Fractures of Forearm Bones – Operative Methods of Treatment

Most of the fractures of both bones of forearm i.e. radius and ulna are treated by operative methods as non operative methods are not very successful especially in displaced fractures.

For closed fractures of these bones, the surgery is either fixation with plate and screws or intramedullary nailing.

Fixation With Plate and Screws

Stainless steel, limited-contact, dynamic compression plate is the treatment of choice for displaced fractures of the radius and ulna and provide very good results.

The preferred plate is the eight-hole dynamic compression plate with 3.5-mm cortical screws. [Read more...]

Popularity: 1% [?]

Clinical Photograph of Massive Lipoma of Thigh

This is an image of thigh of a seven years old child who presented with a large swelling of the thigh that had been progressively increasing after its appearance about 3 years back.  Tumour was quite large in size measuring 20 cms in length and involved whole circumference of the thigh and posteriorly extended into popliteal fossa as well.

Lipoma of Thigh in 7 Yeras old

Lipoma of Thigh in 7 Years old

[Read more...]

Popularity: 5% [?]

Xray of Fracture Shaft of Humerus With Failed Implant

40 years old lady who had been operated for fracture of shaft of humerus at her native place presented in the OPD with complaint of discharge from the fracture site and pain. Patient had angulation of the arm and onexamination it should abnormal mobility.

One of the screws were visible through the wound and had backed out for most of its length.

Fracture of lower third of shaf of humerus with failed implant. The plate is off  and screws have come out of the bone

Fracture of lower third of shaf of humerus with failed implant. The plate is off and screws have come out of the bone

Xray revealed a failed plate with  backed out screws.

The patient was planned for implant removal, wound debridement and external fixation to control the infection and then followed by definitive surgery.

The patient never reported back.

Popularity: 4% [?]

Treatment of Fractures of Radius and Ulna

Fractures of radius and ulna can be treated with various options. These vary from cast immobilization, plate fixation, intramedullary nailing to external fixation with each of them having an appropriate indication.

The basic principle behind the treatment is accurate anatomic reduction, rigid fixation, and early mobilization of the soft tissues.
Majority  of  displaced fractures of the shafts of the radius and ulna are treated by operative method. Closed treatment of displaced fractures of the radius and ulna  should be undertaken only if there is a specific contraindication to operative treatment. Nondisplaced fractures of the shafts of both the radius and the ulna are very rare in adults. [Read more...]

Popularity: 2% [?]

Single Intraarticular Anakinra Injection Not Effective For Osteoarthritis

anakinraAnakinra is an interleukin-1 (IL-1) receptor antagonist and is common;y used for treatment of rheumatoid arthritis. Anakinra blocks the biologic activity of naturally occurring IL-1 by competitively inhibiting the binding of IL-1 to the Interleukin-1 type receptor.

IL-1 is produced in response to inflammatory stimuli and mediates various physiologic responses, including inflammatory and immunologic reactions. IL-1 stimulates bone resorption and induces tissue damage like cartilage degradation as a result of loss of proteoglycans.

The anakinra molecule is a recombinant, non-glycosylated version of human IL-1 receptor antagonist prepared from cultures of genetically modified Escherichia coli using recombinant DNA technology.

The drug is used as biological response modifier. [Read more...]

Popularity: 2% [?]

Fractures of Shaft Radius and Ulna – Clinical Presentation, Radiography and Diagnosis

Fractures of shaft of radius and ulna occurs following substantial trauma . They are quite common fractures in adults. They are also common in children but the fractures in children would be discussed elsewhere.

Clinical Presentation

In adults it is very rare for these fractures to be undisplaced. As radius and ulna are strong bones, an injury of sufficient force is required to break them. This force is good enough to cause displacement.

The patient usually presents with history of significant trauma which results in pain, swelling, deformity and loss of associated function of the forearm. Oftent the displacement is significant enough to make a clinical diagnosis. Level of the deformity or level of tenderness in case of undisplaced fractures tells about the level of the fracture. [Read more...]

Popularity: 1% [?]

Fractures of Shaft of Radius and Ulna – Mechanism of Injury

Fractures of forearm bones are very common in young active adults. Forearm has got two bones radius and ulna.  They articulate at elbow and wrist with each other and and other bones to form part of  elbow and wrist  joints. On most of occasions, both bone fracture together. In case of single bone fractures, the proximal or distal joint might be injured.

It is uncommon for  a single bone to be injured without any associated injury to other bone or either joint. [Read more...]

Popularity: 1% [?]

Few Terms Used In Fracture Treatment – Types of Reduction and Fixations

Fracture treatment has evolved from its earlier days and now includes many modalities. This has led to coining of new terms to describe new procedures. While we can continue this discussion endlessly, in this article we would stick to very basic terms that one should know.

Closed Reduction

Closed reduction of the fracture means reducing the fracture fragments into acceptable anatomical position  After reduction has been achieved by manipulation and maneuvers, the alignment is generally maintained by plaster cast.

Open Reduction

This means the fracture fragments are surgically opened, accessed and reduced. This opens the fracture hematoma and therefore term open is used for this kind of reduction. [Read more...]

Popularity: 4% [?]

Passive And Auto Stretching of Soft Tissue of Manipulative Therapy in Pain Management

Passive stretching of soft tissues

In soft tissues after any injury immediate repair takes place by formation of fibrous tissue (scar). This scar has an inherent property of contracture and tends to bind tissues together. When this scar tissue forms in fascia, muscles and ligaments it limits the function of tissue because of its lower elasticity.

It hurts when the scar tissue is stretched beyond a limit. Early ambulation is essential after injury to ensure that scar tissue is laid down in the correct plane of movement. Despite all these precautions, nerve entrapment happens in scar tissue.

Passive stretching of soft tissues is most often done for frozen shoulder, early osteoarthritis, sprain and other conditions. [Read more...]

Popularity: 2% [?]

Dose of Vitamin D May Be Important In Fracture Prevention

In a recently published paper in march issue Archives of Internal Medicine, prevention of nonvertebral fractures with vitamin D is dose-dependent for individuals aged 65 years or older. The paper is based on meta-analysis of of randomized controlled trials.

Researchers found a significant positive trend between serum 25-hydroxyvitamin D concentrations and hip bone density and lower extremity strength. The reviewers identified 12 double-blind RCTs for nonvertebral fractures, enrolling a total of 42,279 subjects, and 8 RCTs for hip fractures, enrolling a total of 40,886 subjects, which compared the effects of oral vitamin D, with or without calcium, with those of calcium alone or of placebo. [Read more...]

Popularity: 1% [?]