BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To ...BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To evaluate the effectiveness of DUSO and MUSO for UIS treatment and determine the factors that should be considered when choosing surgical treatment for UIS.METHODS Articles comparing the effectiveness of DUSO and MUSO for UIS treatment were systematically retrieved from MEDLINE(Ovid),PubMed,EMBASE,and Cochrane Library.The demography,incidence of complications,secondary operation rate,postoperative DASH score,wrist pain on the visual analogue scale,and grip strength improvement were also evaluated.In addition,the correlation between the improvement of grip strength and the shortening of osteotomy length of ulna was analyzed.The outcome of the patient was discontinuous,and the odds ratio,risk ratio(RR),and 95%CI were calculated and analyzed via RevMan5.3 software.RESULTS Six studies,including 83 patients receiving MUSO(experimental group)and 112 patients receiving DUSO(control group),were included in the meta-analysis.The second operation rate was significantly higher after DUSO than after MUSO.The DASH scores were slightly lower in the MUSO group than in the DUSO group.The patients receiving MUSO had slightly better pain relief effect than patients receiving DUSO.However,the incidence of complications and improvement of grip strength were not significantly different between the two groups.CONCLUSION Although DUSO and MUSO provide similar effects for UIS,MUSO is associated with a lower secondary operation rate,slightly lower postoperative DASH scores and slightly better pain relief effect than DUSO,indicating that MUSO can effectively be used for UIS treatment.展开更多
The cerclage wire is an important adjuvant in the management of Orthopaedic and trauma cases and is particularly useful in long bone fractures. It is especially useful for addressing the fractures, especially the comm...The cerclage wire is an important adjuvant in the management of Orthopaedic and trauma cases and is particularly useful in long bone fractures. It is especially useful for addressing the fractures, especially the comminuted ones with a butterfly fragment. Orthopaedic cerclage Wiring is used as an adjunct to maintain fracture reduction (either temporarily or permanently), while the bone is primarily stabilised by either a plate intramedullary nail or external fixation frame. Multiple cerclage wires provide adjunctive fixation against compressive shear, bending & rotational forces and have been used in traumatology since many years. The aim of this article is to introduce a new year simple low cost instrument named as “Suyash cerclage wire passer”, with excellent outcomes without any major complications to the Orthopaedic community.展开更多
The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedull...The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedullary nails and achieve union with least trauma to the shoulder and the rotator cuff. The multiple elastic screw nails achieve the inherent stability based on the principle of “three point fixation”. We aim to propose that the screw intramedullary nail is an effective implant to facilitate uneventful fracture union, with rapid recovery, low morbidity and low learning curve capable of being replicated in any smaller operative set up.展开更多
Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral sha...Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.展开更多
Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radi...Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radial and median nerve can cause significant disability.A detailed clinical examination is therefore necessary following humeral shaft fractures.We report a patient with closed diaphyseal humeral fracture （AO 12A-2.3） together with radial and median nerve palsy,its management and review of the literature.As the patient had two nerves involved,surgical exploration was planned.Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression pla te.There was no external injury to both radial and median nerves on surgical exploration.Neurological recovery started at 3 weeks＇ follow-up.Complete recovery was seen at 12 weeks.Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries,which allows better management and rehabilitation of the patient.展开更多
Background:The epidemiology of fractures of the humeral shaft has received little attention in Nigeria.This study was aimed at investigating the possible risk factors associated with diaphyseal humeral fractures among...Background:The epidemiology of fractures of the humeral shaft has received little attention in Nigeria.This study was aimed at investigating the possible risk factors associated with diaphyseal humeral fractures among Nigerians.Methods:The study was carried out retrospectively at the Department of Medical Records,National Orthopaedic Hospital,Igbobi,Lagos State,Nigeria,between 2007 and 2012.Case notes and plain films of X-ray from a total number of 206 patients of ages from birth to one hundred years(0–100 years),comprising of 140 males and 66 females,were used for the study.The analyses were done using Statistical Package for Social Sciences(SPSS)version 16.0 and presented in bar charts.The frequencies were reported as percentages.The differences in frequencies were compared using chi-square test.Results:The results showed that the percentage frequency of diaphyseal humeral fractures was significantly higher(P<0.05)in males than in females.The main cause(P<0.05)of diaphyseal humeral fractures was road traffic accident followed by fall.Conclusions:The major causes of diaphyseal humeral fractures are road traffic accidents and falls.Since diaphyseal humeral fracture is an issue of harsh economic consequences,adequate measures should be taken by all the parties involved,especially government agencies,to address this menace in term of road maintenance and general well-being of the citizens.Furthermore,since it was observed that different regions of the bones of interest present diverse characteristics with respect to associated risk factors,it is recommended that such studies as this should be region-based rather than whole-bone based.展开更多
