dos Dedos/cirurgia , Fraturas Ósseas/cirurgia , Traumatismos da Mão/cirurgia , Metacarpo/lesões , Adolescente , Adulto , Fios Ortopédicos , Desenho de Equipamento , Feminino , Traumatismos dos Dedos/diagnóstico por imagem , Seguimentos , Consolidação da Fratura/fisiologia , Fraturas Ósseas/diagnóstico por imagem , Fraturas Expostas/diagnóstico por imagem , Fraturas Expostas/cirurgia , Traumatismos da Mão/diagnóstico por imagem , Humanos , Masculino , Metacarpo/diagnóstico por imagem , Metacarpo/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , RadiografiaRESUMO
Mesenteric lymphangiomas are rare benign tumours of lymphatic vessels. We present the case of a mesenteric lymphangioma in a 14 year old boy.
Assuntos
Linfangioma Cístico , Mesentério , Neoplasias Peritoneais , Adolescente , Humanos , Linfangioma Cístico/patologia , Masculino , Mesentério/patologia , Neoplasias Peritoneais/patologiaRESUMO
Previous authors have demonstrated that the optimum position for screw placement in the occiput is in the inner occipital crest. The position of this structure is usually taken as being in the midline; however, this has not been previously validated. Computerized tomography (CT) of the occipital region was performed prospectively according to a standard protocol. The study included 100 patients (53 female and 47 male, 18-75 years of age). CT images were analyzed to determine the position of the inner occipital crest in relation to the midline. The inner occipital crest is located off the midline (> or = 2 degrees ) in 48% of patients. Preoperative CT evaluation may be helpful prior to occipitocervical fixation on the basis of this study.
Assuntos
Parafusos Ósseos , Osso Occipital/diagnóstico por imagem , Osso Occipital/cirurgia , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Tension band wiring is a recognised standard treatment for olecranon fractures. We studied the effect of K-wire position on backing out of the wire in a group of 80 patients with closed transverse olecranon fractures with a minimum follow-up time of 9 months. The rate of wires backing out as seen on X-ray was three times greater in patients who had K-wires passed down the long axis of the ulna rather than across the anterior cortex as recommended by the AO group. There was a corresponding higher rate of local complications in these patients. 42% of this group had to have the metal removed compared with 11.4% of the transcortical group. We compared the biomechanical properties of both K-wires positions in a human cadaveric model. The maximum pull-out strength for each configuration was recorded in 20 elbow joints. The average maximum pullout strength for the intramedullary wires was 56.3 N (range 27. 7-95.6 N) and 122.7 N for the transcortical wires (range 56.7-201.2). The results of both the clinical study and biomechanical data support the routine use of transcortical placement of K-wires in tension-band wiring of transverse olecranon fractures.