Incidence and analysis of radial head and neck fractures

AIM: To investigate several complications like persistent radial head dislocation, forearm deformity, elbow stiffness and nerve palsies, associated with radial head fractures. METHODS: This study reviewed the clinical records and trauma database of this level Ⅰ Trauma Center and identified all patients with fractures of the radial head and neck who where admitted between 2000 and 2010. An analysis of clinical records revealed 1047 patients suffering from fractures of the radial head or neck classified according to Mason. For clinical examination, range of motion, local pain and overall outcome were assessed. RESULTS: The incidence of one-sided fractures was 99.2% and for simultaneous bilateral fractures 0.8%. Non-operative treatment was performed in 90.4%(n = 947) of the cases, surgery in 9.6%(n = 100). Bony union was achieved in 99.8%(n = 1045) patients. Full satisfaction was achieved in 59%(n = 615) of the patients. A gender related significant difference(P = 0.035) in Mason type distribution-type Ⅲ fractures were more prominent in male patients vs type Ⅳ fractures in female patients-was observed in our study population. CONCLUSION: Mason typeⅠfractures can be treated safe conservatively with good results. In type Ⅱ to Ⅳ surgical intervention is usually considered to be indicated.

Nerve compression and pain in human volunteers with narrow vs wide tourniquets

AIM: To assess the clinical effects and the morphological grade of nerve compression.METHODS: In a prospective single-center randomized, open study we assessed the clinical effects and the morphological grade of nerve compression during 20 min of either a silicon ring(group A) or pneumatic tourniquet(group B) placement variantly on the upper non-dominant limb in 14 healthy human volunteers. Before and during compression, the median and radial nerves were visualized in both groups by 3 Tesla MR imaging, using high resolutional(2.5 mm slice thickness) axial T2-weighted sequences. RESULTS: In group A, Visual analog pain scale was 5.4 ± 2.2 compared to results of group B, 2.9 ± 2.5, showing a significant difference(P = 0.028). FPS levels in group A were 2.6 ± 0.9 compared to levels in group B 1.6 ± 1, showing a significant difference(P = 0.039). Results related to measureable effect on median and radial nerve function were equal in both groups. No undue pressure signs on the skin, redness or nerve damage occurred in either group. There was no significant difference in the diameters of the nerves without and under compression in either group on T2 weighted images.CONCLUSION: Based on our results, no differences between narrow and wide tourniquets were identified. Silicon ring tourniquets can be regarded as safe for short time application.