In the presented case report, we evaluated mechanism of axillary artery thrombosis in cases of repeated fracture of the shoulder. A 73-year-old female fell down on an outstretched hand. Radiographs demonstrated a Neer’s 2-part displaced fracture of the proximal humerus and open fracture of the acromion. Forty years ago, in a car accident, fractures of the same proximal humerus and clavicle occurred and were surgically treated. Two hours after fixation with Kirschner wires, thrombosis of the axillary artery was quickly diagnosed and rapid treatment allowed revascularisation of the arm without any consequences.
Background/Aim: The management of horizontal root fracture is not straight forward. It depends upon the location of the fracture, mobility and vitality of fractured tooth segment. The goal of treatment is to restore the shape and function of affected tooth.
Case report: This following case report described the conservative management of horizontal root fracture which was also displaced but somehow maintained its vitality. The affected tooth was initially stabilized and followed up in the subsequent appointments for evaluation of vitality that turned out to be vital, thus, preventing any unnecessary intervention.
Conclusions: Horizontal root fractures in the vital teeth should be initially managed conservatively and every effort should be made to preserve the vitality of tooth.
Fractures of the proximal humerus account for 4% to 5% cases out of all fractures, and about 85% of them are minimally displaced. The purpose of the study was to observe the effectiveness of physiotherapeutic methods used in the proximal fractures of the humerus. Material and method: the research was performed on a group of 13 patients who have been orthopedically treated for fractures at the proximal end of the humerus. Five subjects followed the TECAR therapy and physical exercise, and eight subjects followed classical physiotherapy and physical exercise. The evaluations have been performed at the beginning of the recovery, after 14 days, after 28 days and after 42 days of treatment. Pain intensity (VAS score), joint amplitude (goniometry), muscle strength and functionality (the PENN questionnaire) were assessed in all patients. The results of the evaluations showed a decrease in pain, after the first 14 days, especially for the patients who underwent the Tecar therapy. Also, the results showed that the patients with surgical neck fractures had the best evolution in cases of goniometry evaluation, compared to the rest of the patients. In conclusion, physical therapies for proximal humerus fractures play an important role in the recovery and reintegration of the patients into family and at work.
Ankle fractures are frequent and have a significant impact upon the function of the lower limb, as this joint has a crucial role in standing and especially in walking. Several classification systems have been developed concerning these fractures, connecting the traumatic mechanism to their treatment. Due to their character of articular fractures, functional restoration of local anatomy is necessary; therefore, surgery is mandatory in displaced fractures, affecting the congruency, the stability or the mobility of the ankle joint. The purpose of this paper is to describe the factors influencing the results of surgical treatment in these fractures, as it results from the experience of a level 1 Trauma Centre.
Supracondylar humeral fractures (SCHF) are the most common elbow fractures in children, representing 3% of all paediatric fractures. Treatment options for SCHF in children are based on the Gartland classification. Treatment of non-displaced fractures (type I) is non-operative. Plaster immobilization for 3 to 4 weeks is recommended, depending on the age of the child and fracture healing. Treatments of displaced supracondylar fractures (type II and III) of the humerus in children are still undefined in clinical practice. Because of divided opinions, the aim of this study was to evaluate whether delayed or immediate surgical treatment has an advantage in the treatment of supracondylar fractures in children. This is a prospective – retrospective clinical study. This study included 64 patients from 5 to 15 years old; 47 (73.4%) were boys and 17 (26.6%) were girls. The most common age range (59.4%) in this study was 5-8 years old. All patients were diagnosed with supracondylar fractures at the Institute for Orthopaedic Surgery “Banjica”. We analysed 17 parameters, which were obtained either from direct patient interviews or from their medical history. All patients were divided into two groups with matched characteristics. Group I consisted of 26 patients who had immediate operations. Group II consisted of 38 patients who had delayed operations.
Based on the results of the analysed parameters, consisting primarily of functional results, the absence of subjective symptoms and myositis ossificans one year after surgery suggests that emergency surgical treatment of displaced supracondylar humeral fractures is optimal.
Diagnosis of hip fractures is particularly important due to the high dependence on the integrity of this structure for people to function in their daily lives. Left unrecognized, patients face increasing morbidity and mortality as time from the original injury lengthens. A delay of just 2 days in surgical treatment for an acute hip fracture doubles mortality. In addition, an unrecognized non-displaced fracture may displace, requiring surgery of much higher risk. This may be part of the reason that the most frequent lawsuit against Emergency Physicians is for missed orthopedic injury. We reviewed the use of MRI and CT for occult hip fractures (OHF) detection at a major urban trauma unit. Our study is a retrospective review. Inclusion criteria: all patients presenting to the Emergency Clinical Hospital of Constanta with a suspected, posttraumatic, occult hip fracture, over a 5 years period were included. All patients had negative initial radiographs and underwent further imaging with either CT or MRI. A total of 185 cases meeting the inclusion criteria were identified. 72 occult hip fractures were detected with both imaging modalities. Although MRI certainly enables greater image detail, in our experience both modalities are able to provide satisfactory fracture characterization. The choice of imaging should be determined by availability and indication. MRI provides superior imaging of soft tissue but is less sensitive for degenerative changes in presence of bone edema.
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