Database : MEDLINE
Search on : Ulna and Fractures [Words]
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[PMID]: 29193820
[Au] Autor:Steyn C; Soley JT; Crole MR
[Ad] Address:Department of Anatomy and Physiology, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
[Ti] Title:Osteology and Radiological Anatomy of the Thoracic Limbs of Temminck's Ground Pangolin (Smutsia temminckii).
[So] Source:Anat Rec (Hoboken);301(4):624-635, 2018 Apr.
[Is] ISSN:1932-8494
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Temminck's ground pangolin is the only pangolin present in South Africa. It is a myrmecophagous mammal with a bipedal gait. The thoracic limbs are used to break open ant nests, dig for food, and expand previously occupied burrows. This study describes the osteology and radiological anatomy of the thoracic limbs of this threatened species. Thoracic limbs from four Temminck's ground pangolins, which succumbed from electrocution or natural causes, were digitally radiographed in situ. The individual bones were then cleaned, described and digitally radiographed. The skeleton of the thoracic limbs revealed a similar number and arrangement of bones compared to that of domestic carnivores. The bones were robust and displayed numerous open epiphyseal lines. The latter provide an estimate of sexual maturity and should not be confused with fractures in injured ground pangolins. The scapula was broad and triangular-shaped. The humerus displayed a massive medial epicondyle. The radius and ulna were similarly sized, and displayed a broad radial trochlea and large olecranon tuber, respectively. The manus was composed of seven carpal bones, five short metacarpal bones and five digits of which the three central digits were the best developed. The unguicular process of the distal phalanx was bifid and elongated. The osteological characteristics indicate that the thoracic limbs of Temminck's ground pangolin are specifically adapted for protraction and retraction, strong elbow extension, flexion of the carpus and digits as well as pronation and supination of the antebrachium, as opposed to weight-bearing. These functions are likewise documented for other scratch-digging species. Anat Rec, 301:624-635, 2018. © 2017 Wiley Periodicals, Inc.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1002/ar.23733

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[PMID]: 29392339
[Au] Autor:Blossey RD; Krettek C; Liodakis E
[Ad] Address:Unfallchirurgische Klinik, Medizinische Hochschule Hannover (MHH), Carl-Neubergstr. 1, 30625, Hannover, Deutschland. blossey.richard@mh-hannover.de.
[Ti] Title:Posttraumatische Torsionsfehler am Unterarm : Messmethoden und Entscheidungsleitfaden für die Korrektur. [Posttraumatic torsional deformities of the forearm : Methods of measurement and decision guidelines for correction].
[So] Source:Unfallchirurg;121(3):206-215, 2018 Mar.
[Is] ISSN:1433-044X
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:Forearm fractures are common in all age groups. Even if the adjacent joints are not directly involved, these fractures have an intra-articular character. One of the most common complications of these injuries is a painful limitation of the range of motion and especially of pronation and supination. This is often due to an underdiagnosed torsional deformity; however, in recent years new methods have been developed to make these torsional differences visible and quantifiable through the use of sectional imaging. The principle of measurement corresponds to that of the torsion measurement of the lower limbs. Computed tomography (CT) or magnetic resonance imaging (MRI) scans are created at defined heights. By searching for certain landmarks, torsional angles are measured in relation to a defined reference line. A new alternative is the use of 3D reformation models. The presence of a torsional deformity, especial of the radius, leads to an impairment of the pronation and supination of the forearm. In the presence of torsional deformities, radiological measurements can help to decide if an operation is needed or not. Unlike the lower limbs, there are still no uniform cut-off values as to when a correction is indicated. Decisions must be made together with the patient by taking the clinical and radiological results into account.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s00113-018-0457-z

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[PMID]: 29169599
[Au] Autor:Chen NC
[Ad] Address:Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 20114, USA. Electronic address: nchen1@partners.org.
[Ti] Title:Elbow Fractures with Instability: Evaluation and Treatment Strategies.
[So] Source:Hand Clin;34(1):75-83, 2018 02.
[Is] ISSN:1558-1969
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The treatment goals of elbow fracture dislocations are congruent reduction of the ulnohumeral and radiocapitellar joints, stable fixation of the proximal ulna, stable fixation or arthroplasty of the radial head, and soft tissue repair. Fracture dislocations occur in patterns, and recognition of these patterns help guide surgical treatment. In patients with persistently unstable fractures after standard fixation, additional temporary joint spanning implants are useful to protect repairs.
[Mh] MeSH terms primary: Elbow Joint/injuries
Elbow Joint/surgery
Fracture Dislocation/surgery
Joint Instability/surgery
[Mh] MeSH terms secundary: Arthroplasty, Replacement, Elbow
Collateral Ligaments/injuries
Collateral Ligaments/surgery
Fracture Fixation, Internal
Humans
Joint Instability/etiology
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[Js] Journal subset:IM
[Da] Date of entry for processing:171125
[St] Status:MEDLINE

