摘要:

Twenty subtalar dislocations were reviewed in patients seen at the hospital complex of the University of Pennsylvania, 1950–1979. All patients were available for followup examination and roentgenographic review. There were 15 males and five females in the study. Length of followup ranged from 6 months to 23 years, mean, 4.2 years. Medial dislocation was most frequent, occurring in 17 out of 20. All three with lateral dislocations had associated fractures. All of the dislocations were closed injuries and only one patient required open reduction. Immobilization was maintained in a below-knee weight bearing cast for 6 weeks post-reduction. Of the patients, 80% demonstrated significant restriction of motion and 30% had roentgenographic evidence of arthritis. Few were symptomatic. Fourteen had excellent results, two good, two fair, and two poor. In general, a satisfactory result is to be expected with closed reduction following parenteral medication.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

From a review of 186 patients with ‘typical knee sprains’ in two separate studies conducted at the University of Cincinnati Sports Medicine Institute (one retrospective and the second one a prospective evaluation by arthroscopy and examination under anesthesia) the actual diagnosis was compared to the pertinent historical and clinical findings. The following conclusions were reached: 1) The commonly encountered ‘mild knee sprain’ may be a serious knee injury which is easily underestimated. 2) Traumatic hemarthrosis indicates a serious knee injury which in our studies revealed significant intraarticular injury in greater than 90% of the patients. The decision to use arthroscopy, and/or examination under anesthesia should be based on the patient's age, health, and activity level, and the treatment methods available to the examining physician. 3) If an examining physician conducts a thorough historical and clinical evaluation with special emphasis on ligamentous instability and/or acute hemarthrosis followed by examination under anesthesia and arthroscopy when indicated, an accurate diagnosis can be made more than 95% of the time, with the subsequent determination of a rational treatment program.In the prospective study, a surprising 72% showed disruption of the anterior cruciate ligament. In addition, associated injuries included meniscal tears (62%), osteochondral fractures or fissures (20%), and other significant ligament disruptions (20%). The initial clinical exam alone consistently underestimated the extent of the injury, providing inadequate data for treatment decisions.We wish to emphasize that a joint effusion within 24 hours of knee injury, no matter how trivial, usually represents a hemarthrosis implying a serious injury and therefore possible need for further diagnostic tests beyond the initial examination. Regardless of the physician's method of treatment, the patient must be advised and counseled as to the potential seriousness of any knee injury resulting in an acute hemarthrosis.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Twenty-seven cases with delayed union and nonunion were selected for the present study. Osteomedullograms were positive in 12 and negative in 15 cases. All the fractures with positive osteomedullograms united after conservative treatment. Fourteen of 15 fractures with negative osteomedullograms needed surgical treatment. Of 14, two are still in followup. One case with negative signs on osteomedullogram refused surgery.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

In an experimental study of 60 rabbits (120 preparations) in which a bilateral fibular osteotomy was performed, a group of 40 rabbits had ligation of the vena cava, and a group of 20 rabbits were used as controls. The results were evaluated by microscopic study by H&E, PAS and Alcian Blue staining and showed that venous stasis accelerates the process of fracture healing by increasing fibroblastic and osteoblastic proliferation and bone production. The effects of changes in pH, and concentrations of oxygen and carbon dioxide are suggested as the factors that modify the mechanism of osteogenesis, and greater quantities of mucopolysaccharide substances were observed at the fracture site in the group with venous stasis.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

An 18-year-old male accidentally fell into a vat of saturated ferrous chloride in a dilute solution of hydrochloric acid. He aspirated the iron solution to his lungs, ingested it into his stomach, and absorbed it through the burned skin. His clinical course paralleled acute iron intoxication with GI bleeding, acidosis, and transient improvement before his demise. In addition, he developed a severe disseminated intravascular coagulopathy which was temporarily ameliorated with heparin and clotting factors.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Two cases of Peltier's Type II C fracture of the pelvis without any internal organ involvement are presented. Lack of hemodynamic or respiratory complications and failure of conservative treatment enabled open reduction and internal fixation. The resultant rigid fixation allowed an early mobilization and contributed to the rapid recovery of these aged patients.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A case of acomplextype of Lisfranc fracture/dislocation is presented. This variant is peculiar in that there is a diastasis between the medial and middle cuneiforms with interposed anterior tibialis tendon. This anatomic situation necessitates an open reduction and internal fixation.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

An unusual fracture of the base of the fifth metatarsal bone is described. The type of fracture and the displacement of the proximal fragment was unlike that of most other fractures of this region of the foot. It required open reduction and internal fixation which was successfully carried out by means of tension wires.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID