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1: Osteoporos Int. 2003 Nov 5 [Epub ahead of print].

The fracture iaison service: success of a pro!ra" for the eva uation and"ana!e"ent of patients #ith osteoporotic fracture.

$c%e an &'( )a acher *+( ,raser $( $c-ui ian .

/estern Infir"ar ( ) as!o#( .

Introduction: ,racture care often represents the first opportunit forc inica"ana!e"ent of osteoporosis ho#ever( "an patients do not receive aneva uationafter a fracture. In ) as!o#( *cot and( fe#er than 104 of fracture patientsunder#ent bone "inera densit 6$78 testin!. In an effort to better "eet theneeds of fracture patients b providin! routine assess"ent and( #herenecessar (treat"ent for osteoporosis after their fracture( a nove service The ,racture%iaison *ervice8 #as desi!ned and i"p e"ented in t#o separate Nationa 9ea th

*ervice trusts in ) as!o#. $ethods: &n a!reed upon standard of care for "enand#o"en 50; ears of a!e #ith fractures #as estab ished in co aboration #ithorthopedic sur!eons and pri"ar care ph sicians. The ,racture %iaison *erviceassu"es responsibi it for fracture case findin! and for assessin! andperfor"in! dia!nostic eva uations inc udin! a


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>no#n to be si!nificant reduced in post"enopausa #o"en #ith vertebra andhipfractures. 6 contrast( there is ver itt e infor"ation about ca ciu"absorption in other t pes of post"enopausa fracture. /e no# report a seriesof5@G untreated( aucasian post"enopausa #o"en in #ho" #e recorded preva ent

fractures( "easured radioca ciu" absorption( and obtained radio!raphs of theatera thoracic and u"bar spine. Of these #o"en( 1H2 had no preva entfractures( sho#ed nor"a spine radio!raphs( and served as contro s H2 had oneor "ore periphera fractures but nor"a spine radio!raphs 1@H had one or "ore#ed!ed or crushed vertebrae but no periphera fractures and 15? had a historof periphera fracture and one or "ore fractured vertebrae. &!e ad ustedradioca ciu" absorption #as si!nificant o#er in the t#o !roups #ith spinafractures than in the contro s DJ0.0018 but not in the !roup #ith peripherafractures on . It #as a so o#er in the cases #ith "ore than t#o spinafractures than in those #ith t#o or ess DJ0.0018. In respect of peripherafractures( the !reatest a!e ad usted absorption deficit #as found in fracturesof the hu"erus 3548 fo o#ed b hip 3248( spine 2148( #rist 1G48( and rib1H4 a si!nificant but not si!nificant different fro" each other8. %esser

deficits in tibia( an> e and foot fractures #ere not si!nificant but t pe 2errors cou d not be e factor.

D$I7: 1@5G?02@ [Dub$ed as supp ied b pub isher]

3: ,oot &n> e Int. 2003 Oct 2@ 108:HH1 @.

Investi!ation of incidence of superficia peronea nerve in ur fo o#in!an> efracture.

'edfern 7+( *auve D*( *a>e ariou &.

,ri" e Dar> 9ospita N9* Trust( Dorts"outh 'oad( ,ri" e ( *urre ( .david. .redfernKbtinternet.co"

The ai" of this stud #as to investi!ate the incidence of superficia peroneanerve *DN8 in ur fo o#in! an> e fracture and to estab ish #hether thisdiffered bet#een those treated b open reduction and interna fi e. *ur!eons shou d be a#are that the *DN is at ris> durin!

atera approach to the fibu a and that in ur to this nerve can freCuent beidentified as a cause of chronic an> e pain.

D$I7: 1@5?HGG1 [Dub$ed in process]


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@: &cta Orthop Trau"ato Turc. 2003 3H @8:2GG 303.

[Treat"ent of tri"a eo ar fractures. Is osteos nthesis needed in posterior

"a eo ar fractures "easurin! ess than 254 of the oint surfaceL][&rtic e in Tur>ish]

atio 9( 6o"baci 9( )or!ec $.

7epart"ent of Orthopedics and Trau"ato o! Ortopedi ve Trav"ato o i ini!i8(9a darpasa Nu"une Trainin! and 'esearch 9ospita ( s>udar( Istanbu ( Tur>e .

O6+E TIFE*: /e eva uated the effect of posterior "a eo ar fractures( #hich"easured ess than 254 of the oint surface( on the resu ts of an> efractures.$ET9O7*: The stud inc uded @@ patients 21 fe"a es( 23 "a es "ean a!e @@

ears ran!e 1H to HA ears8 #ho under#ent sur!ica treat"ent for /eber t pes6or an> e fractures. ,ibu a fractures #ere associated #ith de toid i!a"entruptures in 12 patients( and #ith "edia "a eo ar fractures in 32 patients.*io#s>i $,.

7epart"ent of Orthopaedics( niversit of $ar and *choo of $edicine(6a ti"ore21201( *&. apo a>Ku"oa.u"".edu

6& )'O N7: & thou!h a nu"ber of investi!ators have docu"ented c inicaoutco"esand co"p ications associated #ith tibia p afond( or pi on( fractures( verfe#have e


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Datient( in ur ( and treat"ent characteristics #ere recorded fro" patientintervie#s and "edica record abstraction. *tud participants returned to theinitia treat"ent centers for a co"prehensive eva uation of their hea thstatus.The pri"ar outco"es that #ere "easured inc uded !enera hea th( #a >in!abi it ( i"itation of ran!e of "otion( pain( and stair c i"bin! abi it . &

secondar outco"e "easure #as e"p o "ent status. 'E* %T*: Ei!ht H?48 of 103e i!ib e patients #ere eva uated at a "ean of 3.2 ears after in ur . )enerahea th( as "easured #ith the *hort ,or" 3A *, 3A8( #as si!nificant poorerthan a!e and !ender "atched nor"s. Thirt five percent of the patientsreportedsubstantia an> e stiffness 2G4( persistent s#e in! and 334( on!oin! pain.Ofsi fractures #ith absorbab e a!scre#]

[&rtic e in hinese]

%iu %,( ai +,( %ian! +.

Trau"atic Orthopedic 7epart"ent( )enera 9ospita of +inan $i itar o""and(+inan( *handon!( D. '. hina 250031.

O6+E TIFE: To stud a ne# >ind of operation for disp aced ta ar nec>fractures.$ET9O7*: ,ro" &pri 1GGA to $arch 2001( G ta ar nec> fractures #ere treated binterna fi e *ociet *core &O,&*8.Onecase had the co"p ication of superficia infection of #ound and s>in ed!enecrosis after operation( #hich #as 9a#>ins t pe III. %ate co"p icationinc udedt#o cases of avascu ar necrosis &FN8. &"on! the"( one &FN of 9a#>ins t pe II#ascaused b ear #ei!ht bearin! five #ee>s after operation and !ained the fair


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score. The other &FN of 9a#>ins t pe III #as inefficient to conservativetherapand proceeded an> e fusion in the end. The &O,&* of the patient #as bad.

ON % *ION: Treat"ent of ta ar nec> fractures b interna fi e Int. 2003 *ep 2@ G8:H2@ author rep H2@ A.

'E: $ethod for "anua reduction of disp aced intra articu ar fracture of theca caneus: techniCue( indications and i"itations( O"oto 9( Na>a"ura ( ,oot&n> e Int. 22 118:?H@ ?HG( 2001.

i" 79( 6er>o#it $+.Dub ication T pes: o""ent %etter

D$I7: 1@52@525 [Dub$ed in process]

?: + 'econstr $icrosur!. 2003 +u 1G 58:2G5 ?.

)raci is "usc e sp it into t#o free f aps.