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[PMID]: 29367029
[Au] Autor:Zheng W; Tao Z; Chen C; Zhang C; Zhang H; Feng Z; Li H; Cheng L; Cai L; Chen H
[Ad] Address:Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, China.
[Ti] Title:Comparison of three surgical fixation methods for dual-bone forearm fractures in older children: A retrospective cohort study.
[So] Source:Int J Surg;51:10-16, 2018 Feb 01.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The aim of this study was to compare the outcomes of dual ESIN (D-ESIN) fixation, hybrid fixation, and open reduction and dual plate (d-plate) fixation in the treatment of dual-bone forearm fractures in children aged 10-16 years. MATERIALS AND METHODS: 137 patients with dual-bone forearm fractures (48 patients in the D-ESIN group, 45 patients in the hybrid group, and 44 patients in the d-plate group) were reviewed. Duration of surgery, length of incision, intraoperative blood loss, intraoperative times of fluoroscopy, and duration of postoperative immobilisation were recorded. Radiographic outcomes, functional outcomes, and complication rate were also recorded. RESULTS: Surgeries and incisions were significantly shorter, and less intraoperative blood loss occurred, in the hybrid group than the d-plate group (P < 0.001). The hybrid group was also characterised by less intraoperative fluoroscopy times and shorter duration of postoperative immobilisation compared with the D-ESIN group (P < 0.001). The union rate of the ulna at 3 months postoperatively was higher in the hybrid and d-plate groups than in the D-ESIN group (P = 0.003). The union rate of the radius was similar in all three groups (P = 0.403). No significant difference in the union rate of the radius or ulna was observed among groups at 6 months postoperatively (P = 0.052). The mean union time was notably later in the D-ESIN group than in the hybrid and d-plate groups. However, no significant difference in functional outcome or complication rate was observed among the three groups (P = 0.822 and P = 0.912). CONCLUSION: Hybrid fixation was superior in terms of the duration of surgery, intraoperative use of fluoroscopy, intraoperative blood loss, duration of postoperative immobilisation, delayed union of the ulna, and bone union time. Therefore, hybrid fixation is a safe and effective treatment for dual-bone forearm fractures in children aged 10-16 years.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[St] Status:Publisher

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[PMID]: 29466912
[Au] Autor:Ding BTK; Pillay K; Sechachalam S
[Ad] Address:Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
[Ti] Title:Radial shaft fracture obliquity as a predictor of distal radioulnar joint instability.
[So] Source:J Hand Surg Eur Vol;:1753193418756591, 2018 Jan 01.
[Is] ISSN:2043-6289
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:We assessed whether radial shaft fracture obliquity measurements on radiographs could predict intra-operative distal radioulnar joint instability. We also clinically validated previously described predictors of distal radioulnar joint instability, which included a fracture line within 7.5 cm of the lunate fossa, radial shortening >5 mm, and ulna styloid fracture. We retrospectively analysed the radiographs of all surgically managed patients in our unit with radial shaft fractures from 2006 through 2016. The degree of obliquity was analysed on the basis of the maximum fracture-line angle in either the coronal or the sagittal plane. A radial shaft fracture obliquity >30° is predictive of distal radioulnar joint instability ( P = 0.001). Radial fracture shaft obliquity >30° was the most sensitive radiological parameter (76%) for predicting distal radioulnar joint instability. Oblique radial shaft fractures appear to be associated with increased incidence of distal radioulnar joint instability. This radiologic parameter may be used together with established parameters in predicting distal radioulnar joint instability for surgical treatment. LEVEL OF EVIDENCE: III.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:Publisher
[do] DOI:10.1177/1753193418756591

