OBJECTIVETo analyze the reason of error diagnosis and inappropriate treatment of radius head fractures complicating distal radioulnar joint dislocation (Essex-Lopresti injury) and to seek for the reasonable treatment.

METHODSFrom 2008 to 2009, 2 male patients of radius head fractures complicating distal radioulnar joint dislocation were treated, the age was 56 and 66 years old respectively. The symptom included elbow swelling and limitation of forearm rotation. X-ray showed comminuted fractures of capitulum radius. There were 1 case of Mason type III and 1 cases of type IV. Two patients were treated by resection of capitulum radius and plaster fixation after operation.

RESULTSBoth of the 2 cases had limited rotation of forearm and the distal radioulnar joint pain. The X-ray showed that the distal radioulnar joint was separated obviously and the proximal radius was translocated.

CONCLUSIONThe early diagnosis is very important for the Essex-Lopresti injury. Rebuilding the longth of the radius and reduction fixating the distal radioulnar joint after fixated is an effective treatment while the interosseous membranes can't be repaired and rebuilded.

Aged ; Diagnostic Errors ; Elbow Joint ; injuries ; Humans ; Joint Dislocations ; diagnosis ; therapy ; Male ; Middle Aged ; Radius Fractures ; complications ; Ulna Fractures ; complications

Fractures of the distal radius are common among elderly patients. Although the indications for surgical treatment are clearly defined, there are patients who will not consent to an operation, even when it is indicated. Inevitably, these cases will require conservative treatment. The aim of this study was to determine the relation between the functional and anatomic stati of these patients. One hundred and eight patients, with intra-articular distal radial fractures, who had been treated non-surgically, were investigated in this study. Functional and anatomic assessments were also performed. The mean follow up period was 39.5 months. The mean age of the subjects was 73.9 years. Although 25.9% of the patients had fair and poor anatomic scores, 88.9% were considered to have good and excellent functional results.
Aged ; Aged, 80 and over ; Arthritis/etiology ; Female ; Human ; Male ; Middle Aged ; Radius Fractures/complications/*therapy

Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones. It is imperative to diagnose exact cause of palsy as it forms the basis for treatment. MRI scan can help diagnosis and accordingly guide the management. Simple nerve contusion should be treated conservatively, and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve. Surgery is not the treatment of choice in cases that could be managed conservatively.
Accidental Falls ; Child ; Diagnostic Errors ; Fractures, Closed ; complications ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Radius Fractures ; complications ; diagnosis ; therapy ; Ulna Fractures ; complications ; diagnosis ; therapy ; Ulnar Nerve ; injuries ; Ulnar Neuropathies ; diagnosis ; etiology

OBJECTIVETo explore the effects of qianggu capsules (QGC) on the fracture healing and the bone mineral density (BMD) in radius distal osteoporosis fracture (RDOF) patients.

METHODSBone mineral density (BMD) of femoral neck in 65 patients with RDOF was detected after the fracture was fixed manually. They were then randomly divided into two groups. Thirty-three patients in the treated group took QC, 1 capsule (180 mg) each time, three times a day, while 32 patients in the control group took D-Cal Biocal 2 tablets (1500 mg) each time, once daily. The therapeutic course for both groups was three months. X-ray examination on the broken end of the fractured bone was taken every month to observe the bony callus formation for comparing the curative effect, and BMD of femoral neck were detected again after patients were treated for 3 months. The bony callus appeared earlier, more in volume with thicker cortex in the treated group after 2 months of treatment versus that in the control group. The fracture healing time in the treated group was 9.4 +/- 2.5 weeks and that in the control group was 12.5 +/- 2.9 weeks, showing significant difference between them (P < 0.05). BMD in the treated group before treatment was 0.621 +/- 0.085 g/cm2, which was lower than that after treatment (0.646 +/- 0.090 g/cm2) with significant difference showing between them (P < 0.05), while no significant change of BMD was found in the control group between before and after treatment, and significant difference was found in BMD between the two groups after treatment (P < 0.05).

CONCLUSIONQGC can promote the formation of bony callus ahead of time, increase the volume of bony callus and BMD, improve the bone structure, and thus the time of external fixation in treating RDOF could be reduced.

Aged ; Bone Density ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fracture Healing ; drug effects ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Phytotherapy ; Radius Fractures ; complications ; drug therapy

Radial head excision has always been a safe commonly used surgical procedure with a satisfactory clinical outcome for isolated comminuted radial head fractures. However, diagnosis of elbow instability is still very challenging and often underestimated in routine orthopaedic evaluation. We present the case of a 21-years old female treated with excision after radial head fracture, resulting in elbow instability. The patient underwent revision surgery after four weeks. We believe that ligament reconstruction without radial head substitution is a safe alternative choice for Mason III radial head fractures accompanied by complex ligament lesions.
Adult ; Elbow Joint ; injuries ; Female ; Fracture Fixation ; Humans ; Joint Instability ; therapy ; Lateral Ligament, Ankle ; surgery ; Radius Fractures ; complications ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and long-term efficacy.

METHODSFrom June 2005 to January 2009, 46 patients with distal radius fractures were treated by surgical operation including 17 males and 29 females,ranging from 27 to 90 years old with an average age of 48 years. All fractures were reduced satisfactory with smooth articular surface. The postoperative radial shortening was analyzed.

RESULTSAll patients were followed-up for 6 to 24 months with an average of 14 months. Among them, 12 patients had radial shortening. The causes of postoperative radial shortening includes: (1) patients older than 60 years; (2) severe osteoporosis; (3) preoperative displacement and comminuted fractures; (4) inappropriate fixation methods; (5) inadequate bone graft; (6) premature load.

CONCLUSIONThe key points to enhance the treatment outcomes include precise judgement of the fracture type and bone quality, sufficient bone graft, firmly fixed after anatomical reduction and an appropriate plan for early loadless functional exercise. Traumatic arthritis may be avoided or delayed if the above-mentioned six causes can be taken into consideration or preventive measures can be taken.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bone Transplantation ; Female ; Follow-Up Studies ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Osteoporosis ; etiology ; Postoperative Complications ; etiology ; therapy ; Radius ; pathology ; Radius Fractures ; surgery