*choe er T( $eirer '( )urun uo! u '( Di a at er 9( /echse ber!er ).

niversit 9ospita Innsbruc>( %eopo d ,ran ens niversit ( Innsbruc>(&ustria.

& case is presented in #hich the !raci is "usc e #as transverse sp it intot#ofree f aps for covera!e of t#o separate defects in a patient #ith a"u ti se!"ent fracture of the "etatarsa bones and the an> e oint.

D$I7: 1@50A5HA [Dub$ed in process]

G: + Orthop Trau"a. 2003 *ep 1H ?8:5@G 5@.

orrection of tibia "a union and nonunion #ith si< a( NP 10003( *&. david.fe d"anK"ed.n u.edu

O6+E TIFE: To deter"ine the effectiveness of si< a


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Ei!hteen patients #ere inc uded in the stud 11 "a unions and H nonunions8.&defor"ities #ere posttrau"atic in nature. The "ean nu"ber of operations beforethe app ication of the spatia fra"e #as 2.A ran!e 1 A operations8. &patients co"p eted the stud . INTE'FENTION: *i< a e fusionfora "obi e atrophic nonunion. T#o patients had infected tibia nonunions that#eretreated #ith "u tip e debride"ents( antibiotic beads( and bone !raftin! at theti"e of spatia fra"e app ication. & rotationa !astrocne"ius f ap #as used tocover a pros ran!e 12 32#ee>s8.

$&IN O T O$E $E&* 'E$ENT*: &ssess"ent of defor"it correction in si< aneeand an> e ran!e of "otion( incidence of infection( and return to prein uractivities. 'E* %T*: Of the 1? patients treated #ith the Ta or *patia ,ra"e(#ith ad unctive bone !raft as necessar ( 1H achieved union and si!nificantcorrection of their defor"ities in si< a


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&rthroscopic resection of an e e re!ion.

*pahn )( 6ousse ot ,( *chu 9+( 6auer T.

inic of &rthroscop and +oint *ur!er ( Eisenach( )er"an .*pahn.E*&Kt on ine.de

This report describes the case of a 31 ear o d "an #ith a tenos novia !iantce tu"or in the eft an> e re!ion. The tu"or deve oped over a period of 5"onths. & conservative treated fracture of the e! in the patientBs histor#as i"portant. The presur!ica "a!netic resonance i"a!in! $'I8 eno#n deve op"ent of "a i!nant tu"ors( arthroscopice e fractures in 13 patients #ith diabetes#eretreated. The "ean fo o#up #as 1G "onths ran!e( A ?@ "onths8. & patients#erefo o#ed up unti union( a"putation( or for at east A "onths. Nine of 1@enee a"putation. On three of 1@fracturesin three patients hea ed #ithout co"p ications. Open an> e fractures inpatients#ith diabetes are i"b threatenin! in uries #ith hi!h a"putation and infectionrates despite conte"porar techniCues of open reduction and interna fi


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13: 'ofo ,ortschr )eb 'ont!enstr Neuen 6i d!eb Ferfahr. 2003 *ep 1H5 G8:11G3H.

'apid "uscu os>e eta "a!netic resonance i"a!in! usin! inte!rated para eacCuisition techniCues ID&T8 initia enee( an> e and hip under#ent $' i"a!in! at 1.5 T. ,or

si!na detection of the >nee and an> e( #e used a A channe bod arra coithat#as p aced around the oints( for hip i"a!in! t#o @ channe bod arra coi sandt#o e e"ents of the spine arra coi #ere co"bined for si!na detection. &patients #ere investi!ated #ith a standard i"a!in! protoco that "ainconsisted of different turbo spin echo seCuences D7 ( T 28 #ei!hted T*E #ithand #ithout fat suppression( *TI'8. & seCuences #ere repeated #ith aninte!rated para e acCuisition techniCue iD&T8 usin! a "odified sensitivitencodin! "*EN*E8 techniCue #ith an acce eration factor of 2. Overa i"a!eCua it #as sub ective assessed usin! a five point sca e as #e as theabi it for detection of patho o!ic findin!s. 'E* %T*: 'e!ardin! overa i"a!eCua it ( there #ere no si!nificant differences bet#een standard i"a!in! andi"a!in! usin! "*EN*E. & patho o!ies occu t fracture( "enisca tear( tornandinterpositioned 9offaBs c eft( carti a!e da"a!e8 #ere detected b bothtechniCues. iD&T ed to a @? 4 reduction of acCuisition ti"e co"pared #ithstandard techniCue. &dditiona ( ti"e savin!s #ith iD&T ed to a decrease ofpain induced "otion artifacts in t#o cases. ON % *ION: In ti"es of increasin!cost pressure( iD&T usin! "u tip e coi e e"ents see"s to be an efficient andecono"ic too for fast "uscu os>e eta i"a!in! #ith dia!nostic perfor"anceco"parab e to conventiona techniCues.

Dub ication T pes: Eva uation *tudies

D$I7: 12GA@0H3 [Dub$ed inde e fracture and 1 #ith a


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$aisonneuve t pe in ur . The 5 "" scre# consisted of a po ! co icacid po actic acid copo "er p aced in standard fashion at the ti"e of openreduction and interna fi *choo of $edicine(%e ( *&.

This stud revie#s 2@ patients #ith ipsi atera fractures of the dista tibia"etaph sis and an> e oint. & fractures #ere eva uated and cate!ori ed bthe"echanis" of in ur that is( bendin! force versus torsion. & tibiafractures in this series #ere "ana!ed b a statica oc>ed intra"edu arnai#ith appropriate stabi i ation of the an> e in ur as indicated b thefractureor in ur pattern. This treat"ent protoco resu ted in an e


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eft undia!nosed b orthopaedic sur!eons and su!!ests the routine app icationofadvanced radio!raphic studies i.e.( T scan8 in the reco!nition of D$T,,. Ita so eva uates nonoperative "ana!e"ent of D$T,,. $ET9O7*: &fter obtainin!Institutiona 'evie# 6oard approva ( the "edica records over a 5 ear period

1GGH 20018 #ere retrospective revie#ed fro" the foot and an> e service of a

eve 1 trau"a center( identif in! a cases of D$T,,. harts #ere revie#edforre evant data. 'esu ts of treat"ent #ere assessed durin! fo o# up ph sicae


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Cua itative assess"ent of the rotationa re ationship bet#een the tibia andfibu a above( at( and be o# the fracture site at the eve of the "ortise #asa so perfor"ed. The difference in the ratio ca cu ated b subtractin! therotation ratio of the nor"a side fro" the fracture side8 de"onstrated #hetherthe fractured fibu a is eard %( 6er!er ( Drior + ( +oseph %( 9an e 7&(O s ns>i /D( $urra T$( &nastassiades T( 9op"an /( 6ro#n +D( ir> and *(+o ce

( Dapaioannou &( Do iCuin *( Tenenhouse &( Dapadi"itropou os E&.

7epart"ent of $edicine( *t. +osephBs 9ospita ( $c$aster niversit ( har ton&venue East( *uite 501( %? N 1P2( 9a"i ton( Ontario( anada.

