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Flexor tendon healing
Injury (1986) 17, 425-427
Printed in Great Britain
425
Abstracts FRACTURES AND DISLOCATIONS Open tibia1 fractures
Where there is severe damage to the skin and other soft parts and the limb is viable, the wound should be closed within a few days, using flaps of muscle rather than skin. Fill flaps and bone grafts also play an important part in managing defects in bone. Byrd H. S., Spicer T. E. and Cierney G. (1985) Management of open tibia1 fractures. Plast. Reconstr. Surg. 76, 719. Compression screw fixation of femoral fractures One hundred and ninety-eight subcapital fractures were fixed
with sliding screws and plates, irrespective of age or severity of fracture. Twenty-three per cent of displaced fractures failed within 1 year because of non-union or infection and 27 per cent of those that united showed subsidence of the upper part of the head of the femur within 3 years; only half of these required further operations. Skinner P. W. and Powles D. (1986) Compression screw fixation for displaced subcapital fracture of the femur. J. Bone Joint Surg. 68B, 78. Scapular fractures In
the victim of multiple injuries, fractures of the scapula are usually associated with fractures of the underlying ribs-the so-called ‘stove-in shoulder-and damage to the subclavian vessels and the brachial plexus. Thompson D. A., Flynn T. C., Miller P. W. and Fischer R. P. (1985) The significance of scapular fractures. 1. Trauma 25, 974.
VASCULAR INJURIES Subclavian
artery injury
Up to 7.6cm (3 in) of length can be gained by passing the subclavian artery through the first intercostal space; simple suture may suffice rather than grafting. Schimpf P. P., Burt D. W. and Wagner R. B. (1985) Left subclavian artery trauma. 1. Trauma 25, 1069.
PATHOLOGY AND EXPERIMENTAL WORK Trendelenburg garments
position vs pneumatic
antishock
Unlike pneumatic antishock garments, the Trendelenburg position did not reduce the cardiac index nor increase the systemic vascular resistance index in dogs. Zippe C., Burchard K. W. and Gana D. S. (1985) Trendelenburg versus PASG application in moderate haemorrhagic hypoperfusion. J. Trauma 25, 923. Pneumatic hernia
antishock garments
and diaphragmatic
Compressing the abdomen by inflating the splint to 60mmHg displaced viscera into the chest and hampered breathing. If such garments are used in humans any embarrassment of
breathing requires that the pressure on the abdomen be lowered and diaphragmatic hernia considered, if it is not already known to exist. Maul1 K. I., Krahwinkel D. J., Rozycki G. S. and Nelson H. S. (1986) Cardiopulmonary effects of the pneumatic antishock garment on swine with diaphragmatic hernia. Surg. (;ynecol.
Obstet. 162, 17.
Repair of injured menisci
Longitudinal cuts in the middles of animals’ menisci did not heal if they were stitched but longitudinal, transverse or F-shaped cuts did heal if a flap of synovial tissue was stitched into them. Ghadially F. N., Wedgy J. H. and Lalonde J.-M. A. (1986) Experimental methods of repairing injured menisci. J. Bone Joint Surg. 68B, 106.
TENDONS AND LIGAMENTS Flexor tendon healing
Chickens’ flexor tendons healed and recovered better if their sheaths were not excised but were restored by simple repair or the use of vein to provide a patch to bridge a defect. Strauch B., de Moura W., Ferder M., Hall C., Sagi A. and Greenstein B. (1985) The fate of tendon healing after restoration of the integrity of the tendon sheath with autogenous vein grafts. J. Hand Surg. lOA, 790. Treatment
of ruptured ankle ligaments
Patients treated in plaster returned to work a week or two earlier than those whose ligaments were repaired and they had less final stiffness. Recurrent giving way occurred more frequently in ankles that had been operated on although there was no increase in the degree of tilting of the talus. Evans G. A., Hardcastle P. and Frenyo A. D. (1984) Acute rupture of the lateral ligaments of the ankle. J. Bone Joint Surg. 66B, 209. Calcaneal tendon reconstruction
Eleven out of 13 tendons were repaired more than 4 weeks after rupture. A flap was turned down from the upper end in order to fill a gap, otherwise V-Y advancement was used. One tendon ruptured again but all the others compared quite well with the normal side in respect of strength and range of movement and eight patients were satisfied. The two patients whose tendons were not repaired had much poorer results. Barnes M. J. and Hardy A. E. (1986) Delayed reconstruction of the calcaneal tendon. J. Bone Joint Surg. 68B, 121. Repair of torn rotator cuff
Thirty months, on average, after repair of a ruptured rotator cuff 18 out of 20 shoulders were shown by arthrography to have a defect in the cuff. Nevertheless, 17 had no pain and 12 had a full range of elevation at the shoulder. Calvert P. J., Packer N. P., Stoker D. J., Bayley J. I. L. and Kessel L. (1986) Arthrography of the shoulder after operative repair of the torn rotator cuff. J. Bone Joint Surg. 68B, 147.
