Adult ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Ulna ; surgery ; Ulna Fractures ; therapy ; Young Adult

Dislocation of the elbow along with shaft fractures of both bones of the ipsilateral forearm is a rare injury though elbow dislocation or fracture of the forearm bones may occur separately. Such injuries need a concentric reduction of the dislocation and an anatomical fixation of forearm bones for optimal functional outcomes. We report a case of elbow dislocation with fracture of the lateral condyle of the humerus along with fractures of shafts of the radius and ulna in a 44-year-old female. Closed reduction of the elbow and operative stabilization of all fractures were done with good clinical, radiological and functional outcomes in 2 years follow-up period. A significant degree of force is needed to produce a combined dislocation of a joint and fracture of bones around that joint and these complex injuries may be missed if the clinician is not aware of the possibility of such injuries. The fact that the previously reported cases had a posterolateral dislocation while our case had a posteromedial dislocation and a fracture of the lateral humeral condyle as well makes it unique in its presentation and worth reporting. We have also included an up to date literature review on this topic.
Adult ; Elbow Joint ; injuries ; Female ; Humans ; Humeral Fractures ; surgery ; Joint Dislocations ; surgery ; Radius Fractures ; surgery ; Ulna Fractures ; surgery

OBJECTIVETo evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back".

METHODSFrom January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function.

RESULTSAll patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist.

CONCLUSIONUsing the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

Adolescent ; Child ; Female ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Ulna Fractures ; physiopathology ; surgery

During imaging studies or surgical procedures, anomalous forearm and wrist muscles are occasionally encountered. Among them, the flexor carpi radialis brevis is very rare. Because the trend is growing toward treating distal radius fractures with volar plating, the flexor carpi radialis brevis is worth knowing. Here, we report two cases with a review of the literature.
Female ; Forearm/*abnormalities ; Fractures, Comminuted/surgery ; Humans ; Middle Aged ; Muscle, Skeletal/*abnormalities ; Radius Fractures/surgery ; Ulna Fractures/surgery ; Wrist/*abnormalities

This study retrospectively evaluated the effectiveness of an open reduction and internal fixation of a tension band wiring technique for treating displaced or unstable comminuted distal ulnar shaft fractures without a radial fracture. Ten patients were treated for an isolated distal ulnar shaft fracture. There were 6 cases of a fracture 2.5 cm below the lower end of the ulna, and 4 cases with the fracture being 2.5 cm to 5 cm away from the lower end of the ulna. The authors classified the fractures of the distal ulnar into 3 types: a type I-simple fracture, a type II-comminuted fracture without a distal radioulnar joint (DRUJ) involvement, and a type III- comminuted fracture with DRUJ involvement. There were 3 cases of a type I fracture, 4 of type II and 3 of type III. The open reduction and internal fixation using tension band wiring were performed in 10 of these cases. After the operation, the wrist was placed in a cast for six weeks before active movement was allowed. The clinical results were excellent in 7 cases, good in 2 and poor in 1. In conclusion, tension band wiring surgery is recommended for treating an isolated distal ulnar with unreduced displaced fractures, in a comminuted fracture that cannot be maintained by a closed reduction and when there is the potential encroachment of fracture fragments in the DRUJ.
Adolescent ; Adult ; Aged ; Dislocations/surgery ; Female ; Fracture Fixation, Internal/*methods ; Fractures, Comminuted/surgery ; Human ; Male ; Middle Age ; Ulna Fractures/*surgery

Female ; Humans ; Manipulation, Orthopedic ; Middle Aged ; Radius Fractures ; surgery ; Ulna Fractures ; surgery ; Ulnar Nerve Compression Syndromes ; surgery

When compared to adults, pediatric fractures unite readily and nonunion is quite rare. Nonunion is often associated with open fractures, operative interventions, infection, pediatric osteogenesis imperfecta and neurofibromatosis. There are only a few studies and reports mentioning nonunion following conservative ma- nagement of closed pediatric fractures. We report here a case of an eighteen-month-old child who developed nonunion following treatment of fracture of both forearm bones with cast and was successfully treated with plating. To the best of our knowledge, this is the youngest reported case of nonunion following conservative management of closed diaphyseal pediatric fracture.
Bone Plates ; Casts, Surgical ; Fractures, Ununited ; etiology ; surgery ; Humans ; Infant ; Male ; Radius Fractures ; therapy ; Ulna Fractures ; therapy

Adolescent ; Adult ; Casts, Surgical ; Child ; Female ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Splints ; Ulna Fractures ; surgery

OBJECTIVETo explore the advantages of conservative treatment for trauma of children,and evaluate effect of external fixation for the treatment of double fractures of forearm.

METHODSFrom June 2007 to June 2008, 52 patients with double fractures of forearm were treated with manipulative reduction and modified external fixation by splints. Among them, 33 males and 19 females,the age was from 4 to 15 years with an average of 8.6 years. The course of disease was from 1 hour to 7 days. All patients had a definite history of trauma, and pre-treatment X-ray film showed double fracture of ulna and radius.

RESULTSAll patients were followed up from 6 to 14 months with an average of 9.4 months. All fractures healed and the healing time was from 4 to 8 weeks with an average of 6 weeks. The clinical effect was evaluated according to Berton criteria, 37 cases obtained excellent result, 15 good.

CONCLUSIONStrict choose indication of conservative treatment can obtain satisfied effect in treating double fractures of forearm in children. The method has advantages of safe operation, less injury, cheap expense, which can well obtain functional rehabilitation of patients.

Adolescent ; Child ; Child, Preschool ; External Fixators ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Radius Fractures ; surgery ; Splints ; Ulna Fractures ; surgery

OBJECTIVETo study clinical effects of surgery for the treatment of Mayo II B comminuted fracture in ulna olecranon.

METHODSFrom May 2008 to March 2015, a total of 37 patients with Mayo II B comminuted fracture in ulua olecranon were treated, including 20 males and 17 females, ranging in age from 40 to 65 years old ,with an average of 53 years old. All the patients were treated with open reduction and internal fixation within 4 to 7 days after injuries. All the patients had pain and functional disorder uf elbow joint. The X-ray and CT examination showed ulna olecranon comminuted fracture of Mayo II B. Postoperative complications were observed ,and Broberg-Morrey criteria was used tu evaluate therapeutic effects.

RESULTSAll the patients were followed up ,and the duraiton ranged from 9 to 30 months ,with a mean of 15 months. Two patients had surface infection around incision ,and were healed by changing dressings. No other complications occurred such as needle slipping to stimulate skin ,screw loosening and wire broken. One patient had slight uneveness of joint surface without obvious functional disorder. According to Broberg-Morrey elbow fracture curative effect criteria, 11 paients got an excellent result, 24 good and 2 fair,and the total score was 87.0 ± 7.3.

CONCLUSIONFor the Mayo II B comminuted fracture in ulna olecranon, preoperative preparation, intraoperative restoring of the articular surface smooth and reasonable internal fixation, and postoperative rehabilitation actively, can obtain satisfactory clinical effects.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Olecranon Process ; injuries ; Ulna Fractures ; surgery