Osteoporotic fractures can be a "a or cause of "orbidit . It is i"portant todeter"ine the i"pact of fractures on hea th re ated Cua it of ife 9'-%8. &tota of 3(3G@ #o"en and 1(122 "en 50 ears of a!e and o der( #ho #ererecruitedfor the anadian $u ticentre Osteoporosis *tud a$os8( participated in thiscross sectiona stud . $ini"a trau"a fractures of the hip( pe vis( spine(

o#erbod inc uded upper and o#er e!( >nee( an> e( and foot8( upper bod

inc udedar"( e bo#( sternu"( shou der( and c avic e8( #rist and hand inc udedforear"(hand( and fin!er8( and ribs #ere studied. Darticipants #ith subc inicavertebra defor"ities #ere a so e


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re ationship depends on fracture t pe and !ender. The "u ti attribute scoresforthe $ar> II s ste" #ere ne!ative re ated to hip 0.05 G54 I: 0.0G(

0.018(o#er bod 0.02 G54 I: 0.03( 0.0008( and subc inica vertebra fractures

0.02 G54 I: 0.03( 0.008 for #o"en. The "u ti attribute scores for the

$ar>III s ste" #ere ne!ative re ated to hip 0.0G G54 I: 0.1@( 0.038 andribfractures 0.0A G54 I: 0.11( 0.008 for #o"en( and rib fractures 0.0AG54

I: 0.12( 0.008 for "en. In conc usion( this stud de"onstrates a ne!ativeassociation bet#een osteoporotic fractures and Cua it of ife in both #o"enand"en.

D$I7: 12G2050H [Dub$ed as supp ied b pub isher]

21: Eur + Fasc Endovasc *ur!. 2003 &u! 2A 28:1HA ?.

& co"parison of patients #ho deve oped venous e! u ceration before and aftertheir 50th birthda .

$ac en ie ' ( 6ro#n 7&( & an D%( 6radbur &/( 'uc> e F.

Fascu ar *ur!er nit( 'o a Infir"ar ( Edinbur!h( *cot and( .

6& )'O N7: a thou!h chronic venous u ceration F 8 is often vie#ed pri"arias a disease of the e der ( recent epide"io o!ica data su!!est that asi!nificant proportion of patients first deve op F before "idd e a!e. *uchpatients "a represent a distinct !roup in ter"s of aetio o! ( naturahistor (pro!nosis and therapeutic options. &I$: to co"pare patients #ho deve oped Fbefore )roup 18 and after )roup 28 their 50th birthda . $ET9O7*: one hundredand ei!hteen consecutive patients #ith RpureR F under#ent histor andee to be "a e 32 5@ [5G4] vs 1@ A@ [234](pJ 0.001 chi 288( to have a hi!her "edian interCuarti e [I-']8 bod "ass inde<

32 [2H 3G] vs 2H [23 3@]( p S 0.003( $ann /hitne [$/ ]8( to have a historof deep venous thro"bosis 23 5@ [@34] vs 1A A@ [254]( p S 0.0@ chi 288 and ofipsi atera on! bone fracture 13 5@ [2@4] vs 5 A@ [?4]( p S 0.01( chi 288(tohave previous under!one venous sur!er 2H 5@ [504] vs 1G A@ [304] a "edian

I-'8 of 11.5 A.5 1G8 and 10 2 208 ears ear ier respective ( and to have#orse disease in ter"s of the duration of present u cer 12 A 3A8 vs ?.5 [31?]"onths( p S 0.035 $/ 8( the tota duration of u cer disease 21A [H2 3A0] vs@?[12 120] "onths( p J 0.001 $/ 8( and the nu"ber of episodes of u ceration 3[2 H] vs 1 [1 3]( p S 0.002 $/ 8. There #as no si!nificant difference bet#eenthe t#o !roups in the pattern and severit of venous ref u< #ith @A 5@ ?548of)roup 1 and 5@ A@ ?@48 of )roup 2 patients havin! sur!ica correctab esuperficia venous ref u


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50th birthda appear to represent a distinct !roup in ter"s of aetio o! (natura histor and pro!nosis. The i"portance of thro"bo e"bo ic proph a


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'econstruction of articu ar carti a!e defects of the tibiota ar oint re"ainsacha en!e. & thou!h arthrodesis and tota an> e arthrop ast are treat"entoptions( #e present fresh tibiota ar a o!raftin! as an a ternative techniCue.The avera!e a!e of 12 patients #ho under#ent tibiota ar a o!raftin! #as @3

ears. The avera!e fo o# up #as 21 "onths. & !rafts hea ed at the

host donorinterface. o"p ications inc uded intraoperative fracture in one patient and!raft co apse that reCuired revision a o!raftin! in another. $ost patients#ere re ieved of preoperative pain and #ere satisfied #ith the procedure.Dostoperative function #as a so si!nificant i"proved( based on Cuestionnaireand ph sician assess"ent. ,resh tibiota ar a o!raftin! is an e


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rupture of the &chi es tendon and an avu sion of the ca caneofibu ar i!a"entfro" the ca canea #a #ere seen. 6oth in uries #ere sur!ica repaired( andthe patient subseCuent did #e . The "echanis" of in ur #as thou!ht to bei"pact h perdorsif e e #ith rupture of the &chi es tendonacco"panied b an inversion in ur . sin! a iterature search( it #as foundthat

this co"bination of in uries has not been previous reported.D$I7: 12G02HG5 [Dub$ed in process]

2A: Dh siother 'es Int. 2003 ? 28:AG ?2.

Derfor"ance after sur!ica treat"ent of patients #ith an> e fractures 1@"onthfo o# up.

Ni sson )( N ber! D( E>dah ( Eneroth $.

'esearch 7epart"ent( %und niversit 9ospita ( 7epart"ent of Dh sica Therap (%und niversit ( *#eden. !ertrud.".ni ssonKs>ane.se

6& )'O N7 &N7 D 'DO*E: ,e# studies have been pub ished that e e *core O$&*8 O erud and $o ander( 1G?@8and so"e additiona Cuestions. Datients #ere a so ca ed for a ph sica andradio!raphic e e fractures indicated poorresu ts. One reason for this "i!ht be insufficient rehabi itation.

D$I7: 12?HGH2G [Dub$ed in process]

2H: + &" Dodiatr $ed &ssoc. 2003 +u &u! G3 @8:33A G.

* ndes"otic rupture #ithout an> e fracture. & report of t#o cases inprofessiona footba p a ers.

Endean T( in! /( $artin 9'.

7epart"ent of *ports $edicine( Da o & to $edica ,oundation( Da o & to( &


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G@301( *&.

T#o patients #ith s ndes"otic rupture #ithout fracture are presented tode"onstrate that i!a"entous in ur to the dista s ndes"osis can occur as aniso ated in ur . In both cases dia!nosis #as de a ed o#in! to a ne!ativeradio!raph on the da of in ur . o"prehensive fo o# up is i"perative to

correct dia!nose this in ur pattern.D$I7: 12?AGA0A [Dub$ed inde e in pre!nanc :characteristicsand therapeutic "ana!e"ent]

[&rtic e in ,rench]

*er!ent ,( $ouro>o 7( *e a" '( $arpeau %.

iniCue ! neco o!iCue et obstetrica e( hopita har es Nico e( 9 de 'ouen(1( rue de )er"ont( HA031 'ouen cede of ref e<s "patheticd stroph . Decu iarities of ref e< s "pathetic d stroph Bs treat"ent in thecourse of pre!nanc are evo>ed. The end of the pre!nanc can be shortened #ith


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the ai" of stabi i in! disease even to activate its hea in!. Dathoph sio o!ic"echanis"s of ref e< s "pathetic d stroph in pre!nanc see" "u tip e andco"p e *( Decina $( uipers 9( $oran +( 9asp $.

7epart"ent of Dh sica $edicine and 'ehabi itation( *veti 7uh )enera9ospita (

a!reb( roatia.