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[PMID]: 29463126
[Au] Autor:Boretto JG; Zaidenberg EE; Gallucci GL; Sarme A; De Carli P
[Ad] Address:1 Hospital Italiano de Buenos Aires, Argentina.
[Ti] Title:Comparative Study of Internal Fixation of the Ulna and Distal Ulna Resection in Patients Older Than 70 Years With Distal Radius and Distal Metaphyseal Ulna Fractures.
[So] Source:Hand (N Y);:1558944718760000, 2018 Feb 01.
[Is] ISSN:1558-9455
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Acute management of fractures of the distal ulna that are associated with fractures of the distal radius remains difficult, particularly in the elderly. METHODS: In this study, we investigated whether internal fixation of the distal ulna is associated with a higher rate of complications than resection of the distal ulna in patients older than 70 years. Twenty-four consecutive patients were included in this study, 12 of whom had undergone open reduction and internal fixation (ORIF) of the distal ulna, and 12 who had undergone distal ulna resection. Patients were retrospectively assessed for range of motion, grip strength, pain, and radiographic appearance. The functional outcome was evaluated by the Mayo Wrist Score. Complications were classified according to the Classification of Surgical Complications. RESULTS: There were no differences in patient demographics between the 2 groups, except patient age. Clinical evaluation showed no difference at follow-up; however, there were significantly more complications associated with ORIF compared with resection. CONCLUSIONS: The results from our study show that women older than 70 years with fracture of the distal radius and distal ulna have a higher rate of complications if ORIF of the distal ulna is performed. Patients should be warned, by surgeons, of this in cases where ORIF of the distal ulna is suggested.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:Publisher
[do] DOI:10.1177/1558944718760000

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[PMID]: 29457246
[Au] Autor:Ree JJ; Baltzer WI; Nemanic S
[Ad] Address:Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
[Ti] Title:Randomized, controlled, prospective clinical trial of autologous greater omentum free graft versus autogenous cancellous bone graft in radial and ulnar fractures in miniature breed dogs.
[So] Source:Vet Surg;, 2018 Feb 19.
[Is] ISSN:1532-950X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To determine the rate of radiographic healing, complications, vascularization, and bone density after repair of radial and ulnar fractures in dogs <6 kg that were treated with an autogenous cancellous bone graft (BG) or free autologous omentum graft (OG). STUDY DESIGN: Prospective, randomized, controlled clinical trial with owners/radiologists blinded to treatment. ANIMALS: 25 dogs with naturally occurring traumatic radial/ulnar fractures. METHODS: Fractures underwent plate fixation with OG or BG. Power Doppler ultrasonographic, computed tomographic (CT), and radiographic examinations of the affected antebrachium were performed preoperatively and every 3 weeks postoperatively until healed. Pressure-sensitive walkway gait analysis and owner and veterinarian assessments were obtained preoperatively (0 weeks) and 3, 6, 9, 12, and 24 weeks postoperatively. RESULTS: Owner/veterinarian assessments improved postoperatively but did not differ significantly between groups. The improvement in peak vertical force/vertical impulse was greater in dogs with OG than in those with BG, beginning 3 weeks postoperatively. Radiographic healing occurred earlier in bones treated with OG (median, 9 weeks) than in those treated with BG (12 weeks). Cortical bone density derived from CT of the distal ulna was higher in bones with BG compared with bones with OG. Signal intensity and the number of vessels in the fracture callus declined over time in both groups, according to results of ultrasonography. However, bones retained more vessels and greater signal intensity when treated with OG compared with treatment with BG, according to multiple views at 6 and 9 weeks postoperatively. CONCLUSION: Omental grafting was not associated with major complications, and it accelerated bone healing and return to weight bearing in dogs. CLINICAL SIGNIFICANCE: Omental grafting should be considered as an adjunct to stabilization of antebrachial fractures in toy and small breed dogs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[St] Status:Publisher
[do] DOI:10.1111/vsu.12774

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[PMID]: 29174872
[Au] Autor:Delpont M; Louahem D; Cottalorda J
[Ad] Address:Service de chirurgie pédiatrique, hôpital Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France. Electronic address: m-delpont@chu-montpellier.fr.
[Ti] Title:Monteggia injuries.
[So] Source:Orthop Traumatol Surg Res;104(1S):S113-S120, 2018 Feb.
[Is] ISSN:1877-0568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:The Monteggia injury is defined as radial head dislocation with a fracture of the ulnar shaft. This combination should be sought routinely in patients with ulnar fractures, even when the displacement is small. The emergent management is simple, as reducing the ulnar fracture is usually sufficient to stabilise the radial head. Internal fixation of the ulna deserves to be widely used to fully stabilise the radial head. Irreducibility of the radial head at the acute stage may indicate an interposition, which requires open surgery on the joint. Radial head dislocation may occur even with minimal displacement of the ulnar fragment. Chronic Monteggia fractures are more challenging to treat and their outcomes are more variable. The radial head becomes irreducible after 2 to 3 weeks. When a simple surgical approach fails to ensure stable reduction, the most widely used method at present is open reduction of the radial head and proximal osteotomy of the ulnar shaft. Stability must be obtained intra-operatively. Without treatment, radial head dislocation may be well tolerated for several months or even years. In the long term, however, osteoarticular remodelling results in loss of joint congruence, pain and, eventually, osteoarthritis. Radiographs must therefore be obtained on an emergency basis and analysed with great care to avoid missing a Monteggia fracture.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1711
[Cu] Class update date: 180218
[Lr] Last revision date:180218
[St] Status:In-Data-Review

