Institutional review board approval was obtained for this study which ia a retrospective case control had analyzed of 256 consecutive supracondylar fractures of the humerus in children admitted from January 2010 to December 2012 operated by 17 surgeons and residents. The institu¬tion is located in a rural setting and is a referral center for trauma for the region. All patients with open growth plates and those aged below 12 years who were treated for a supracondylar humerus fracture during the study period were included. Patients with open fractures were excluded from the study. Clinical data and radiographs were obtained from stored clinical records and the medical records for the patients were reviewed to con¬firm correct documentation of data related to age, gender, Body mass index(BMI), side of injury,energy type of injury, fracture type, surgical details, pin configuration, presence of associated injuries; nerve injury; vascular injury and timing of surgery.
The main outcome was the frequency of loss of reduction after treatment with open or closed reduction and fixation with k -wires which needed re-operation .
An unacceptable reduction and loss reduction were defined as excessive rotation or transla¬tion of bone fragment. Rotational mal-alignment was defined on a lateral radiograph as a 3-mm difference existed in the width of the bone at the fracture site between the proximal and distal fragments (Figure 1). Translational mal-alignment was defined on a lateral radiograph as less than 50% cortical contact existed between the proximal and distal fragments (Figure 2). 8
Poor surgical technique was defined as the lack of fixation of one or more wires either in the distal or in the proximal fragment, convergence of the pin...
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...nt to referral center and may be need to open reduction.
For conclusion, the loss of reduction following fracture fixation is assonated with poor surgical technique which inadequate purchase of the fragments by the pins or inadequate spread in lateral pinning. Cross pinning was found to be appropriate to fixation . In Gartland type 3 which unstable had trended to more loss of reduction after fixation. For the obese children(BMI>25), they also had risk for loss reduction. For this condition ,the surgeons may be carefully for treat supracondylar fracture with good operative technique and fixation. While the intra operative clarified of the fracture configuration may help in achieving good outcome. And other factors such as the fracture patterns, quality of initial reduction, time to surgery and timing of surgery were not associated with loss of reduction .
In the article, Gawande shares a story from when he worked in a hospital as a resident. His first real procedure, placing a central line through a stout man’s heart to receive nutrition, would result in few problems if it were performed by experienced hands. However, knowing this is his first operation to be done alone, Gawande’s nervousness grew with every thought of what could go dramatically wrong. Before beginning, the author recollects studying all of the precise moves and cuts his superior named S. carried out on the same type of procedure on a person beforehand. After feeling informed and confident, Gawande begins by gathering all the necessary tools needed for the job. But as he thought he finished, S. chimes in reminding him of the multiple things he failed to remember to grab or setup. He uneasily shook off the mistakes, and began by locating the point on the man’...
Venipuncture involves several important steps with which the medical assistant must be thoroughly familiar before attempting the procedure. (Proctor, D., Adams, A. (2014). Kinn’s the Medical Assistant: Applied Learning Approach, 12th Edition.). When Margaret was given the requisition form for Mr. James Brown. She
Intra articular fractures of calcaneus occurs following eccentric loading of the talus on the calcaneus.(fig 5.1) The severity, type and location of fracture are determined by the position of the foot, the direction and magnitude of applied force and quality of bone 49.
However, these types of repair have a large amount of issues concerning pain in the back of the knee cap. Other problems such as pain with kneeling, stiffness may take place. The hamstring tendon autograft consist of the tendon on the inside of the knee. An additional tendon that may be used is called the gracilis. This creates a double or four strand tendon graft. The problems following this surgery are few including less stiffness, smaller slits and faster improvement?
The patients chart was reviewed and a history of fractures was brought to the attention of the physician. Her fracture list includes her right clavicle, right humorous, three ribs, multiple finger and toe fractures, the left femur, and her right distal fibula. Many different diagnoses have included accident trauma, child abuse, and many bone disorders including OI. This disease effects on average one child in every 20,000 to 60,000 births each year. Suspected abuse where there is none present can lead to some damaging outcomes for all included and involved. Children with OI and their families can be protected in situations like these, and they are offered the best available
What is meant by a “complete, comminuted, intertrochanteric fracture of the right hip”? A complete, means that the bone is broken completely through a communication means that the bone has been broken into many pieces and a intertrochanteric means that it involves the greater and lesser trochanter of the femur bone.
Kyphoplasty- procedure where a balloon is inserted into the vertebrae and covered by cement, it elevates the fracture.
"Chapter 37." Operative Techniques in Orthopaedic Surgery. Ed. Sam Wiesel. 4th ed. Vol. 2. Lippincott Williams & Wilkins, 2011. eBook.
Complete means when a fracture is completely though the bone. A communited fracture is when the broken bone has shattered into numerous smaller pieces. Intertrochanteric is when a fracture is located between the greater trochanter and lesser trochanter of the femur.
...y within a medical setting has stepped away from the shadows and into a brighter future with the development of the da Vinci Surgical System in the medical world. Before the surgical robot, doctors or surgeons would have had to make several incisions to their patient’s body, which would cause the patients recovery to be elongated and possibly painful. The da Vinci Surgical System allows surgeons to make smaller, less visible incisions to the patient’s body and have a better precision during the procedure. Throughout several years, surgeons relied on their typical laparoscopic surgery to be able to provide patients with the procedures that required them to make large incisions through the patient’s abdomen. Nowadays, surgeons and their patients can have a sigh of relief because the surgical robot provides surgeons with the precision that they long strived for.
Fibular fractures may be complete or incomplete fractures. Fibula fractures may occur anywhere along the bone. The fracture we are trying to fixate is a complete fracture. Fractures occur when a force is placed on the bone that is greater than it can withstand, and when a fracture does occur in the fibula, it’s usually at the same time as the tibia. When only the fibula fractures, it is usually because of a direct blow to the side of the leg or an extreme sideways bend at the ankle or knee. Some other common causes of fibular fracture include, direct hit from doing contact sports such as hockey or lacrosse, stress fracture; weakening of the bone from repeated stress, or indirect injury, caused by twisting, turning quickly, or violent muscle contraction. Tripping, falling or impact during an accident are also major causes of fibular
Norvell, J. G. (2013, June 11). Tibia and Fibula Fracture Clinical Presentation. Retrieved from http://emedicine.medscape.com/article/826304-clinical
Marcus, Miriam. “Ten Plastic Surgical Risks You Need To Know.” Forbes, n.p. 10 October 2007. Web. 17 February 2012.
American Society of Plastic Surgery. 2008. “2007 Report of 2006 Statistics”. Retrieved on January 28th, 2008. From http://www.plasticsurgery.org/media/Press_Kits/Procedural-Statistics-Press-Kit-Index.cfm
type of surgery. Another plus that patient’s consider an advantage is the reduction in eyeglass