6& )'O N7: There has been rapid !ro#th in the technica and ph sio o!ic

de"ands"ade on s>aters #ho perfor" "ore and "ore difficu t u"ps( spins( ifts(thro#s(and free s>atin! "ove"ents. D 'DO*E: To investi!ate the freCuenc of in uriesand overuse s ndro"es in e ite unior s>aters. *T 7P 7E*I)N: -uestionnaire.$ET9O7*: 7urin! four consecutive +unior /or d ,i!ure *>atin! ha"pionships andthe roatia up( #e intervie#ed 23A fe"a e and 233 "a e s>aters bCuestionnaireto deter"ine the freCuenc of in uries and overuse s ndro"es. 'E* %T*:,ift nine of the fe"a e s>aters 2548 and A5 of the "a e s>aters 2H.G48reported sustainin! acute in uries 101 fe"a e @2.?48 and 10A "a e @5.548s>aters reported overuse s ndro"es. %o# bac> pain #as reported b 1G fe"a eand23 "a e s>aters. The "ost freCuent acute in ur #as an> e sprain. In sin! esfe"a e s>aters( the "ost freCuent overuse in ur #as stress fracture 1G.?48(fo o#ed b u"perBs >nee [email protected]. In sin! es "a e s>aters( u"perBs >nee

1A.148 #as the "ost freCuent in ur ( fo o#ed b Os!ood *ch atter [email protected]. $ore than 504 of in uries in oun! sin! es fi!ure s>aters invo ved

overuse s ndro"es. Dairs s>aters and ice dance s>aters had a hi!her ris> ofacute in ur than overuse s ndro"e because of fa s fro" ifts and thro#

u"ps.ON % *ION*: Dro!ra"s to i"prove postura a i!n"ent( f e e oint has been a "atter ofspecu ation for a on! ti"e. In recent ears( the desi!ns of an> e prostheseshave been i"proved( and three desi!ns( a used #ithout bone ce"ent( current


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do"inate the "ar>et. 9o#ever( docu"entation of the c inica resu ts of the useof these prostheses is sparse. /e revie#ed the inter"ediate ter" resu ts offift one consecutive *candinavian Tota &n> e 'ep ace"ents *T&'8. $ET9O7*:6et#een 1GG3 and 1GGG( fift one consecutive an> es #ere rep aced #ith anunce"ented( h dro< apatite coated *T&' tota an> e prosthesis. inicaeenpart in the operations. *tandardi ed radio!raphs #ere used. o"p ications andfai ures #ere recorded( and patient satisfaction and functiona outco"e scores#ere deter"ined for a patients #ith an unrevised i"p ant. 'E* %T*: T#e vean> es had to be revised. *even #ere revised because of oosenin! of at eastone of the co"ponents t#o( because of fracture of the "eniscus and three(forother reasons. & co"ponent #as e e #as successfu fused in the other five. &n additionaei!htan> es had radio!raphic si!ns of oosenin!. The thirt nine unrevised an> es

thirt seven patients8 #ere e e rep ace"ents( so"e#hat satisfied after t#o( and notsatisfied after sis of oosenin! andfai ure are sti hi!her than are such ris>s after tota hip or tota >neerep ace"ent.

D$I7: 12?5135? [Dub$ed inde e fracture.

E!o &( *hei>ha adeh &( $o!atederi *( 6arnett &( ova +.

7epart"ent of Orthopaedic *ur!er ( Ne# Por> niversit 9ospita for +oint7iseases( Ne# Por> 10003( *&. e!o K#or dnet.att.net

6& )'O N7: The purpose of this stud #as to deter"ine #hen patients recovertheabi it to safe operate the bra>es of an auto"obi e fo o#in! operativerepairof an an> e fracture. $ET9O7*: & co"puteri ed drivin! si"u ator #as deve opedand tested. E even hea th vo unteers #ere tested once to estab ish nor"a"eanva ues )roup I8( and a !roup of thirt one vo unteers #ith a fracture of the


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ri!ht an> e #ere tested at sis fo o#in! operativerepair )roup II8. The sub ects #ere tested #ith a series of drivin! scenarios

cit ( suburban( and hi!h#a 8. *cores on the *hort ,or" $uscu os>e eta&ssess"ent #ere recorded at sis and #ere co"pared #iththe resu ts of the drivin! test. /e investi!ated the effect of the ti"e of thevisit and of the testin! condition on the bra>in! ti"es. 'E* %T*: The tota

bra>in! ti"e #as 10HG "sec for )roup I and 1330( 11H2( and 11A0 "sec for )roupII at sis( respective ( postoperative p S [email protected] tota bra>in! ti"e consistent i"proved for each of the drivin! scenariosat each successive data point p S 0.058. The increase in the tota bra>in!ti"eat si< #ee>s "eant an increase in the distance trave ed b the auto"obi ebeforebra>in! of 22 ft A.H "8 at A0 "ph GA.A >" hr8( and the increase at nine#ee>s"eant an increase of ? ft 2.@ "8 at A0 "ph. The functiona outco"e i"provedateach successive visit( a thou!h no si!nificant association #as found bet#eenthe

functiona scores and nor"a i ation of tota bra>in! ti"e. ON % *ION: 6 nine#ee>s( the tota bra>in! ti"e of patients #ho have under!one fi e fracture returns to the nor"a ( base ine va ue.

D$I7: 12?513@0 [Dub$ed indein necrosisaround the #ound #as seen in four cases( #ound infection and puru entdischar!e#ere seen in t#o cases( and an!u ar defor"it #as seen in t#o cases. 7e a edunion and ref e< s "pathetic d stroph #ere not seen in an cases. & thou!htibiota ar narro#in! #as seen in four cases( no cases reCuired tibiota ararthrodesis or subseCuent bon reconstruction at the ti"e of their "ost recentfo o# up. The avera!e residua an> e ran!e of "otion #as p antar f e


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de!rees and dorsif e e arthrodesis is a si"p e(re iab e( reproducib e techniCue #ith a G04 union rate. The va ue of thetechniCue has been confir"ed in patients #ith rheu"atoid arthritis beva uatin!the outco"e usin! a scorin! s ste" that is va idated and re evant to thispopu ation.

Dub ication T pes: inica Tria

D$I7: 12?3?0A3 [Dub$ed inde"a I( *o a>o! u ( 'odop O.

)u hane $i itar $edica &cade" ( 9a darpasa Trainin! 9ospita ( 7epart"ent ofOrthopaedics and Trau"ato o! ( Istanbu ( Tur>e . o ipehKe >o a .net

%isfrancBs oint in uries are rare and co"p e


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traffic accident( #as ad"itted because of partia dorso aterafracture dis ocation of the %isfrancBs oint. The dia!nosis #as "ade bph sicae e #as fu ( #ith no pain on dai activities.

D$I7: 12?3A115 [Dub$ed inde


23/115

deter"ination and i"a!in! perfusion scinti!raph ( vascu ar 7opp eru trasound(echocardio!raph and pu "onar an!io!raph 8 is discussed( a on! #iththerapeuticapproaches to consider #hen "ana!in! pu "onar e"bo is".

D$I7: 12?2530? [Dub$ed inde.

hara a"bous D( ipitis *( u"ar '( 9irst D( Dau &*.

7epart"ent of Trau"a and Orthopaedics( $anchester 'o a Infir"ar ( $anchester(.

&I$*: To investi!ate #hether there are e


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describes a ne# i!a"entop ast #ith a sp it peroneus on!us tendon !raft that"i"ics the nor"a anato"ic conditions of the s ndes"otic co"p e< in 1Apatients#ith s "pto"atic chronic s ndes"otic insufficienc after pronation e e oint. Dostoperative (no infections or he"ato"as #ere seen. One patient had as "pto"atic brea>a!e of

the s ndes"osis scre# one patient had a 10 de!ree decrease of dorsif e e because of a partia anterior tibiofibu ar s nostosis. ,ifteen of 1Apatients had pain re ief at a "ean fo o# up period of 1A.@ "onths ran!e( 132G"onths8 a patients had re ief of the chronic s#e in! of the an> e and the!ivin! #a . The "ean ar sson score at fo o# up #as ?? ran!e( H0 1008points.It "a be conc uded that peroneus on!us i!a"entop ast in a pre i"inarseriesresu ted in re iab e an> e stabi it and considerab e pain re ief in patients#ith chronic s ndes"otic instabi it .

