The elbow is highly constrained and stable joints in the body, but dislocation is not uncommon due to trauma such as traffic accident and sports injury. The relative incidence of associated fractures in previously reported series of elbow dislocations has ranged from 12% to 62%. Post-traumatic sequelae of the elbow fractures and dislocations are joint stiffness, nerve injury, non-union and heteroDopic ossification. Operative procedures for repair and reconstruction of the injured elbow are technically demanding and require careful planning. Because of the proximity of crucial neurovascular structures, a thorough knowledge of the anatomy and extensile exposure is essential. Thirteen adult patients with elbow dislocation associated with fractures about the elbow from June 1990 to June 1995 who had taken operative treatment were studied. The results were as follows ; 1. Most common direction of dislocation is posterior(8 cases) and most common associated fracture is radial head & neck fracture(7 cases).
2. Most common and disabling complication is limitation of motion(7 cases).
3. By the Mehlhoffs criteria, with regard to limitation of motion, pain, instability and neurovascular deficit, relatively good results are obtained at 9 cases(69%).
4. For better functional results, early reduction of dislocation, stable fixation of fracture and early motion is essential option in the management of elbow fractures and dislocations.
It has been known that early recognition and prompt decompression is critical in acute compartment syndrome with tibial fracture because inappropriate treatment lead to signincant functional disabilities.
We treated 567 cases of tibial fracture and experienced 21 cases of acute compartment syndrome between September 1988 and June 1994.
The purpose of this study is to analysis the initial degree of intracompartmental pressure and duration between the diagnosis and decompression, to evaluate the functional results and to discuss the complications.
The result obtained were as follows 1. Anterior intracompartmental pressure was ranged from 25mnHg to 81mmHg (average 43.4mmHg), and deep posterior intracompartmental pressure ranged from 19mmHg to 61mmHg (average 32.7mmHg).
2. Among the 21 cases, common peroneal neuropathy were developed in 19 cases. We experienced complete recovery in 5 cases, incomplete recovery in 13 cases and 1 case of no change. We found posterior tibial neuropathy in 8 cases, and experienced complete recovery in 2 cases, incomplete recovery in 5 cases and 1 case of no change.
3. As an complications, clawing of toe developed in 3 cases, equinovarus deformity of ankle in 2 cases, superficial wound infection, osteomyelitis and nonunion in 1 case.
4. We obtained good or excellent results in 16 cases(76.1%).
5. We thought that the most important factor to decide the prognosis seems to be duration of high level of tissue pressure and also it is neccessary early diagnosis and early treatments to obtain good results.
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Is CT Angiography a Reliable Tool for Diagnosis of Traumatic Vessel Injury in the Lower Extremities? Jong-Hyuk Park, Kwang-Bok Lee, Hyuk Park, Jun-Mo Lee Journal of the Korean Fracture Society.2012; 25(1): 26. CrossRef