文摘BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To evaluate the effectiveness of DUSO and MUSO for UIS treatment and determine the factors that should be considered when choosing surgical treatment for UIS.METHODS Articles comparing the effectiveness of DUSO and MUSO for UIS treatment were systematically retrieved from MEDLINE(Ovid),PubMed,EMBASE,and Cochrane Library.The demography,incidence of complications,secondary operation rate,postoperative DASH score,wrist pain on the visual analogue scale,and grip strength improvement were also evaluated.In addition,the correlation between the improvement of grip strength and the shortening of osteotomy length of ulna was analyzed.The outcome of the patient was discontinuous,and the odds ratio,risk ratio(RR),and 95%CI were calculated and analyzed via RevMan5.3 software.RESULTS Six studies,including 83 patients receiving MUSO(experimental group)and 112 patients receiving DUSO(control group),were included in the meta-analysis.The second operation rate was significantly higher after DUSO than after MUSO.The DASH scores were slightly lower in the MUSO group than in the DUSO group.The patients receiving MUSO had slightly better pain relief effect than patients receiving DUSO.However,the incidence of complications and improvement of grip strength were not significantly different between the two groups.CONCLUSION Although DUSO and MUSO provide similar effects for UIS,MUSO is associated with a lower secondary operation rate,slightly lower postoperative DASH scores and slightly better pain relief effect than DUSO,indicating that MUSO can effectively be used for UIS treatment.
文摘The cerclage wire is an important adjuvant in the management of Orthopaedic and trauma cases and is particularly useful in long bone fractures. It is especially useful for addressing the fractures, especially the comminuted ones with a butterfly fragment. Orthopaedic cerclage Wiring is used as an adjunct to maintain fracture reduction (either temporarily or permanently), while the bone is primarily stabilised by either a plate intramedullary nail or external fixation frame. Multiple cerclage wires provide adjunctive fixation against compressive shear, bending & rotational forces and have been used in traumatology since many years. The aim of this article is to introduce a new year simple low cost instrument named as “Suyash cerclage wire passer”, with excellent outcomes without any major complications to the Orthopaedic community.
文摘The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedullary nails and achieve union with least trauma to the shoulder and the rotator cuff. The multiple elastic screw nails achieve the inherent stability based on the principle of “three point fixation”. We aim to propose that the screw intramedullary nail is an effective implant to facilitate uneventful fracture union, with rapid recovery, low morbidity and low learning curve capable of being replicated in any smaller operative set up.
文摘Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.
文摘Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radial and median nerve can cause significant disability.A detailed clinical examination is therefore necessary following humeral shaft fractures.We report a patient with closed diaphyseal humeral fracture （AO 12A-2.3） together with radial and median nerve palsy,its management and review of the literature.As the patient had two nerves involved,surgical exploration was planned.Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression pla te.There was no external injury to both radial and median nerves on surgical exploration.Neurological recovery started at 3 weeks＇ follow-up.Complete recovery was seen at 12 weeks.Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries,which allows better management and rehabilitation of the patient.
文摘Background:The epidemiology of fractures of the humeral shaft has received little attention in Nigeria.This study was aimed at investigating the possible risk factors associated with diaphyseal humeral fractures among Nigerians.Methods:The study was carried out retrospectively at the Department of Medical Records,National Orthopaedic Hospital,Igbobi,Lagos State,Nigeria,between 2007 and 2012.Case notes and plain films of X-ray from a total number of 206 patients of ages from birth to one hundred years(0–100 years),comprising of 140 males and 66 females,were used for the study.The analyses were done using Statistical Package for Social Sciences(SPSS)version 16.0 and presented in bar charts.The frequencies were reported as percentages.The differences in frequencies were compared using chi-square test.Results:The results showed that the percentage frequency of diaphyseal humeral fractures was significantly higher(P<0.05)in males than in females.The main cause(P<0.05)of diaphyseal humeral fractures was road traffic accident followed by fall.Conclusions:The major causes of diaphyseal humeral fractures are road traffic accidents and falls.Since diaphyseal humeral fracture is an issue of harsh economic consequences,adequate measures should be taken by all the parties involved,especially government agencies,to address this menace in term of road maintenance and general well-being of the citizens.Furthermore,since it was observed that different regions of the bones of interest present diverse characteristics with respect to associated risk factors,it is recommended that such studies as this should be region-based rather than whole-bone based.
