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Register a new userFailunion after distal radius Fractures (Fonctional disorders)
سوء اندمال كسور النهاية القاصية للكعبرة (النتائج الوظيفية)
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Tishreen University ورقة بحثية
Publication date
2016
fields
Medicine
and research's language is
العربية
Authors
غياث حلوم( باحث )
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Shamra Editor
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إن كسور النهاية القاصية للكعبرة داخل المفصل لها نتائج سيئة أكثر بكثير من كسور النهاية القاصية للكعبرة خارج المفصل من حيث مجال حركتي الثني و البسط, الانحراف الكعبري و الانحراف الزندي للمفصل . إن قصر الكعبرة و اتجاه السطح المفصلي للكعبرة لابد من إعادة تصحيحهما . سلامة السطح المفصلي للكعبرة يلعب دور مهم في تقرير النتائج. إن تبدل السطح المفصلي للكعبرة أكثر من 1 مم تحدث الم معند على العلاج و قسط مفصلي فيما بعد. أكثر من 92 % من المرضى الذين كان عندهم عدم تطابق في السطح المفصلي للكعبرة مع افتراق أكثر من 2 مم حدث لديهم تنكس في المفصل الكعبري الرسغي. من خلال فحص المرضى الذين حدث لديهم اندمال مع قصر في الكعبرة أكثر من 2 مم, لاحطنا نقص في مجال حركة مفصل المعصم ( الثني / البسط , الكب / الاستلقاء) بشكل أكثر من المرضى الذين لم يحدث عندهم قصر في الكعبرة. أيضا لم نتمكن من إيجاد إحصائية كافية عن الألم أثناء الحركة.
The intraarticular fracture of distal end of radius have bad returns more than extra articular fractures whereform the range of motion in flexion and extension, radial variance and ulnar variance of the joint. Shortness of the radius and the direction of articular surface of the radius should be corrected. The integrity of radial articular surface play an important rule in determining results. Displacement of the articular surface more than 1 mm cause an obstinate pain and synarthrophysis thereafter. More than 92% of the patients with disalignment of articular surfaces with space more than 2 mm end with arthrosis in the radial carpal joint. Through examening patients with union with shortness of radius more than 2 mm, we notices recuction of the wrist range of motion ) flextion-extention- pronation -supination) more than patients without shortness. Also we couldnt find sufficient statitics about the pain during motion.
References used
Axelrod T, Paley D, Green J McMurtry RY: Limited open reduction of the lunate facet in comminuted intraarticular fractures of the distal radius. J Hand Surg Am 13: (2001) 372-377
Aro HT, Koivunen T: Minor axial shortening of the radius affects outcome of Colles´ fracture treatment. J Hand Surg 16-A: (2004) 392-398
Dresing K, Peterson T, Schmidt-Neuerburg KP: Compartment pressure in the carpal tunnel in distal fractures of the radius. A prospective study. Arch Orthop Trauma Surg 113: (1994) 285-289
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The study included 37 cases of fractures of one or both isolated malleoluer in adult patients whose attended al-Assad University Hospital in Lattakia between 2011 and 2014. Patients' ages ranged between 20 and 75 years, the ratio of males was 54 % .
Greatest range of injury in ages from 30 to 39 years old (27%) . The largest ratio of the mechanism of injury while was walking (56.8%), followed by traffic accidents (29.7%) and during sports (13.5%). Ratio of isolated malleoluer fractures is like the isolated medial malleolus (35.1%), and the isolated lateral malleolus is (29.8%). Surgically treated 25 cases (67.6%), while 12 cases were treated conservatively (32.4%). The functional results in males were better than in females, and in the younger ages were better than the older ages. The best results were in the surgical treatment by (51.3%), especially the isolated malleoluer fractures (21.6%), the best results for patients treated conservatively were in the treatment of isolated medial malleolus fracture (8.1%), while the worst results were in the isolated lateral malleolus (5.4%).