D$I7: 12?011G@ [Dub$ed indeed increased because of the e


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cases( in association #ith either oca 13 cases8 or free three cases8f aps.Fascu ari ed bone transfer #as perfor"ed in 2@ cases( #ith eitherosteocutaneous!roin f aps 10 cases8( so eus fibu a f aps 12 cases8( or osteocutaneous

atera ar" f aps t#o cases8. ,or three patients( bone reconstruction #as

perfor"ed #ith a techniCue that co"bines the induction of a "e"brane around ace"ent spacer #ith the use of an auto o!ous cance ous bone !raft. Infections#ere observed to be responsib e for pro on!ed hospita sta s and treat"entfai ures. The cu"u ative rates of sepsis #ere @.A percent at 1 #ee> afterin urand A2.? percent at 2 "onths. Fascu ar co"p ications #ere a so re ated toinfections and #ere responsib e for four secondar a"putations. One patientas>ed for secondar a"putation because of a painfu nonfunctiona o#er i"b.6one hea in! occurred in 3H of @3 cases( and the avera!e ti"e to union #as G.5"onths( #ith an avera!e of ?.H procedures. The "ean en!ths of sta #ere @Gda sfor conventiona bone !rafts and A2 da s for vascu ari ed bone !rafts. & ofthe 50 patients #ere ab e to #a >( #ith an avera!e ti"e of 1@ "onths. & of

thepatients #ith a"putations under#ent prosthetic rehabi itation. Datients "ostco"p ained about the reconstructed i"b A2.? percent8. +oint stiffness #aspresent in @0 percent of the cases. Other on! ter" co"p ications #ere pain

nine cases8( ac> of sensation five cases8( infection five cases8( andpseudarthrosis one case8. 9o#ever( a of the patients #ith successfureconstructions preferred their sa va!ed e! to an a"putation. Of @1 patients#ho #ere #or>in! before the in ur ( 2A returned to #or>.


D$I7: 12HG@@A3 [Dub$ed inde


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+anis %'( /i >e 6( 6eas e 67( D oot E( %a" &T.

)rant Dodiatric *ur!ica 'esidenc Dro!ra"( 7epart"ent of $edica Education()rant $edica enter( 111 *. )rant &venue( o u"bus( O9 @3215( *&.

anis rKortho in>.net

This artic e discusses the oint de!eneration pro!ression associated #ithpost trau"atic arthrosis of the an> e. & representative case stud of thisdebi itatin! condition #as out ined( and treat"ent #ith tota an> e ointrep ace"ent #as presented. & thou!h an> e arthrodesis continues to be astandardoption fo o#in! the pro!ression of severe post trau"atic osteoarthritis(totaan> e rep ace"ent is "aturin! as a viab e option for this condition.

Dub ication T pes: 'evie# 'evie#( Tutoria

D$I7: 12HHAG?5 [Dub$ed indeo /( onard &( *tanton 'D.

& fred I. duDont Institute( /i "in!ton( 7E( *&.enneth.Ta orKna.a"edd.ar" ."i

$u ticentric !iant ce tu"or of bone is the rare variant of a esion that isre ative co""on in a s>e eta "ature popu ation. &n other#ise hea th13 ear o d bo presentin! #ith this entit #as fo o#ed up for A ears.7urin!this period( the patient #as dia!nosed #ith and treated for si< individua

esions. One recurrence reCuired resection( I i arov bone en!thenin!( andsubseCuent an> e arthrodesis. 9e re"ains fu active and free of distant"etastasis.


D$I7: 12HH1?3G [Dub$ed inde


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scans. The patterns #ere found to be si"i ar to those in adu ts.& e scored BfairB.This patient had "i d i"itation of an> e "ove"ent( a others had fu an> e"ove"ent. ,ive had unrestricted subta ar "ove"ent( in t#o it #as "i d

i"itedand in three it #as "oderate i"ited 50 ?048. There #as no evidence ofabnor"a it of the ph ses on fo o# up = ra s. /e conc ude that operativetreat"ent of this fracture ie ds !ood resu ts.

D$I7: 12HAHHG3 [Dub$ed indeniversit

*choo of $edicine( Ne# Por>( NP 1001A( *&. shihan10Kao .co"

*no#boardin! is one of the fastest !ro#in! #inter sports and is associated#itha re ative hi!h rate of an> e in uries. Dresented is a patient #ho( afterfa in! #hi e sno#boardin!( co"p ained of atera an> e pain and #as"isdia!nosed #ith an an> e sprain. ,urther #or>up revea ed a atera processofthe ta us fracture( an in ur that is rare outside of sno#boardin!. & ateraprocess of the ta us fracture shou d be suspected #hen there is a histor ofinversion #ith dorsif e


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chronic pain. Ear reco!nition "a decrease this re ative hi!h rate of"orbidit .

D$I7: 12HA@3@2 [Dub$ed inde e in. 2003 $ar ? 18:131 @H( i


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a unin ured oints(#ith the hi!hest !radient bet#een 10 and 20 N #ith noa e oint sub u fracture: a case report.

Tho"as '9( 7anie s T'.

*t. $ichae Bs 9ospita ( Toronto( Ontario( anada.

,or a 2G ear o d "an #ith a three #ee> o d 9a#>ins T pe IF ta ar nec>fracture(intra operative reduction and fi


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ta us reconstruction inc udin! the posterior "a eo us.

/eber $( )an '.

7epart"ent of Orthopaedic *ur!er ( niversit of 6ern( Inse spita ( 3010 6ern(*#it er and. "artin.#eberKinse .ch

$a union after a "a eo ar fracture can inc ude a disp aced posterior"a eo us#ith associated postero atera sub u n S 338. & patients received ur!ent 7opp eru trasound assess"ent and( #here possib e( an> e brachia s sto ic inde<"easure"ent. Of a patients( @0 received an an!io!ra"( hae"od na"icinstabi it"a>in! this investi!ation i"practica in others. Dri"ar arteria repair #asthe"ost freCuent e"p o ed sur!ica procedure n S 5@8 fo o#ed b auto!enous


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reverse on! saphenous vein %*F8 interposition !raft n S 1@8( e"bo ecto" nS58 and DT,E interposition !raft n S 38. The "ost co""on post operativeco"p ication #as #ound infection n S 118. &"putation( as a ast resort( #asreCuired in 13 cases fo o#in! either pri"ar or auto!enous reverse %*F repairco"p icated b sepsis or critica ischae"ia. ON % *ION*: Fascu ar trau"a(

especia in con unction #ith severe soft tissue( nerve or orthopaedic in urcarries co ossa ph sica ( ps cho o!ica ( financia and socia costs.&ssociatednerve and venous in ur portended poor outco"e in this stud . /hi storthopaedictrau"a #as a co""on association( the concurrence of occu t vascu ar trau"a andsoft tissue in ur #ithout fracture e"phasises the crucia i"portance ofthorou!h and rapid c inica vascu ar assess"ent( investi!ation and sur!icaintervention. ,ascioto" ( especia for the o#er i"b( is i"portant for theprevention of co"part"ent s ndro"e and its( i"b threatenin! seCue ae. Dri"arpreventive road safet pro"otion and interventions( #ith attention to hi!hris>!roups oun! "a es and "otorc c ists8( is ur!ent reCuired.

