Desteli, E. E*
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UNLABELLED: PURPOSE Of THE STUDY: To compare the clinical results of clavicular fractures operated by superior locking plate using either horizontal or vertical incision by physical examination and nerve conduction tests. MATERIAL AND METHODS: Between January 2010 and January 2013, 63 patients with displaced midshaft clavicle fracture were treated with superior locking plate (22 female, 41 male) with either horizontal (n = 38) or vertical incisions (n = 25). Mean interval between trauma and surgery was 3 days (1 to 8 days). Electrodiagnostic tests were performed to 15 patients who felt numbness across their shoulder or chest and ASES test was performed to each of the patient 12 weeks postoperatively. IBM SPSS Statistics 22 (IBM SPSS, Türkiye) programme was used for statistical analysis. Student t-test was used for comparison of normally distributed parameters (quantity) and continuity (yates) test was used. p < 0.05 was accepted to be statistically signifiant. RESULTS: 8 patients of the horizontal incision group and 7 patients of the vertical incision group described numbness across their shoulders. 14 patients had abnormal sensorial electrodiagnostic fidings. Comparison of electrodiagnostic fidings did not reveal any statistical signifiance. The mean ASES score of the affected shoulder was 76.39 ±1.20 in the horizontal group, in the vertical group it was found to be 79.00 ± 2.5 ( p < 0.01). CONCLUSIONS: Electrodiagnostic study revealed similar results in both groups. According to these results, signifiant difference in mean ASES scores of both groups was not related to sensorial injury of the supraclavicular nerve.
- MeSH
- dospělí MeSH
- elektrodiagnostika metody MeSH
- fraktury kostí patofyziologie chirurgie MeSH
- hypestezie diagnóza etiologie MeSH
- klíční kost zranění patofyziologie MeSH
- kostní destičky * MeSH
- lidé MeSH
- obnova funkce MeSH
- rozsah kloubních pohybů MeSH
- vnitřní fixace fraktury škodlivé účinky přístrojové vybavení metody MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
PURPOSE OF THE STUDY: To evaluate whether or not children with displaced proximal humerus fractures are more likely to have attention deficit and hyperactivity disorder (ADHD). PATIENTS AND METHOD: Between January 2010 and February 2013, we retrospectively evaluated 42 children with proximal humerus fractures. Requirements for inclusion were an open epiphyseal plate and a non-pathological fracture of the proximal humerus. Fractures were classified according to Salter-Harris, Neer and Horwitz. Following orthopaedic examination, all of the children were consulted to child psychiatry department of our hospital. Orthopaedic examination included a detailed physical examination; the assessment of the overall shoulder functions using the Constant score. Diagnostic and Statistical Manual of Mental Disorders, Text Revisions (DSM-IV-TR) were used for psychiatric examination. RESULTS: 9 of the 42 children with proximal humerus fractures consulted to child psychiatry were put ADHD diagnoses (21 %). Of the remaining 33 children without ADHD diagnosis, 5 children were operated; percentage of surgery was 15%. We found statistically significant difference between the rates of ADHD diagnosed children with proximal humerus fractures and ADHD diagnoses in normal population (p<0.01). There was also statistically significant difference between operation rates of children with or without ADHD diagnosis (55 % vs. 15 %) (p<0,01). CONCLUSIONS: ADHD can be accepted as a risk factor for sustaining high energy trauma and rate of ADHD children who were operated was significantly more than normal children. This might be due to more displaced, open fractures or polytrauma - higher energy trauma- they sustained. Deciding on the treatment method, surgery may be treatment of choice in certain children with severely displaced, irreducable, fractures or polytrauma with accompanying ADHD due to the potential difficulties during follow up period.
- MeSH
- dítě MeSH
- fraktury humeru komplikace terapie MeSH
- hyperkinetická porucha komplikace MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY The objective of this study was to establish relative fixation strengths of proximal femoral nail (PFN), dynamic hip screw (DHS), monolateral external fixator (EF), and cannulated screw (CS) in basicervical hip fracture model. MATERIAL AND METHODS The study involved four groups of implanted composite proximal femoral synthetic bones of eight specimens per group; nailing with PFN, DHS, fixation with three cannulated screws, and EF. 70˚ osteotomy was performed to simulate a Pauwels Type 3 basicervical fracture. Minimum preload of 100 N was applied before loading to failure. The constructs were subjected to cyclic loading with 16˚ to midline from 100 N to 1,000 N for 10,000 cycles at 3Hz. Axial loading was applied at 10 mm/min until failure. Failure load, failure mode, and displacement were documented. RESULTS Mean failure load was 2182.5 ± 377.9 N in PFN group, 2008.75 ± 278.4 N in DHS group, 1941.25 ± 171.6 N in EF group, and 1551.6 ± 236.2 N in CS group. Average displacement was 15.6 ± 4.5 mm, 15.5 ± 6.7 mm, 11.7 ± 1.9 mm, and 15 ± 1.7 mm, respectively. No significant difference was noted among groups for fixation strength except CS group. All CS constructs failed during cyclic loading. CONCLUSION Our findings suggest that PFN, DHS and EF achieved higher fixation strengths than CS in basicervical fracture. PFN has higher failure loads and possesses biomechanical benefits for fixation of unstable basicervical fractures compared with DHS and EF. Key words: basicervical fracture, internal fixation, biomechanics.
