The Experts below are selected from a list of 195 Experts worldwide ranked by ideXlab platform

M Solomons - One of the best experts on this subject based on the ideXlab platform.

  • Conservative treatment of fractures of the proximal phalanx: an option even for unstable fracture patterns
    Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societ, 2013
    Co-Authors: Michael Held, Maritz Laubscher, P Jordaan, Martin Singer, M Solomons
    Abstract:

    Purpose: The purpose of the study was to assess the efficacy of the conservative management of proximal phalangeal fractures in a dorsal Plaster Slab. Methods: Twenty-three consecutive patients with extra-articular proximal phalangeal fractures were included in this prospective study. Fourteen patients (62%) presented with fractures considered unstable. The fractures were reduced and the position was held with a dorsal Plaster Slab for three weeks. The patients were followed up for an average of seven weeks (range 2 to 45) after the injury. Range of motion of the finger and radiological evidence of union, non-union or malunion was documented after removal of the Plaster. Results: Ninety-one percent of fractures maintained an acceptable reduction. All cases measured less than 15° of angulation. On average 1,1 mm of shortening was measured. In two (9%) cases the reduction was not accepted on follow up assessment and the fractures were managed surgically. Conclusion: Most extra-articular proximal phalanx fractures can be managed conservatively with acceptable results.

  • Conservative management of proximal phalanx fractures: a prospective study
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: Held M, Turner Z, Maritz Laubscher, M Solomons
    Abstract:

    Aim We aimed to assess the efficacy of conservative management of proximal phalanx fractures in a Plaster Slab. Methods 23 consecutive patients with proximal phalanx fractures were included in this prospective study. The fractures were reduced and the position was held with a dorsal Slab for three weeks. They were followed up an average of 7 weeks (range 2 to 45) after the injury. Radiographic confirmation of adequate reduction was carried out each week until union. After removal of the Plaster, range of motion of the finger and radiological evidence of union, non-union or malunion was documented. Results In united fractures, an average angulation of 4° (apex volar) was measured (range 0 to 45°). In one case (45°) this was not acceptable. All other cases measured less than 15° of angulation. On the AP radiograph the angulation was on average 2° (range 0 to 8°). On average 1.3 mm of shortening (range 0 to 5mm) were measured. In one case delayed union with rotational deformity of 20° was evident. After removal of the Slab mild stiffness was noted in one case at the metacarpophalangeal joint and in two cases at the proximal interphalangeal joint. Conclusion Most proximal phalanx fractures can be managed conservatively with acceptable results. NO DISCLOSURES

J. M. Zhu - One of the best experts on this subject based on the ideXlab platform.

  • Supracondylar extension fracture of the humerus in children: MANIPULATIVE REDUCTION, IMMOBILISATION AND FIXATION USING A U-SHAPED Plaster Slab WITH THE ELBOW IN FULL EXTENSION
    The Journal of bone and joint surgery. British volume, 2001
    Co-Authors: R. S. Chen, C. B. Liu, X. S. Lin, X. M. Feng, J. M. Zhu
    Abstract:

    We present a method of manipulative reduction, immobilisation and fixation using a U-shaped Plaster with the elbow in extension for extension-type supracondylar fractures of the humerus in children. When the elbow is in full extension, both the extensor and the flexor muscles are neutralised during manipulative reduction and the carrying angle can be easily assessed thus preventing cubitus varus, the most common complication. In order to evaluate the efficiency of this method, we compared the clinical results of the new method with those of conventional treatment. In a group of 95 children who sustained an extension-type supracondylar fracture of the humerus, 49 were treated by the new method and 46 by the conventional method, reduction and immobilisation in a Plaster Slab with the elbow in flexion. Reduction and immobilisation were easily achieved and reliably maintained by one manipulation for all the children treated by the new method. In 12 children treated by the conventional method, the initial reduction failed and in seven secondary displacement of the distal fragment occurred during the period of immobilisation in Plaster. All required a second or third manipulation. Of the 46 children, 28 (60.9%) had developed cubitus varus at a mean follow-up of 4.6 years when treated by the conventional method. None of the children treated by the new method developed cubitus varus. The mean score, according to the Hospital for Special Surgery (HSS) elbow scoring system, was 91 points using the new method and 78 with the conventional method. The results were statistically significant with regard to the incidence of cubitus varus and the elbow score (p < 0.01) suggesting that the new method is reliable and gives a satisfactory outcome.

G Radcliffe - One of the best experts on this subject based on the ideXlab platform.