D$I7: 12H331AH [Dub$ed inde e. This t pe of esion "a offer a continuation to the four ori!inasta!es. inicians shou d be a#are that this pattern of fracture can occur(andthus a o# a "ore accurate dia!nosis and the provision of so"e aid in thetreat"ent of these in uries.

D$I7: 12H2G12@ [Dub$ed inde e rep ace"ent. The resu ts in 200 an> es.

/ood D%( 7ea>in *.

/ri!htin!ton 9ospita for +oint 7isease( /i!an( En! and( .

6et#een 1GG3 and 2000 #e i"p anted 200 ce"ent ess( "obi e bearin! *T&' totaan> e rep ace"ents. None #as ost to fo o# up for reasons other than thedeathof a patient. The "ean fo o# up #as for @A "onths 2@ to 1018. & co"p icationreCuirin! further sur!er deve oped in ei!ht an> es and 1@ #ere revised orfused. The cu"u ative surviva rate at five ears #as G2.H4 G54 I ?A.A to


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G?.?8 #ith ti"e to decision to revision or fusion as an endpoint. The "ostfreCuent co"p ications #ere de a ed #ound hea in! and fracture of a "a eo us.These beca"e ess co""on #ith e e fractures in e der #hite #o"en. Incidence and ris> factors.

9asse "an T( Fo!t $T( *tone %( au e +&( onti *,.

niversit of Dittsbur!h( Denns vania( *&.

6& )'O N7: & thou!h foot and an> e fractures are a"on! the "ost co""on

nonspina fractures occurrin! in o der #o"en( itt e is >no#n about theirepide"io o! . This stud #as desi!ned to deter"ine the incidence of and ris>factors for foot and an> e fractures in a cohort of GH0@ e der ( nonb ac>#o"enenro ed in the "u ticenter *tud of Osteoporotic ,ractures. $ET9O7*: &t theirfirst c inic visit( bet#een 1G?A and 1G??( the #o"en provided infor"ationre!ardin! ifest e( sub ective hea th( and function. 6one "inera densit #as"easured in the pro e fractures #as 3.0 per 1000 #o"an ears. The "ost co""onan> efracture #as an iso ated fibu ar fracture preva ence( 5H.A48( and the "ostco""on foot fracture #as a fracture of the fifth "etatarsa 5A.G48. /o"en #hosustained an an> e fracture had been s i!ht oun!er at the ti"e of studenro "ent than the #o"en #ho did not sustain such a fracture H1.0 co"pared#ith H1.H ears8( the had a hi!her bod "ass inde< 2H.A co"pared #ith 2A.58(and the #ere "ore i>e to have fa en #ithin the t#e ve "onths prior tofi in! out the ori!ina Cuestionnaire 3?.14 co"pared #ith 2G.H48. Theappendicu ar bone "inera densit #as not si!nificant different bet#eentheset#o !roups of sub ects. /o"en #ho sustained a foot fracture had a o#er bone"inera densit in the dista part of the radius 0.3@5 ! c" 28 co"pared #ith0.3A3 ! c" 28 8 and a o#er ca canea bone "inera densit 0.3G@ ! c" 28co"pared #ith 0.@0@ ! c" 28 8 than the #o"en #ithout a foot fracture( the#ere

ess i>e to be ph sica active A2.34 co"pared #ith AH.?48( and the #ere"ore i>e to have had a previous fracture after the a!e of fift @5.54co"pared #ith 3A.?48 and to be usin! either on! or short actin!ben odia epines. ON % *ION*: Overa ( foot fractures appeared to be t picaosteoporotic fractures( #hereas an> e fractures occurred in oun!er #o"en #ithare ative hi!h bod "ass inde


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5A: Orthopedics. 2003 &pr 2A @8:@15 ?.

7iabetic neuroarthropath harcot oints8: the i"portance of reco!ni in!chronic sensor deficits in the treat"ent of acute foot and an> e fractures in

diabetic patients.)raves $( TarCuinio T&.

7epart"ent of Orthopedic *ur!er and 'ehabi itation( niversit of $ississippi$edica enter( 2500 N *tate *t( +ac>son( $* 3G21A( *&.

Datients #ith diabetic neuropath are at a hi!her ris> of deve opin!co"p ications( especia harcot arthropath . Ear dia!nosis andinterventionis the >e to opti"i in! outco"e. Therefore( diabetic patients #ith a o#ere e sprains.

9atch '%.

Dub ication T pes: o""ent %etter

D$I7: 12H22?@3 [Dub$ed inde


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a enderer O( )unes O( O ca abi IT( O u> *.

I "ir ** Tepeci> E!iti" 9astanesi II. Ortopedi ve Trav"ato o i ini!i.o>a endererK ahoo.co"

O6+E TIFE*: /e eva uated the resu ts of pi on fractures treated b openreduction and interna fi


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had an uneventfu recover . 6 the second postoperative "onth( the #ere ab eto#a > nor"a and had a pain ess ran!e of "otion of the an> e. 6 the third"onth( a patients #ere ab e to underta>e their dai activities( and afractures #ere conso idated. The c inica re evance of this stud is ear#ei!ht bearin!( after open reduction interna fi e *ociet &O,&*8 "id foot scorin! sca e. ,ourpatientshad an e


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A@: *in!apore $ed +. 2002 Nov @3 118:5AA G.

'idin! "otorc c es: is it a o#er i"b ha ardL

%ateef ,.7epart"ent of E"er!enc $edicine( *in!apore )enera 9ospita ( 1 9ospita7rive(Outra" 'oad( *in!apore 1AGA0?. !aefa Ks!h.co".s!

The "orbidit and "orta it a"on! "otorc c ists invo ved in road trafficaccidents 'T&8 in *in!apore is hi!h. 7ue to their re ative s"a si e( therepresent a vu nerab e !roup of road users. $an reports fro" studiesperfor"edoverseas have sho#n that both o#er i"b and head in uries appear to be co""ona"on! "otorc c ists. O6+E TIFE*: To stud the characteristics of o#er i"bin uries a"on! "otorc c ists invo ved in 'T&( #ho present to the 7epart"ent of

E"er!enc $edicine of an urban( tertiar ( teachin! hospita for treat"ent.$ET9O7*: The stud #as conducted prospective fro" 1 +u 2000 to 30 +une2001.7e"o!raphic data #as co ected to!ether #ith detai s of the t pe of in uries("echanis" invo ved( "ana!e"ent and disposition. *D** hica!o( Inc.8 #asuti ised for data "ana!e"ent and statistica ana sis. 'E* %T*: Of the 1(?0G"otorc c ists studied( 1(05A 5?.348 sustained o#er i"b in uries( 32?

1?.148had head in uries and 25A [email protected]( sustained facia in uries. The "ean a!e #as2A.@ ; H.2 ears and "a es "ade up the "a orit of the patients 1(H33(G5.?48. 9e "et usa!e #as 1004.The co""onest t pe of o#er i"b in ur #asfractures 531( 50.348.The "ost co""on t pe of fracture #as that of the shaftofthe tibia and fibu a 231( @3.548( fo o#ed b fractures around the an> e

1?A(35.048. ,or those #ith "ore than one bod re!ion in ured( head in ur #asnotedto be not co""on associated #ith o#er i"b in uries. The co""onest"echanis"of in ur #as co ision #ith another vehic e( #hi e approachin! a turn HAG(@2.548.There #ere GA "otorc c ists 5.348 #ho had c inica evidence of a cohoconsu"ption on their breath at presentation. There #ere 533 2G.548 patients#ho#ere ad"itted for in patient "ana!e"ent and the "ean duration of sta #as @.?; @.5 da s.&"on!st those #ith o#er i"b in uries( the ad"ission rate #as30.54 322 of 1(05A8 and the "ean duration of hospita isation #as 5.3 ; 3.Gda s. ON % *ION: %o#er i"b in uries represent the co""onest for" of in ura"on! "otorc c ists invo ved in 'T&. I"proved trainin! via "otorc c e ridereducation( better desi!n of future "otorc c es and protective foot#ear "ahe pto reduce this prob e".

