ABSTRACT
Fractures of the proximal humerus in children are rare and constitute only 3% of all epiphyseal injuries. From 1992 to 2002 sixteen patients aged 4 - 15 years with a displaced fracture of the proximal humerus were treated at our level I trauma unit. The mean follow-up of the patients was 23.8 months (8 - 72). Ten children had a metaphyseal fracture and six a Salter and Harris Type II injury. Only one metaphyseal fracture was treated conservatively; the other patients underwent surgery (ORIF [= open reduction internal fixation] in ten patients, CRIF [= closed reduction internal fixation] in five patients). Follow-up examination showed no shortening or major angulation of the humerus in any of the sixteen cases. Fifteen children showed excellent and good results. There was only one average result in a polytraumatized child with additional injuries in both upper extremities. Based on the results of this study we suggest performing ORIF/CRIF in displaced fractures of the proximal humerus in children.
Subject(s)
Fracture Fixation, Internal , Shoulder Fractures/surgery , Child , Female , Follow-Up Studies , Humans , Male , Radiography , Retrospective Studies , Shoulder Fractures/diagnostic imaging , Time FactorsABSTRACT
A highly specific and sensitive isocratic reversed-phase high performance liquid chromatography (HPLC) method for the determination of the major component of teicoplanin in tissue is reported. Comparing fluorescamine and o-phthalaldehyde (OPA) as derivatizing agents, the derivative formed with the latter exhibits superior fluorescence intensity allowing detection of femtomole quantities. Pretreatment for tissue samples is by solid-phase extraction which uses Bakerbond PolarP C(18) cartridges and gives effective clean up from endogenous by-products. Linearity was given from 0.6 to 100 ng per injection. The coefficient of variation did not exceed 5.8% for both interday and intraday assays. It was found that when bone defects are repaired with a hydroxyapatite-teicoplanin mixture, the antibiotic does not degrade, even when it is in the cement for several months. The stability of teicoplanin in bone cement was determined fluorodensitometrically.
Subject(s)
Bone Cements/analysis , Bone and Bones/chemistry , Chromatography, High Pressure Liquid/methods , Hydroxyapatites/analysis , Teicoplanin/analysis , Animals , Bone and Bones/surgery , Cementation/adverse effects , Fluorescamine , Fractures, Bone/metabolism , Fractures, Bone/surgery , Gram-Positive Bacterial Infections/etiology , Gram-Positive Bacterial Infections/prevention & control , Hydroxyapatites/therapeutic use , Materials Testing/methods , Rabbits , Spectrometry, Fluorescence/methods , Teicoplanin/therapeutic use , o-PhthalaldehydeABSTRACT
Avulsion fractures of the tibial apophysis are rare. Seven cases were treated between 1993 and 1998 in our department. The treatment was conservative in 1 case, in the other 6 open reduction and internal fixation was used. The results after an average of 23 months were good. There were no growth disturbances.
Subject(s)
Tibia/injuries , Adolescent , Athletic Injuries/diagnosis , Athletic Injuries/therapy , Humans , Male , Radiography , Tibia/diagnostic imagingABSTRACT
Dislocation of the hip is rare and so we regard every hip dislocation as an emergency until it has been reduced. From 1977 to 1996 a total of 82 patients with hip dislocation were treated at the Traumatic Surgery Clinic, University of Vienna, Austria. The average age at injury was 29 years. Some 77 patients had unilateral dislocation of the hip, but only in 5 cases was bilateral dislocation found. Iliac dislocation was most common (54 patients). Our treatment consisted in reduction within 6 h of the injury under general anaesthesia (Böhler) and 14 days bedrest. Then the patients were mobilized with full weight bearing, depending on the pain. Of the patients 29 had no clinical infirmities, 8 patients reported temporarily occurring pain and in 6 patients we found a limited range of movement in the hip joint with occasional pain. In all, 43 patients were followed up after 1/2 to 19 years. Radiological signs were seen in 17 patients and avascular necrosis of the femoral head in 1. So after careful evaluation of the patients and the kind of treatment, we recommend the following: 1. Immediate, gentle reduction of the hip joint; 2. Bedrest for 14 days; 3. Early mobilization with full weight bearing.
Subject(s)
Hip Dislocation/therapy , Adolescent , Adult , Bed Rest , Biomechanical Phenomena , Child , Early Ambulation , Female , Femur Head Necrosis/etiology , Follow-Up Studies , Hip Dislocation/complications , Hip Dislocation/physiopathology , Hip Joint/diagnostic imaging , Hip Joint/physiology , Humans , Male , Middle Aged , Osteoarthritis, Hip/etiology , Radiography , Range of Motion, ArticularABSTRACT
Dislocation of the hip is rare and so we regard every hip dislocation as an emergency until it has been reduced. From 1977 to 1996 a total of 82 patients with hip dislocation were treated at the Traumatic Surgery Clinic, University of Vienna, Austria. The average age at injury was 29 years. Some 77 patients had unilateral dislocation of the hip, but only in 5 cases was bilateral dislocation found. Iliac dislocation was most common (54 patients). Our treatment consisted in reduction within 6 h of the injury under general anaesthesia (Böhler) and 14 days bedrest. Then the patients were mobilized with full weight bearing, depending on the pain. Of the patients 29 had no clinical infirmities, 8 patients reported temporarily occurring pain and in 6 patients we found a limited range of movement in the hip joint with occasional pain. In all, 43 patients were followed up after 1/2 to 19 years. Radiological signs were seen in 17 patients and avascular necrosis of the femoral head in 1.So after careful evaluation of the patients and the kind of treatment, we recommend the following:1. Immediate, gentle reduction of the hip joint2. Bedrest for 14 days3. Early mobilization with full weight bearing.