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[PMID]: 29439370
[Au] Autor:Hua Z; Wang JW; Lu ZF; Ma JW; Yin H
[Ad] Address:Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China.
[Ti] Title:The biomechanical analysis of three-dimensional distal radius fracture model with different fixed splints.
[So] Source:Technol Health Care;, 2018 Jan 30.
[Is] ISSN:1878-7401
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: The distal radius fracture is one of the common clinical fractures. At present, there are no reports regarding application of the finite element method in studying the mechanism of Colles fracture and the biomechanical behavior when using splint fixation. OBJECTIVE: To explore the mechanism of Colles fracture and the biomechanical behavior when using different fixed splints. METHODS: Based on the CT scanning images of forearm for a young female volunteer, by using model construction technology combined with RPOE and ANSYS software, a 3-D distal radius fracture forearm finite element model with a real shape and bioactive materials is built. The material tests are performed to obtain the mechanical properties of the paper-based splint, the willow splint and the anatomical splint. The numerical results are compared with the experimental results to verify the correctness of the presented model. Based on the verified model, the stress distribution of different tissues are analyzed. Finally, the clinical tests are performed to observe and verify that the anatomical splint is the best fit for human body. RESULTS: Using the three kinds of splints, the transferred bone stress focus on the distal radius and ulna, which is helpful to maintain the stability of fracture. Also the stress is accumulated in the distal radius which may be attributed to flexion position. Such stress distribution may be helpful to maintain the ulnar declination. By comparing the simulation results with the experimental observations, the anatomical splint has the best fitting to the limb, which can effectively avoid the local compression. CONCLUSION: The anatomical splint is the most effective for fixing and curing the fracture. The presented model can provide theoretical basis and technical guide for further investigating mechanism of distal radius fracture and clinical application of anatomical splint.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:Publisher
[do] DOI:10.3233/THC-171050

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[PMID]: 29424160
[Au] Autor:Zhao JF; Zhang TJ; Gao QY; Zhao CF; Han LL; Chen G
[Ad] Address:Luoyang Bone-setting Hospital, Luoyang 471002, Henan, China.
[Ti] Title:[Bone setting manipulative reduction for the treatment of children's distal radioulnar fracture and dorsal dislocation].
[So] Source:Zhongguo Gu Shang;30(7):664-668, 2017 Jul 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To observe the effect of different manipulative reduction for children's distal radioulnar fracture and dorsal dislocation. METHODS: From June 2013 to June 2014, 80 children with distal radioulnar fracture and dorsal dislocation were treated by bone setting manipulative reduction including 51 males and 29 females with an average age of 6.5 years old ranging from 3 to 14 years old. Time from injury to treatment was 1 h to 6 d, 31 cases were on the right, 49 cases were on the left. Among them, 45 cases were type I of overlapping displacement, 35 cases were type II. The displacement of the fracture was observed by clinical manifestations and X-ray examination. Under fluoroscopy, different techniques were used for reduction and fixation. After 3 weeks of over wrist fixation, the splints were overturned and fixed again for 1 to 2 weeks, then were removed. The wrist joint function was evaluated based on Dienst criteria. RESULTS: Eighty cases of fracture were successfully operated one time, all reached anatomic reduction or near anatomic reduction. Eighty children were followed up for 3 months to 1 year. All the fractures healed, and the healing time was 4 to 5 weeks with an average of 4.6 weeks. All patients removed the splint 3 months later, the results were excellent in 72 cases, good in 7 cases and fair in 1 case, the excellent and good rate was 98.75%. CONCLUSIONS: Bone setting manipulation for children's distal radioulnar fracture and dorsal dislocation can get good reduction. At 1 month after the removal of the splint, wrist function and finger strength gradually recovered and returned to normal after 3 months.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.07.017


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