Distraction for proximal interphalangeal joint contractures: long-term results.

Purpose: To report the medium- to long-term outcomes of joint distraction using a unilateral external fixator in the treatment of chronic post-traumatic proximal interphalangaeal (PIP) joint contractures.

Method: Between September 2001 and October 2011, 94 consecutive patients (98 PIP joints) with a mean age of 43 years (range, 17-69 y) were treated with external fixation for chronic flexion deformity of the PIP joint from trauma. The average time from injury to surgery was 48 months (range, 6-84 mo), and the duration of joint distraction was 10 days (range, 7-22 d).

Management of posttraumatic proximal interphalangeal joint contracture.

Chronic flexion contracture of the proximal interphalangeal (PIP) joint presents a common yet challenging problem to hand surgeons. Over the years, multiple treatment modalities have been described for this problem, producing limited results. Nonoperative treatment using serial casting and splints should be tried before attempting open surgical release, which should be done in selected patients.

A new technique for closed management of displaced intra-articular fractures of metacarpal and phalangeal head delayed on presentation: report of eight cases.

We present the outcomes of the delayed management of eight displaced intra-articular fractures of the metacarpal and phalangeal heads treated with capsuloligamentotaxis using the Penning mini-external fixator. Closed anatomical reduction with a 2 mm over-distraction was achieved at the time of operation at an average of 20 days after the initial injury. Excellent outcomes in terms of function and pain were obtained at 6 month's follow-up in all cases.

Treatment of Rolando fracture by capsuloligamentotaxis using mini external fixator: a report of 16 cases.

Treatment of Rolando fractures remains a challenge for hand surgeons. We present a case series of 16 comminuted Rolando type fractures treated by controlled capsuloligamentous distraction (and over distraction by 2 mm) using the Pennig mini-external fixation system. Additional Kirschner wire(s) were used to maintain fracture reduction and stability.

Single-stage distraction correction for neglected dorsal fracture dislocations of the proximal interphalangeal joint: a report of eight cases.

We present the outcome of treatment of eight chronic neglected dorsal fracture dislocations of the proximal interphalangeal joint treated with a single-stage ligamentous distraction using the Penning mini-external fixator and a closed reduction. The distraction correction and 2 to 3 mm over distraction was performed acutely at the time of operation in all eight cases at an average injury-to-surgery time of 6 weeks. Satisfactory results with an average range of motion of 79 degrees were obtained at an average follow-up of 20 months.

Post-traumatic cortical cysts in paediatric fractures: is it a concern for emergency doctors? A report of three cases.

Post-traumatic cortical bone cyst is a rare occurrence in children. It is typically located in the distal radius, as a result of greenstick fracture. We report three cases referred to our fracture clinic as a tumour in bones.

Distraction correction of chronic flexion contractures of PIP joint: comparison between two distraction rates.

Purpose: The surgical correction of chronic flexion contractures of the proximal interphalangeal (PIP) joints is quite challenging because the extensive soft-tissue surgery needed is demanding, and the results often are discouraging. Gradual joint distraction recently was shown to be effective in the correction of PIP joint contractures. We performed this study to determine the optimum rate and amount of daily distraction and the optimum duration for which the external fixator should be left in situ after correction.

Gradual joint distraction of post-traumatic flexion contracture of the proximal interphalangeal joint by a mini-external fixator.

We present the outcome of the treatment of chronic post-traumatic contractures of the proximal interphalangeal joint by gradual distraction correction using an external fixator. A total of 30 consecutive patients with a mean age of 34 years (17 to 54) had distraction for a mean of 16 days (10 to 22). The fixator was removed after a mean of 29 days (16 to 40).

Paediatric forearm refractures with retained plates managed with flexible intramedullary nails.

During the past 18 months we have managed four paediatric patients who have sustained forearm refractures associated with retained plates that were used to treat their original fracture. Although this complication is not new, most literature regarding paediatric forearm refracture relates to refractures that occur after closed treatment or after removal of metalwork. We treated the patients in this small series with plate removal and intramedullary stabilisation using elastic stable intramedullary nails (Nancy, Depuy, UK) as opposed to revision plating.

Distal femoral fractures treated by hinged total knee replacement in elderly patients.

