ABSTRACT
This report deals with 51 acute tibial fractures treated between 1981 and 1987 with a interlocking intramedullary nail. All fractures were extraarticular and located in the distal third. Fourty-four patients were followed up for an average of 32 months. The reduction was anatomic in 84%, with the remaining patients having angulation (valgus/antecurvation) of less than 5 degrees and shortening by less than 1 cm. The rate of local complications was 18%, and a secondary operation was required in 12%. There were no cases of deep infection. Bony union was achieved in every case. Overall, the results were judged to be excellent or good in 96% of the tibias. In this series we saw no poor results.
Subject(s)
Ankle Injuries , Fracture Fixation, Intramedullary , Tibial Fractures/surgery , Wound Healing , Adolescent , Adult , Aged , Aged, 80 and over , Female , Fibula/injuries , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
In each of 73 patients with acute knee injuries, both menisci were examined by means of 7.5-MHz sector-scan sonography before arthroscopy was performed. In 87% of the cases the sonographic and arthroscopic diagnoses were identical. The results were better for the lateral meniscus. Overall, the sensitivity was 80% and the specificity, 90%. False-positive and false-negative results each accounted for 6%. In this series there was no correlation between the accuracy of the sonographic diagnosis and the type of meniscal lesion or its location within the meniscus.
Subject(s)
Knee Injuries/diagnosis , Tibial Meniscus Injuries , Ultrasonography/methods , Adolescent , Adult , Aged , Arthroscopy , Diagnosis, Differential , Female , Humans , Male , Menisci, Tibial/pathology , Middle AgedABSTRACT
A free fascio-cutaneous flap can be raised from the lateral arm. This flap is especially suitable for smaller defects. The area is supplied by a terminal branch of the profunda brachii artery. The anatomy of the donor site as well as several steps in dissection are described. Three cases where a lateral arm flap has been used are shown, together with a rare intraoperative complication.
Subject(s)
Microsurgery/methods , Surgical Flaps , Adult , Cicatrix/surgery , Female , Foot/surgery , Foot Injuries , Forehead/injuries , Fractures, Open/surgery , Humans , Male , Postoperative Complications/etiology , Skin Ulcer/surgery , Tibial Fractures/surgeryABSTRACT
The primary treatment of extensive, deep 3 degrees burn injuries of the lower leg can lead to adhesion of the split-thickness graft with the anterior tibial shaft. Chronic recurring defects with correlative soft-tissue infection can be the consequences, which complicate the patient's rehabilitation. In most cases large defects are involved, so that the secondary reconstructive measures must be planned on accordingly generous scale. The transfer of a latissimus dorsi free flap enables the surgeon to cover defects of almost the entire anterior aspect of the lower leg as well as the ventral circumference. We covered the muscle surface with mesh graft. All patients on whom this technique was practiced achieved an adequate, stable skin coverage without further recurrence of infection. A description of the technique is given based on case reports and their subsequent follow-up.