• MeSH
• chirurgie operační metody   škodlivé účinky   MeSH
• diafýzy * patofyziologie   zranění   MeSH
• fraktury humeru * chirurgie   komplikace   patofyziologie   terapie   MeSH
• fraktury kostí chirurgie   komplikace   terapie   MeSH
• humerus patofyziologie   zranění   MeSH
• infekce měkkých tkání terapie   MeSH
• intramedulární fixace fraktury metody   škodlivé účinky   MeSH
• konzervativní terapie metody   škodlivé účinky   MeSH
• kosti a kostní tkáň patofyziologie   zranění   MeSH
• kosti horní končetiny patofyziologie   zranění   MeSH
• lidé MeSH
• nervus radialis zranění   MeSH
• ortopedické výkony metody   škodlivé účinky   MeSH
• poranění paže chirurgie   patofyziologie   rehabilitace   MeSH
• pseudoartróza chirurgie   terapie   MeSH
• vnitřní fixace fraktury metody   škodlivé účinky   MeSH
• Check Tag
• lidé MeSH

• MeSH
• chirurgie operační metody   MeSH
• fraktury humeru chirurgie   patofyziologie   terapie   MeSH
• fraktury kostí * chirurgie   klasifikace   komplikace   patofyziologie   terapie   MeSH
• fraktury ulny chirurgie   patofyziologie   terapie   MeSH
• fraktury vřetenní kosti chirurgie   patofyziologie   terapie   MeSH
• humerus patofyziologie   zranění   MeSH
• kosti a kostní tkáň patofyziologie   zranění   MeSH
• kosti horní končetiny patofyziologie   zranění   MeSH
• loketní kloub * chirurgie   patofyziologie   zranění   MeSH
• nestabilita kloubu * chirurgie   patofyziologie   terapie   MeSH
• olecranon chirurgie   patofyziologie   zranění   MeSH
• ortopedické výkony metody   škodlivé účinky   MeSH
• poranění paže chirurgie   komplikace   terapie   MeSH
• poranění předloktí chirurgie   patofyziologie   terapie   MeSH
• předloktí patofyziologie   MeSH
• protézy kloubů MeSH
• pseudoartróza chirurgie   terapie   MeSH
• radius patofyziologie   zranění   MeSH
• ulna patofyziologie   zranění   MeSH
• vnitřní fixace fraktury metody   škodlivé účinky   MeSH

A rare case of a fracture of the anatomical neck of the humerus associated with a posterior dislocation of the shoulder in a 43-year-old man is presented. It was managed by immediate surgery using locking plate osteosynthesis. The shoulder was immobilised for 5 weeks in a Gilchrist brace. The outcome was very good with a full range of motion and a stable shoulder at 1 year after injury, with no signs of avascular necrosis of the humeral head. The aetiology of this injury and possibilities of its treatment are discussed. Key words: shoulder dislocation, humeral fractures.

• MeSH
• dospělí MeSH
• fraktury humeru patologie   patofyziologie   chirurgie   MeSH
• hlavice humeru patologie   patofyziologie   chirurgie   MeSH
• kostní destičky MeSH
• lidé MeSH
• luxace ramenního kloubu patofyziologie   chirurgie   MeSH
• rozsah kloubních pohybů MeSH
• vnitřní fixace fraktury přístrojové vybavení   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Elastic bundle nailing is a method for simple humeral mid-shaft fracture osteosynthesis. The aim of our subsequent numerical simulations was to find out torsional and bending stiffness of an elastic bundle nailed humerus. Parametrical 3D numerical model was developed. The diameter of nails was the varying parameter of 1.8, 2.5, 3 and 4 mm. From our results can be seen that the bending stiffness in bundle nailing technique does not depend on nail diameter. On the contrary the torsional stiffness does highly depend on nail diameter. The dependency of the maximal stress on a nail diameter during bending and torsion of the humerus is non-linear. It can be seen that the higher diameter is used the higher stress occurs. Achieved results allow us for the recommendation of optimal nail diameter for this method, which lies between 2 and 3 mm.