To identefi the Bacterials agents in Meningitis resulting from basal skull
Fractures, The antibiotics sensitivity, and The benefit of pneumo 23 vaccine to prevent the occurrence of
meningitis in these cases.
Background& Objective: The acetabular bone deficiency secondary to acetabular fractures presents a
complex clinical problem and a big challenge to the orthopedic surgeons due to the technical difficulties
related to this deficiency, considering tha
t significant number of patients treated either surgically or
without surgery will require T.H.A in the future.
The purpose of our study was to determine the outcome of T.H.R performed in patients with a history of
acetabular fracture.
Materials & Methods: We performed T.H.R in 21 patients with previous acetabular fractures in Al-Assad
Hospital between2004-2009prespectively, these cases were divided into 3 groups:
-first group formed of 7 patients were treated conservatively. Second group formed of 9 patients did an
open reduction and internal fixation by screws and plates.
-Third group formed of 5 elderly patients with fresh acetabular fractures and were treated primarily by a
total prosthesis with use a reinforcement Muller ring .
For the clinical evaluation of our cases we used the modified Harris Hip Score Scale and for the
radiological evaluation we used the Delee and Charnley scale system .
Results: Our overage Harris Hip Score was 83.(80 for the first group, 86 for the second group, and 83 for
the third group).
-No complications were encountered intraoperative, in the early postoperative period one case developed
superficial wound infection and treated by repeated dressing and antibiotic, there was one case of D.V.T
on the 4th day treated by rest and anticoagulant, and one case developed loosening of acetabular
component 8 months after T.H.A and underwent to revision.
Conclusion: T.H.R in acetabular fractures despite the difficulties faced during the procedure is a safe and
effective way to salvage the hip when secondary osteoarthritis develops, open reduction and internal
fixation of acetabular fractures may have benefits even if it fails to prevent posttraumatic arthritis
.Furthermore the clinical results of T.H.R after surgical treatment of acetabular fractures are better than
it after conservative treatment of these fractures.
Reinforcement ring is an ideal solution when the decision of T.H.R is taken as a primary treatment of
acetabular fractures depending on the indications described by Joly.
The number of patients reached 15 patients, the number of females ranged was 1 patient
percentage 6,6%, The number of males 14 ranges by 93.4% . Mean age of the occurrence
of the injury was at the third decade.The patients of the Study had isolated
common
peroneal nerve injuries after Trauma.
We have basted in the diagnosis of these injuries mainly on the clinical study, which
followed by EMG, it showed loss of the ability of the nerve to respond to alert the electric
stimulation. we hope with these situations is to maintain a relatively acceptable function,
not a full return of it, Authors said that the function cannot return 100%. We have good
results one year after the surgery in terms of muscle tone of the leg 67%, In addition to a
good improvement in the movement of ankle joint 60%. All patients followed physical
therapy in specialized Center in physical therapy after removing the plaster.
The study showed that a full and regular cooperation between the surgeon therapist and
a doctor of physical therapy has a big role in getting a good results.
This paper studies 60 Patients with cerebral hydrocephalus (34 Mal, 26 females).
Their age ranged between 6 months and 72 years. They were treatment with VP shunts
with laparoscopic insertion of the peritoneal end.
The main indication was hydrocep
halus following trauma (28.3%), followed by
Sylvius canal stenosis(25%), after intracerebral hemorrhage (20%), meningocele(15%) and
finally by tumor- associated hydrocephalus (11.6%).
55% of patients had no previous abdominal operations and 45% have previous an
abdominal procedure.
The results showed that 81.6 of cases had op-duration less than one hour. Length of
abdominal incision was in 88.3% less than 1.5 cm. the hospitalization was significantly
shorter than open method, and so were the complications: only 3.3% had wound infection,
and 8.3 had shunt obstruction.
These findings support the importance of using endoscopic methods in the
implantation of the distal end of catheter, as they contribute to shortening the duration of
the work and reduce the length of surgical incision and shorten the period of
hospitalization of patients . it is also associated with a small percentage of complication.
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