  • Monitoring minimally displaced, closed, paediatric tibial fractures for compartment syndrome: is it necessary?
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: K Malhotra, Pai S, G Radcliffe
    Abstract:

    Aims Compartment syndrome (CS) is a well-recognised, serious complication of long bone fractures. The association between CS and tibial shaft fractures is well documented in adult patients and in children with open or high velocity trauma. There is, however, little literature on the risk of developing CS in children with closed tibial fractures. In a number of units these children are routinely admitted for elevation and monitoring for CS. We audited our experience of managing paediatric tibial fractures to ascertain whether it may be safe to discharge a sub-group of these children. Methods We audited all children up to the age of 12 years admitted to our hospital over a 5 year period. We reviewed radiographs and clinical notes to determine fracture pattern, modality of treatment, and complications. Results We audited 159 tibial fractures. The mean age was 5.8 years (1–12 years), 95 boys, 64 girls. 105 (66%) closed fractures were conservatively managed: 87 of these were diaphyseal and 20 involved both tibia and fibula. Of the conservatively managed fractures, 89 (85%) were minimally displaced ( In the conservatively managed group there were 3 cases of angulation in cast, managed with wedging. There were no other complications and no cases of compartment syndrome. Conclusion Of the 105 closed tibial fractures we managed conservatively, most were minimally displaced, diaphyseal, tibia-only fractures. No patient developed compartment syndrome. Based on our experience we suggest that children with closed, minimally displaced tibial fractures do not require admission for monitoring of CS and may go home in a Plaster-Slab with early fracture clinic follow-up providing suitable supervision is in place, pain is controlled, and they are able to mobilise safely.

R. S. Chen - One of the best experts on this subject based on the ideXlab platform.

  • Supracondylar extension fracture of the humerus in children: MANIPULATIVE REDUCTION, IMMOBILISATION AND FIXATION USING A U-SHAPED Plaster Slab WITH THE ELBOW IN FULL EXTENSION
    The Journal of bone and joint surgery. British volume, 2001
    Co-Authors: R. S. Chen, C. B. Liu, X. S. Lin, X. M. Feng, J. M. Zhu
    Abstract:

    We present a method of manipulative reduction, immobilisation and fixation using a U-shaped Plaster with the elbow in extension for extension-type supracondylar fractures of the humerus in children. When the elbow is in full extension, both the extensor and the flexor muscles are neutralised during manipulative reduction and the carrying angle can be easily assessed thus preventing cubitus varus, the most common complication. In order to evaluate the efficiency of this method, we compared the clinical results of the new method with those of conventional treatment. In a group of 95 children who sustained an extension-type supracondylar fracture of the humerus, 49 were treated by the new method and 46 by the conventional method, reduction and immobilisation in a Plaster Slab with the elbow in flexion. Reduction and immobilisation were easily achieved and reliably maintained by one manipulation for all the children treated by the new method. In 12 children treated by the conventional method, the initial reduction failed and in seven secondary displacement of the distal fragment occurred during the period of immobilisation in Plaster. All required a second or third manipulation. Of the 46 children, 28 (60.9%) had developed cubitus varus at a mean follow-up of 4.6 years when treated by the conventional method. None of the children treated by the new method developed cubitus varus. The mean score, according to the Hospital for Special Surgery (HSS) elbow scoring system, was 91 points using the new method and 78 with the conventional method. The results were statistically significant with regard to the incidence of cubitus varus and the elbow score (p < 0.01) suggesting that the new method is reliable and gives a satisfactory outcome.

Held M - One of the best experts on this subject based on the ideXlab platform.

  • Conservative management of proximal phalanx fractures: a prospective study
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: Held M, Turner Z, Maritz Laubscher, M Solomons
    Abstract:

    Aim We aimed to assess the efficacy of conservative management of proximal phalanx fractures in a Plaster Slab. Methods 23 consecutive patients with proximal phalanx fractures were included in this prospective study. The fractures were reduced and the position was held with a dorsal Slab for three weeks. They were followed up an average of 7 weeks (range 2 to 45) after the injury. Radiographic confirmation of adequate reduction was carried out each week until union. After removal of the Plaster, range of motion of the finger and radiological evidence of union, non-union or malunion was documented. Results In united fractures, an average angulation of 4° (apex volar) was measured (range 0 to 45°). In one case (45°) this was not acceptable. All other cases measured less than 15° of angulation. On the AP radiograph the angulation was on average 2° (range 0 to 8°). On average 1.3 mm of shortening (range 0 to 5mm) were measured. In one case delayed union with rotational deformity of 20° was evident. After removal of the Slab mild stiffness was noted in one case at the metacarpophalangeal joint and in two cases at the proximal interphalangeal joint. Conclusion Most proximal phalanx fractures can be managed conservatively with acceptable results. NO DISCLOSURES