• MeSH
• biomechanika MeSH
• dospělí MeSH
• fraktury humeru patofyziologie   chirurgie   MeSH
• intramedulární fixace fraktury metody   MeSH
• kostní hřeby * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mechanický stres MeSH
• počítačová rentgenová tomografie MeSH
• počítačová simulace * MeSH
• pružnost MeSH
• torze mechanická MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY: The aim of the study was to retrospectively evaluate the treatment outcomes of displaced supracondylar humerus fractures, including potential complications, in children treated at the Department of Paediatric General Surgery, Orthopaedics and Trauma Surgery of the Faculty of Medicine in Brno between 2000 and 2011. MATERIAL AND METHODS: The study comprised 564 children, 321 (57%) boys and 243 (43%) girls, who were allocated to two groups according to the method of primary treatment. The average age at the time of injury was 6.8 years (range, 1 to 16). In group 1, all 499 patients were indicated for primary closed reduction and percutaneous osteosynthesis with crossed K-wires under general anaesthesia. In group 2, all 65 patients underwent closed reduction under general anaesthesia and immobilisation in a high plaster cast. The per cent failure of primary treatment requiring either repeat surgery or a change in treatment strategy was evaluated. The duration of follow-up ranged from 14 to 150 months. RESULTS: Open fractures were recorded in eight (1.4%) patients. Twenty-five (4.4%) children had further injury to the ipsilateral limb. Three (0.5%) patients underwent open reduction because it was not possible to achieve adequate reduction by the closed method. In group 1, percutaneous osteosynthesis was performed using two crossed K-wires in 484, three K-wires in 13 and four K-wires in two patients. Re-displacement of fracture fragments requiring repeat reduction and percutaneous osteosynthesis occurred in 10 (2%) patients. One patient had two re-operations. In group 2, the primary treatment failed in 13 (20%) children who needed repeat reduction and conversion to percutaneous osteosynthesis. The difference in the occurrence of failure between the two groups was significant (p<0.001). Nerve injury was recorded in 92 patients (16.3% of all children and 18% of those treated with percutaneous osteosynthesis). Neurosurgical intervention was necessary for injury to the ulnar nerve in five patients and to the radial nerve in one patient. Three children had vascular injury requiring vascular surgery. Two patients underwent corrective osteotomy of the distal humerus for cubitus varus deformity. Volkmann's contracture as a complication was not recorded. DISCUSSION: Minimally displaced fractures can be treated by closed reduction and plaster cast immobilisation but this method fails in up to 20% of cases. A poor result is related to the extent of dorsal displacement before reduction; on the other hand, degrees of flexion in a plaster cast have no effect. The most frequent technical errors resulting in re-displacement after primary osteosynthesis include incomplete reduction and primary fixation in displacement, or failure of both K-wires to pass through the opposite cortex or to fix both fragments firmly. A K-wire diameter smaller than 1.6 mm may also be a reason for failure. The main problem of the method of two crossed K-wires is a frequent injury to the ulnar nerve. CONCLUSIONS: Supracondylar humerus fracture is, regardless of advancements in therapy, an injury with an uncertain treatment outcome and a high percentage of complications. Since primary osteosynthesis failed in 20% of the patients treated by simple reduction under general anaesthesia and plaster cast immobilisation, for the patients requiring fracture reduction under general anaesthesia, the authors recommend one-stage primary treatment including K-wire transfixation. Re-displacement after primary osteosynthesis was always due to a technical error during the surgical procedure and can, therefore, be avoided by a precise operative technique.

• MeSH
• dítě MeSH
• fraktury humeru * patofyziologie   radiografie   chirurgie   MeSH
• interní fixátory MeSH
• lidé MeSH
• následné studie MeSH
• nervus radialis zranění   MeSH
• neurochirurgické výkony metody   MeSH
• osteotomie metody   MeSH
• pooperační komplikace * diagnóza   chirurgie   MeSH
• poranění cév * etiologie   chirurgie   MeSH
• poranění periferního nervu * etiologie   chirurgie   MeSH
• reoperace metody   MeSH
• retrospektivní studie MeSH
• špatně zhojené fraktury * patofyziologie   radiografie   chirurgie   MeSH
• vnitřní fixace fraktury * škodlivé účinky   přístrojové vybavení   metody   MeSH
• výkony cévní chirurgie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH