The brachial plexus palsy is a rare complication of a clavicle fracture, occurring in 0.5% to 9.0% of cases. This condition is caused by excessive callus formation, which can be recovered by a spur resection and surgical fixation. In contrast, only seven cases have been reported after surgical reduction and fixation. A case of progressive brachial plexus palsy was observed after fixation of the displaced nonunion of a clavicle fracture. The symptom were improved after removing the implant.
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Arcuate osteoplasty for brachial plexus paralysis after plate fixation of mid-clavicle fracture: a case report and literature review Dongju Shin, Jae Hwi Han Clinics in Shoulder and Elbow.2025; 28(3): 394. CrossRef
PURPOSE This study examined the clinical outcomes of comminuted intraarticular distal radius fractures treated by an anatomical reduction using a brick-work technique. MATERIALS AND METHODS Seventeen patients with AO/OTA type 23-C3 distal radius fractures were enrolled in this study. An anatomical reduction of the articular surface was achieved using a brick-work technique through the dorsal approach and dorsal plates were used for fixation. The postoperative functional results were assessed with the range of motion of the wrist and the modified Mayo wrist score (MMWS). In addition, the radial length, radial inclination, volar tilt, and Lidstrom score were evaluated from the radiology results. The mean postoperative follow-up period was 13.6 months. RESULTS All patients showed bony union and the mean range of motion of the injured wrists was 94% (92% to 95%) of the uninjured side. The mean MMWS was 85.3, and the functional results were excellent in 12 patients, good in 4, and fair in one at the final follow-up. Based on the final radiographic measurements, the radial length, volar tilt, and radial inclination were 11.4 mm (10.0 to 13.5 mm), 6.6° (−1.8° to 9.2°), and 21.3° (20.1° to 25.7°), respectively. The radiologic results according to the Lidstrom score were excellent in 14 patients and good in three. CONCLUSION An anatomical reduction with the brick-work technique is relatively easy, results in a reproducible clinical outcome, and could be a safe and effective treatment option for severe comminuted intraarticular distal radius fractures that are not amenable to volar plate fixation.
Shoulder dislocation is the most common dislocation presenting to the emergency department. In old age, the attempt of closed reduction is made with caution in order to prevent iatrogenic fracture around the shoulder. We report two cases of iatrogenic fractures of humeral shaft and anatomical neck in female patients older than 70 years old, which occurred during the manual closed reduction. One patient was proved as first-time and the other was recurrent. In addition, the second case had a massive irreparable rotator cuff tear. Those patients were treated successfully with humeral nailing and reverse total shoulder arthroplasty, respectively.
PURPOSE To evaluate the modified Ender nailing technique for the treatment of femoral intertrochanteric fractures in elderly patients. MATERIALS AND METHODS 31 cases of femoral intertrochanteric fractures treated by modified Ender nailing from May 1997 to December 2004 were included in this study. We analyzed the method of the anesthesia, amount of intraoperative blood loss, operation time, number of used nail, postoperative ability of ambulation, postoperative complication, and the time for radiological union. RESULTS 22 cases were operated under epidural anesthesia and 9 cases under general anesthesia. The average amount of intraoperative blood loss was 55 ml and average time for operation was 37 minutes. The average number of used nails were 3.1. The postoperative ambulatory ability was clinically recovered to the preoperative ambulatory ability in 23 cases, and decreased than before in 8 cases. Postoperative complications included knee joint pain or limitation of motion of the knee joint and distal migration of the nails. The average time for radiological bone union was 17.1 weeks postoperatively. CONCLUSION The modified Ender nailing technique is the one of the proper method in elderly femoral intertrochanteric fractures with associated medical problems. This method reduce the operation time and the amount of intraoperative blood loss.
PURPOSE To evaluate the clinical and radiologic results of percutaneous surgical treatment of the intra-articular fractures of the distal radius, we have compared the results of percutaneous pinning and the combination of percutaneous pinning with external fixation after closed reduction. MATERIALS AND METHODS We analysed the results of 52 patients with intra-articular fracture who received the operative treatment with closed reduction in the period of June, 1995 to June, 2001 and also were in regular follow-up at least one year. We used the subjective analysis by Cole & Obletz and the objective analysis by Scheck. RESULTS We have found the outcome that 83.3% of percutaneous pinning were graded above "Good" in type B and C1 and 82.2% of the combination treatment of percutaneous pinning with external fixation were graded above "Good" in type C2 and C3. CONCLUSION The percutaneous pinning and external fixator after closed reduction in intra-articular fractures of the distal radius are considered useful to restore the articular congruity and make good clinical results.