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Acute compartment syndrome complicating fracture of femur
Abstracts
365
Acute compartment femur
syndrome
complicating
fracture of
Three cases after closed fractures are reported. They were treated successfully by fasciotomy. Tarlow S. D., Achterman C. A., Hayhurst J. and Ovadia D. N. (1986) Acute compartment syndrome in the thigh complicating fracture of the femur. J. Bone Joint Surg. 68A, 1439.
Sciatica caused by fractures of ischial tuberosity
The avulsing action was not violent and the cause of the sciatica was not at first recognized. Removal of the fragment 4 months after the injury relieved her pain. Miller B., Stedman G. H., Beisaw N. E. and Gross P. T. (1987) Sciatica caused by an avulsion fracture of the ischial tuberosity. J. Bone Joint Surg. 69A, 143. Bipolar clavicular dislocation
Fracture of the patella
Twenty-seven cases were treated. Small fragments that could not be held in place were discarded. Steel pins (Zmm) were passed above and below the patella and their ends were pulled together by external clamps. The pins were removed after a few weeks. Results were nearly all excellent. Liang Q.-Y. and Wu J. W. (1987) Fracture of the patella treated by open reduction and external compressive fixation. J. Bone Joint Surg. 69A, 83.
The medial end went forwards and the lateral end backwards out of place. The deformity was accepted and there was good function. Cook F. and Horowitz M. (1987) Bipolar clavicular dislocation. J. Bone Joint Surg. 69A, 145.
RECREATIONAL Neurapraxia
Compartment
syndrome
in open tibia1 fractures
Nine per cent of open fractures of the shaft of the tibia were associated with Volkmann’s ischaemia, the likelihood of which was inversely related to the severity of the injury. The authors seek to explain this as being a result of inadequate decompression by transverse tears of the investing fascia. Blick S. S., Burmback R. J., Poke A. et al. (1986) Compartment syndrome in open tibia1 fractures. J. Bone Joint Surg. 68A, 1348. Non-union
of the carpal scaphoid
Seventeen patients with ununited fractures of the scaphoid bone of, on average, nearly 3 years’ duration were examined 13-19 years after the styloid process of the radius had been removed and the fracture screwed with compression. Sixtyfive per cent had united and 5 per cent (twice the original proportion) showed radioscaphoid arthritis. Eighty-eight per cent were satisfied and back at work in spite of some stiffness and weakness of the wrist. Brostrijm L. A., Stark A. and Svartengren G. (1986) Nonunion of the carpal scaphoid treated with styloidectomy and compression screw fixation. Scald. J. PM. Reconstr. Surg. 20, 289.
Athletes with congenital and other causes of narrowing of the vertebral canal are at risk of this sort of lesion. Torg J. S.. Pavlov H., Genuario S. E. et al. (1986) Neurapraxia of the cervical spinal cord with transient quadriplegia. J. Bone Joint Surg. 68A, 1354.
Meniscectomy
in athletes
The 147 patients in this study were examined about 4% years after meniscectomy. Fifty-three per cent of patients had complaints after 4th years, 67 per cent after 14%. Instability of the knee increased from 10 per cent to 36 per cent and radiological changes more than doubled to 84 per cent. Nearly 50 per cent had reduced or given up games or sports. In nearly 50 per cent of cases, radiological changes began after 4i/2 years and were more often found after lateral than after medial meniscectomy. Jorgensen U., Sonne-Holm S., Lauridsen L. and Rosenklint A. (1987) Long-term follow-up of meniscectomy in athletes. J. Bone Joint Surg. 69B, 80.
AMPUTATIONS Thumb reolantation
Sacral fractures
Transverse fractures of the sacrum are rare when they affect the upper part. are liable roots. Sabiston C. P. and Wing P. C. (1986) classification and neurologic implications. J. Locked posterior dislocation
and, particularly to damage nerve Sacral fractures: Trauma 26, 113.
of the shoulder
Forty-one cases had had their dislocations for an average of I year before they were diagnosed but 25 were recognized within 6 months. Various methods of treatment were used. with varying degrees of success. Hawkins R. J., Neer C. S., Pianta R. M. and Mendoza F. X. (1987) Locked posterior dislocation of the shoulder. J. Bone Joint Surg. 69A, 9. Displaced intra-articular
fractures
Twenty-two fractures were treated and all but three remained in excellently restored shape. Average movement in the subtalar joint was 75 per cent of normal in range. Stephenson J. R. (1987) Treatment of displaced intraarticular fractures of the calcaneus using medial and lateral approaches, internal fixation and early motion. J. Bone Joint Surg. 69A. 115.
INJURIES
of the cervical spinal cord
or not?
Reattaching severed thumbs was found to offer better social and functional results than amputation, at similar cost in money. Ekerot L., Holmberg J. and Niechajer I. (1986) Thumb replantation or not? Stand. J. Plast. Reconstr. Surg. 20, 293.
PATHOLOGY Evaluation
AND EXPERIMENTAL
WORK
of antishock M.A.S.T.
There was no evidence that inflatable trousers were of benefit to survival, stay in hospital or cost of stay for penetrating injuries that could reach hospital within 30 minutes. Mattox K. L., Bickell W. H., Pepe P. E. and Mangelsdorff A. D. (1987) Prospective randomized evaluation of antishock M.A.S.T. in post-traumatic hypotension. J. Trauma 26, 779. Prehospital
intravenous
fluid therapy
Intravenous infusion is of potential benefit when bleeding is at the rate of 25-lOOml/min; the journey to hospital is likely to take longer than 30 minutes, and the rate of infusion matches the rate of loss. Time spent in setting up the infusion may remove any benefit. Lewis F. R. (1986) Prehospital intravenous fluid therapy: physiological computer modelling. J. Trauma 26, 804.