D$I7: 12A?0525 [Dub$ed inde


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anadian Orthopedic Trau"a *ociet ( a !ar ( & berta( anada.

O6+E TIFE: To report on a co"p ications e e 'u esO&'8 in &ustra ia fo o#in! appropriate education in the use of the ru es.

$ET9O7*: The O&' #ere app ied to consecutive patients 1? ears and overpresentin! #ith acute an> e and foot in uries to the E7 of an urban teachin!hospita . 'E* %T*: Three hundred and thirt three patients had 3AA in uries.There #ere @3 fractures in 2A5 an> e in uries and 1@ fractures in 101 footin uries. *ensitivit #as 1004 for an> e G54 confidence interva I8: G21008and "idfoot fractures G54 I: HH 1008. *pecificit #as 15.?4 G54 I: 11 218


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for an> e fractures and 20.H4 G54 I: 13 318 for "idfoot fractures.ON % *ION:

The O&' had a sensitivit of 1004 for an> e and "idfoot fractures #hen used bboth unior and senior ph sicians.

Dub ication T pes:

Fa idation *tudiesD$I7: 12AH5A22 [Dub$ed inde


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A?: in Orthop. 2003 &pr @0G8:2A0 H.

* ndes"otic disruption in o# fibu ar fractures associated #ith de toidi!a"ent

in ur .

Ebrahei" N&( E !af 9( Dadani a" T.7epart"ent of Orthopaedic *ur!er ( $edica o e!e of Ohio( 7o# in! 9a 30A5&r in!ton &venue( To edo( O9 @3A1@ 5?0H( *&. nebrahei"K"co.edu

%o# fibu ar fractures that #ere associated #ith de toid i!a"ent disruptionandinferior tibiofibu ar s ndes"otic disruption #ere studied. & of the patientshad a T pe 6 /eber fibu ar fracture associated #ith a de toid i!a"ent in ur .It #as difficu t to detect the s ndes"osis disruption on the initiaassess"entof the anteroposterior and "ortise radio!raphs obtained preoperative becausethere #as no obvious ta ar shift on the p ain radio!raph. arefu eva uation

ofthe p ain radio!raph and deter"ination of a the reco""ended "easure"ents#erenecessar to dia!nose the s ndes"otic disruption. 9o#ever( the s ndes"oticdisruption #as easi reco!ni ab e on a


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three arthritic tibiota ar oints in 13 patients seven "a es and si< fe"a es8#ith an avera!e a!e of @2.@ ears ran!e( 21 H3 ears8. Each patient had anavera!e of three prior procedures ran!e( 2 A8. Datients #ere fo o#ed up foranavera!e of [email protected] "onths ran!e( 2@ 55 "onths8. & 13 patients achievedradio!raphic and c inica union an avera!e of 15.A #ee>s ran!e( 12 20 #ee>s8

fro" the date of the definitive procedure. There #ere t#o bro>en scre#s( butnosecondar procedures #ere reCuired to obtain fusion. & patients #erea"bu ator #ithout support at the ast fo o#up. The i"p ant proved effectivefor stab e interna fi '.

7epart"ent of Orthopaedic *ur!er ( )hent niversit 9ospita ( 7e Dinte aan1?5(6 G000 )ent( 6e !iu". >oen.des"etKs> net.be

The authors conducted a retrospective stud of H patients treated #ithtibiota oca canea $archetti Ficen i nai in! one antero!rade and si<retro!radenai s8. & these patients had deve oped pseudarthrosis after previousarthrodesis for posttrau"atic an> e fractures. The resu ts #ere eva uatedc inica and radio!raphica at a "edian ti"e of four ears. ,usionoccurredin three patients( in one of the" on after re"ova of the pro


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7epart"ent of Orthopaedic *ur!er ( *apporo $edica niversit *choo of$edicine( $ina"i 1 o( Nishi 1A cho"e( huo >u( *apporo 0A0 ?5@3( +apan.

& 2A ear o d #o"an #as in ured in a "otor vehic e accident and sustained abi"a eo ar fracture of the ri!ht an> e. 'adio!raphs revea ed a shearin!

fracture of the "edia "a eo us and a !ap in the dista end of the ri!htfibu athat rese"b ed epiph sio sis in chi dren. ,racture of the dista end of thefibu a throu!h a persistent ph sis #as suspected. 9isto o!ica e 7on!( hun! )u( 7ae!u( orea H00 H21.

T#ent four unstab e tibia fractures #ere stabi i ed #ith a narro# i"itedcontact d na"ic co"pression p ate inserted usin! a percutaneous p atin!techniCue under f uoroscopic !uidance. The "a or indication for this techniCue#as a tibia fracture for #hich intra"edu ar nai in! #ou d be difficu t.There#ere 1A pro e function. /e areconfident that the percutaneous p atin! techniCue to treat unstab e tibiafractures for #hich intra"edu ar nai in! #ou d be difficu t #i prove to bean a ternative stabi i ation "ethod( as it avoids the ris> of infection orsofttissue co"pro"ise.

D$I7: 12AA5G52 [Dub$ed inde


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Istituto di Dato o!ia e inica de B&pparato %oco"otore( Do o7idattico *cientifico( Fia Tronto( 10( A0020 Torrette( Ita . a!i!anteKio .it

) enoid fractures are rare. The traditiona "ethod for treatin! the" is openreduction and interna fi


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[&rtic e in Tur>ish]

O tur>"en P( 7o!ru ( ar i $.

** Istanbu E!iti" 9astanesi 1. Ortopedi ve Trav"ato o i ini!i( Istanbu .

O6+E TIFE*: /e eva uated the resu ts of the I i arov "ethod in the treat"entofpseudoarthrosis of the o#er eo#it $+( Dress"an 7N.

7epart"ent of Orthopedics( 7enver( O ?0205( *&. david.h.>i"K>p.or!


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&vu sion fracture of the "edia tuberc e of the posterior process of the ta usoccurs after forcefu dorsif e e. /e eva uated fivepatients #ho had sustained this fracture #hi e participatin! in sportin!activities. T#o patients #ere correct dia!nosed acute and treated #ithi""obi i ation and i"ited #ei!htbearin!. &vu sion fractures in the re"ainin!

three patients #ent undia!nosed acute . This !roup #as treated #ith de a edoperative e


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in uries and &O,&* score *pear"an corre ation coefficient( rS 80.23A(pS0.3318. 'adio!raphic fo o# up de"onstrated ?G4 of an> es #ith radio!raphicchan!es 314 s "pto"atic8 ho#ever( the "a orit of these patients A148 hadanassociated an> e in ur . The subta ar oint de"onstrated radio!raphic chan!esin

?G4 of patients( #ith A34 bein! s "pto"atic H54 of patients #ith subta arointchan!es incurred a fracture about the subta ar oint at the ti"e ofdis ocation.,our patients #ent on to subta ar fusion at an avera!e of ?.? "onthspost dis ocation. The "idfoot sho#ed radio!raphic chan!es in H24 of patients(#ith on 154 of these patients bein! s "pto"atic. & patients #ith "idfoots "pto"s #ere #e contro ed b nonsur!ica "easures.