Printed in Great Britain
425
Abstracts FRACTURES AND DISLOCATIONS Open tibia1 fractures
Where there is severe damage to the skin and other soft parts and the limb is viable, the wound should be closed within a few days, using flaps of muscle rather than skin. Fill flaps and bone grafts also play an important part in managing defects in bone. Byrd H. S., Spicer T. E. and Cierney G. (1985) Management of open tibia1 fractures. Plast. Reconstr. Surg. 76, 719. Compression screw fixation of femoral fractures One hundred and ninety-eight subcapital fractures were fixed
with sliding screws and plates, irrespective of age or severity of fracture. Twenty-three per cent of displaced fractures failed within 1 year because of non-union or infection and 27 per cent of those that united showed subsidence of the upper part of the head of the femur within 3 years; only half of these required further operations. Skinner P. W. and Powles D. (1986) Compression screw fixation for displaced subcapital fracture of the femur. J. Bone Joint Surg. 68B, 78. Scapular fractures In
the victim of multiple injuries, fractures of the scapula are usually associated with fractures of the underlying ribs-the so-called ‘stove-in shoulder-and damage to the subclavian vessels and the brachial plexus. Thompson D. A., Flynn T. C., Miller P. W. and Fischer R. P. (1985) The significance of scapular fractures. 1. Trauma 25, 974.
VASCULAR INJURIES Subclavian
artery injury
Up to 7.6cm (3 in) of length can be gained by passing the subclavian artery through the first intercostal space; simple suture may suffice rather than grafting. Schimpf P. P., Burt D. W. and Wagner R. B. (1985) Left subclavian artery trauma. 1. Trauma 25, 1069.
PATHOLOGY AND EXPERIMENTAL WORK Trendelenburg garments
position vs pneumatic
antishock
Unlike pneumatic antishock garments, the Trendelenburg position did not reduce the cardiac index nor increase the systemic vascular resistance index in dogs. Zippe C., Burchard K. W. and Gana D. S. (1985) Trendelenburg versus PASG application in moderate haemorrhagic hypoperfusion. J. Trauma 25, 923. Pneumatic hernia
antishock garments
and diaphragmatic
Compressing the abdomen by inflating the splint to 60mmHg displaced viscera into the chest and hampered breathing. If such garments are used in humans any embarrassment of
breathing requires that the pressure on the abdomen be lowered and diaphragmatic hernia considered, if it is not already known to exist. Maul1 K. I., Krahwinkel D. J., Rozycki G. S. and Nelson H. S. (1986) Cardiopulmonary effects of the pneumatic antishock garment on swine with diaphragmatic hernia. Surg. (;ynecol.
Obstet. 162, 17.
Repair of injured menisci
Longitudinal cuts in the middles of animals’ menisci did not heal if they were stitched but longitudinal, transverse or F-shaped cuts did heal if a flap of synovial tissue was stitched into them. Ghadially F. N., Wedgy J. H. and Lalonde J.-M. A. (1986) Experimental methods of repairing injured menisci. J. Bone Joint Surg. 68B, 106.
TENDONS AND LIGAMENTS Flexor tendon healing
Chickens’ flexor tendons healed and recovered better if their sheaths were not excised but were restored by simple repair or the use of vein to provide a patch to bridge a defect. Strauch B., de Moura W., Ferder M., Hall C., Sagi A. and Greenstein B. (1985) The fate of tendon healing after restoration of the integrity of the tendon sheath with autogenous vein grafts. J. Hand Surg. lOA, 790. Treatment
of ruptured ankle ligaments
Patients treated in plaster returned to work a week or two earlier than those whose ligaments were repaired and they had less final stiffness. Recurrent giving way occurred more frequently in ankles that had been operated on although there was no increase in the degree of tilting of the talus. Evans G. A., Hardcastle P. and Frenyo A. D. (1984) Acute rupture of the lateral ligaments of the ankle. J. Bone Joint Surg. 66B, 209. Calcaneal tendon reconstruction
Eleven out of 13 tendons were repaired more than 4 weeks after rupture. A flap was turned down from the upper end in order to fill a gap, otherwise V-Y advancement was used. One tendon ruptured again but all the others compared quite well with the normal side in respect of strength and range of movement and eight patients were satisfied. The two patients whose tendons were not repaired had much poorer results. Barnes M. J. and Hardy A. E. (1986) Delayed reconstruction of the calcaneal tendon. J. Bone Joint Surg. 68B, 121. Repair of torn rotator cuff
Thirty months, on average, after repair of a ruptured rotator cuff 18 out of 20 shoulders were shown by arthrography to have a defect in the cuff. Nevertheless, 17 had no pain and 12 had a full range of elevation at the shoulder. Calvert P. J., Packer N. P., Stoker D. J., Bayley J. I. L. and Kessel L. (1986) Arthrography of the shoulder after operative repair of the torn rotator cuff. J. Bone Joint Surg. 68B, 147.