365
Acute compartment femur
syndrome
complicating
fracture of
Three cases after closed fractures are reported. They were treated successfully by fasciotomy. Tarlow S. D., Achterman C. A., Hayhurst J. and Ovadia D. N. (1986) Acute compartment syndrome in the thigh complicating fracture of the femur. J. Bone Joint Surg. 68A, 1439.
Sciatica caused by fractures of ischial tuberosity
The avulsing action was not violent and the cause of the sciatica was not at first recognized. Removal of the fragment 4 months after the injury relieved her pain. Miller B., Stedman G. H., Beisaw N. E. and Gross P. T. (1987) Sciatica caused by an avulsion fracture of the ischial tuberosity. J. Bone Joint Surg. 69A, 143. Bipolar clavicular dislocation
Fracture of the patella
Twenty-seven cases were treated. Small fragments that could not be held in place were discarded. Steel pins (Zmm) were passed above and below the patella and their ends were pulled together by external clamps. The pins were removed after a few weeks. Results were nearly all excellent. Liang Q.-Y. and Wu J. W. (1987) Fracture of the patella treated by open reduction and external compressive fixation. J. Bone Joint Surg. 69A, 83.
The medial end went forwards and the lateral end backwards out of place. The deformity was accepted and there was good function. Cook F. and Horowitz M. (1987) Bipolar clavicular dislocation. J. Bone Joint Surg. 69A, 145.
RECREATIONAL Neurapraxia
Compartment
syndrome
in open tibia1 fractures
Nine per cent of open fractures of the shaft of the tibia were associated with Volkmann’s ischaemia, the likelihood of which was inversely related to the severity of the injury. The authors seek to explain this as being a result of inadequate decompression by transverse tears of the investing fascia. Blick S. S., Burmback R. J., Poke A. et al. (1986) Compartment syndrome in open tibia1 fractures. J. Bone Joint Surg. 68A, 1348. Non-union
of the carpal scaphoid
Seventeen patients with ununited fractures of the scaphoid bone of, on average, nearly 3 years’ duration were examined 13-19 years after the styloid process of the radius had been removed and the fracture screwed with compression. Sixtyfive per cent had united and 5 per cent (twice the original proportion) showed radioscaphoid arthritis. Eighty-eight per cent were satisfied and back at work in spite of some stiffness and weakness of the wrist. Brostrijm L. A., Stark A. and Svartengren G. (1986) Nonunion of the carpal scaphoid treated with styloidectomy and compression screw fixation. Scald. J. PM. Reconstr. Surg. 20, 289.
Athletes with congenital and other causes of narrowing of the vertebral canal are at risk of this sort of lesion. Torg J. S.. Pavlov H., Genuario S. E. et al. (1986) Neurapraxia of the cervical spinal cord with transient quadriplegia. J. Bone Joint Surg. 68A, 1354.
Meniscectomy
in athletes
The 147 patients in this study were examined about 4% years after meniscectomy. Fifty-three per cent of patients had complaints after 4th years, 67 per cent after 14%. Instability of the knee increased from 10 per cent to 36 per cent and radiological changes more than doubled to 84 per cent. Nearly 50 per cent had reduced or given up games or sports. In nearly 50 per cent of cases, radiological changes began after 4i/2 years and were more often found after lateral than after medial meniscectomy. Jorgensen U., Sonne-Holm S., Lauridsen L. and Rosenklint A. (1987) Long-term follow-up of meniscectomy in athletes. J. Bone Joint Surg. 69B, 80.
AMPUTATIONS Thumb reolantation
Sacral fractures
Transverse fractures of the sacrum are rare when they affect the upper part. are liable roots. Sabiston C. P. and Wing P. C. (1986) classification and neurologic implications. J. Locked posterior dislocation
and, particularly to damage nerve Sacral fractures: Trauma 26, 113.
of the shoulder
Forty-one cases had had their dislocations for an average of I year before they were diagnosed but 25 were recognized within 6 months. Various methods of treatment were used. with varying degrees of success. Hawkins R. J., Neer C. S., Pianta R. M. and Mendoza F. X. (1987) Locked posterior dislocation of the shoulder. J. Bone Joint Surg. 69A, 9. Displaced intra-articular
fractures
Twenty-two fractures were treated and all but three remained in excellently restored shape. Average movement in the subtalar joint was 75 per cent of normal in range. Stephenson J. R. (1987) Treatment of displaced intraarticular fractures of the calcaneus using medial and lateral approaches, internal fixation and early motion. J. Bone Joint Surg. 69A. 115.
INJURIES
of the cervical spinal cord
or not?
Reattaching severed thumbs was found to offer better social and functional results than amputation, at similar cost in money. Ekerot L., Holmberg J. and Niechajer I. (1986) Thumb replantation or not? Stand. J. Plast. Reconstr. Surg. 20, 293.
PATHOLOGY Evaluation
AND EXPERIMENTAL
WORK
of antishock M.A.S.T.
There was no evidence that inflatable trousers were of benefit to survival, stay in hospital or cost of stay for penetrating injuries that could reach hospital within 30 minutes. Mattox K. L., Bickell W. H., Pepe P. E. and Mangelsdorff A. D. (1987) Prospective randomized evaluation of antishock M.A.S.T. in post-traumatic hypotension. J. Trauma 26, 779. Prehospital
intravenous
fluid therapy
Intravenous infusion is of potential benefit when bleeding is at the rate of 25-lOOml/min; the journey to hospital is likely to take longer than 30 minutes, and the rate of infusion matches the rate of loss. Time spent in setting up the infusion may remove any benefit. Lewis F. R. (1986) Prehospital intravenous fluid therapy: physiological computer modelling. J. Trauma 26, 804.