Although the use of constrained cemented arthroplasty to treat distal femoral fractures in elderly patients has some practical advantages over the use of techniques of fixation, concerns as to a high rate of loosening after implantation of these prostheses has raised doubts about their use. We evaluated the results of hinged total knee replacement in the treatment of 54 fractures in 52 patients with a mean age of 82 years (55 to 98), who were socially dependent and poorly mobile. Within the first year after implantation 22 of the 54 patients had died, six had undergone a further operation and two required a revision of the prosthesis.

Anterior dislocation of the ulnar-humeral joint in a so-called 'pulled elbow'.

We describe an unusual case of a missed anterior dislocation of the elbow joint in a 1 year old girl who presented with a pulled elbow. To our knowledge, this is the first report of anterior dislocation as a result of a pulled elbow in the literature. We would like to highlight the rarity of this presentation and the importance of chronological assessment and management in the accident and emergency department.

The retrograde nail for distal femoral fractures in the elderly: high failure rate of the condyle screw and nut.

Displaced distal femoral fractures in elderly patients benefit from surgical fixation. We describe the use of a retrograde femoral nail to treat these fractures. The implant has a special condyle screw and nut that allows for manual compression of the fracture when there is an additional inter-condylar split.

Epidemiology of bacterial hand infections.

Objective: The aim of the study was to delineate and update the bacteriological spectrum, characterize patterns and sites of injury, evaluate laboratory tests and possible causes of complications in patients with bacterial hand infections.

Methods: All hand infections operated on in the department of orthopedics at Odense University Hospital during the period 1992-2001 were reviewed retrospectively. A standard protocol was used to collect data for each patient.

Forearm fractures in children. Single bone fixation with elastic stable intramedullary nailing in 20 cases.

We present our experience with elastic stable intramedullary nailing (ESIN) used in the single bone fixation of both bones forearm fractures in children. From May 2002 to July 2004, 20 children (14 boys and 6 girls), median age of 10 years (range 6-15 years) were treated with ESIN for 16 closed and 4 grade I open forearm fractures. All patients were reviewed clinically at a median follow-up of 20 months (range 6-30 months).

Trochanteric-entry long cephalomedullary nailing of subtrochanteric fractures caused by low-energy trauma.

Background: Subtrochanteric fractures of the femur that are caused by low-energy trauma are less common than other proximal femoral fractures, but they occur in a similar population of elderly individuals, who are often socially dependent and medically frail. Although a wide range of operative techniques have been used, cephalomedullary nailing theoretically provides the most minimally invasive and biomechanically stable means of treating these complex fractures. The purpose of the present review was to evaluate the functional outcome and perioperative complications associated with the use of a trochanteric-entry cephalomedullary nail to treat all low-energy subtrochanteric fractures that were seen at a single institution.

Femoral shaft fractures in children: elastic stable intramedullary nailing in 31 cases.

We report our experience with elastic stable intramedullary titanium nailing (ESIN) of femoral shaft fractures in children. From 1998 to 2001, we treated 31 children (20 boys), median age 6 (4-11) years, with ESIN for 29 closed and 2 grade I open femoral shaft fractures. We reviewed 30 children clinically after median 1.

Distraction with external fixator for contractures of proximal interphalangeal joints: good outcome in 10 cases.

We present a new and simple technique for the treatment of proximal interphalangeal (PIP) joint contractures by mini Orthofix external fixator without open surgery. The technique was tested on 10 patients. We found that the fixator is easy to apply and effective in reducing contractures of the PIP joint by soft tissue distraction.

Correction of Madelung's deformity by the Ilizarov technique.

We present our experience with correction of Madelung's deformity by the Ilizarov technique. Seven patients (eight deformities) were treated by osteotomy of the radius with subsequent lengthening and angular correction. They were reviewed at a mean of 30 months (1.

Correction of congenital brachymetatarsia by gradual callus distraction.

Two children with congenital brachymetatarsia of the fourth metatarsal bone were treated by osteotomy of the metatarsal bone and bone lengthening by the Ilizarov technique. Both children were cosmetically improved.

[Evaluation of multitraumatized patients admitted to a trauma center].

Introduction: This study describes the survival possibility in a population of Danish multitraumatized patients. The analysis is related to international standards and to development over time as well.

Material And Methods: The study included 1664 patients admitted as trauma patients to the Odense University Hospital during the period January 1st 1996 to December 31st 2001.