D$I7: 12A2HA2@ [Dub$ed inde


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un!poo> Nationa niversit 9ospita ( Tae!u( orea. c#ohK>nu.ac.>r

T#ent one patients #ith fractures of the dista tibia "etaph sis( so"e #ith"ini"a disp ace"ent in the an> e( #ere treated b percutaneous p ateosteos nthesis #ith a narro# i"ited contact d na"ic co"pression p ate. sin!the c assification b the &rbeits!e"einschaft fur Osteos nthesefra!en and

Orthopaedic Trau"a &ssociation( 1H fractures had no articu ar invo ve"ent(#hereas four inc uded intraarticu ar es. One patient had "a a i!n"ent of the i"b #ith 10 de!reesinterna rotation( but there #ere no an!u ar defor"ities !reater than 5de!reesor an shortenin! !reater than 1 c". & patients had e e function. There #ere no infections or an soft tissue co"pro"ise.Dercutaneous p ate osteos nthesis is a safe and #orth#hi e "ethod of "ana!in!such fractures( #hich avoids so"e of the co"p ications associated #ithconventiona open p atin! "ethods.

D$I7: 12A1A0H2 [Dub$ed inde


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se of the rin! finee and an> e oints on the sa"e side as the fracture #as notrestricted b "ore than 10 de!rees in an of our patients. No osses affectin!activities of dai ivin! #ere reported( and 1G of the 21 patients #eresatisfied #ith the resu t achieved #ith this techniCue. &fter four of the 22operations there #ere co"p ications. $a a i!n"ents #ere visib e radio o!icafo o#in! five of the fractures. ON % *ION*: In osteoporosis inducedfracturesof the o#er e


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Incapretta"ento is a ritua i ed for" of i!ature stran!u ation oftenassociated#ith the Ita ian $afia. The ha "ar>s inc ude i!ature stran!u ation andbindin!of the bod in a hi!h stereot ped fashion. The bindin!s inc ude t in! the#rists and an> es to!ether( #ith the bod in the prone position si"i ar to

Rho!t in!R8( and an additiona i!ature encirc in! the nec> and attached tothebindin!s of the enee and b unt trau"a to the posterior torso #ere found. The i"p ication ofthese #ounds is discussed in re ation to incapretta"ento.

D$I7: 12A0@GGG [Dub$ed inde e fi


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e of fracture to the foot an> e co"p e< in ter"s of aN for a @5 ear o d 50thpercenti e "a e( assu"in! no &chi es tension. The survivor function presentedhere "a be used to esti"ate the ris> of foot an> e fracture that a b unta tibia ae ihood ratios #erepoo edfor severa sub!roups( correctin! for four "ain "ethodo o!ica threats tova idit . 'E* %T*: 32 studies "et the inc usion criteria and 2H studiesreportin! on 15 5?1 patients #ere used for "eta ana sis. The poo ed ne!ative

i>e ihood ratios for the an> e and "id foot #ere 0.0? G54 confidenceinterva0.03 to 0.1?8 and 0.0? 0.03 to 0.208( respective . The poo ed ne!ative

i>e ihood ratio for both re!ions in chi dren #as 0.0H 0.03 to 0.1?8.&pp in!these ratios to a 154 preva ence of fracture !ave a ess than 1.@4 probabi itof actua fracture in these sub!roups. ON % *ION*: Evidence supports theOtta#aan> e ru es as an accurate instru"ent for e e and"id foot. The instru"ent has a sensitivit of a "ost 1004 and a "odestspecificit ( and its use shou d reduce the nu"ber of unnecessar radio!raphsb


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?G: &" + Orthop. 2003 +an 32 18:@A ?.

se of a vertica transarticu ar pin for stabi i ation of severe an> efractures.

*cioscia TN( iran 69.

7epart"ent of Orthopaedic *ur!er ( niversit of Dittsbur!h( Dittsbur!h(Denns vania( *&.

Transarticu ar pin fi efractures. This techniCue is "ost co""on used as provisiona fi


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G2: Osteoporos Int. 2003 +an 1@ 18:AG HA.

7isabi it after c inica fracture in post"enopausa #o"en #ith o# bone

densit : the fracture intervention tria ,IT8.,in> 9&( Ensrud E( Ne son 76( erani 'D( *chreiner D+( hao P( u""in!s *'(Nevitt $ .

$7( $D9( F& $edica enter( One Feterans 7rive( 6o< 11)( $inneapo is( $N55@1H(

*&. ho#ard.fin>K"ed.va.!ov

'e ative itt e is >no#n about outco"es fo o#in! c inica osteoporoticfractures at nonhip( nonvertebra s>e eta sites. To address this issue( #eprospective assessed post fracture disabi it at "u tip e s>e eta sites ina

popu ation of G0G o der a!ed 55 ?1 ears8( co""unit d#e in! #o"en #ith o#fe"ora nec> bone "inera densit #ho had eed(p acebo contro ed tria that #as desi!ned to deter"ine the effect ofa endronate on fracture incidence( and the current stud #as conducted as asecondar ana sis of ,IT data. ,o o#in! incident c inica fractures( ,ITparticipants #ere fo o#ed prospective for assess"ent of site specific(fracture re ated disabi it . $easures of disabi it #ere se f reported da shospita i ed or confined to bed because of the fracture Bbed da sB8 and da sofreduced usua activities because of the fracture B i"ited activit da sB8. Offracture t pes eva uated( those of the hip resu ted in the hi!hest percenta!eofsub ects #ith an bed da s or i"ited activit da s after fracture G@4 #ithanbed da s and 1004 #ith an i"ited activit da s8( thou!h the "ean nu"ber ofbedda s and i"ited activit da s appeared hi!hest after u"bar vertebrafractures

25.? "ean bed da s and 15?.5 "ean i"ited activit da s8. *ubstantiadisabi it a so #as reported after fractures of thoracic vertebrae( hu"erus(dista forear"( an> e and foot. /ithin fracture t pes( post fracturedisabi it#as hi!h variab e( ran!in! fro" none to "ore than A "onths.

D$I7: 125HH1?H [Dub$ed indeno# ed!e. The purposeof


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#ith a cast. Thus( the purpose of this prospective( rando"i ed stud #as toco"pare the on! ter" sub ective( ob ective( and functiona outco"e afterconventiona treat"ent #ith a cast and that after use of functiona bracin! inthe first si< #ee>s fo o#in! interna fi e fracture. $ET9O7*:One hundred patients #ith an unstab e and or disp aced /eber t pe & or 6 an> efracture #ere treated operative and then #ere rando" a ocated to t#o

!roups: i""obi i ation in a be o# the >nee cast fift patients8 or ear"obi i ation in a functiona an> e brace fift patients8 for the first si<postoperative #ee>s. The fo o# up e


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!ivin! a near nor"a appearance to the foot( producin! ess shortenin! anda o#in! "otion to re"ain at the ta onavicu ar and anterior subta ar oints.

op ri!ht 2003 *. ar!er &)( 6ase

D$I7: 125AAGAG [Dub$ed inde e arthrodesis co"bined #ith tibia en!thenin! usin! the I i arovapparatus.

*a>ura>ichi ( Tsuchi a 9( ehara ( abata T( Pa"ashiro T( To"ita .

7epart"ent of Orthopaedic *ur!er ( *choo of $edicine( ana a#a niversit (13 1Ta>ara "achi( ana a#a G20 ?A@1( +apan.

/e report our e e arthrodeses. /e perfor"edco"pression distraction in three patients and bone transport in three. In theco"pression distraction !roup( the "ean en!th !ained #as 1.G c"( the "eane e fusion: resu ts in 15patients.

ats +( van a"pen &( de /aa $a efi t $ .

7epart"ent of Orthopedics( niversit 9ospita Ni "e!en( Dostbo< G101( A500 96Ni "e!en( The Nether ands.

/e retrospective assessed ti"e unti conso idation( co"p ications( andfunctiona resu ts accordin! to $or!an fro" the c inica charts andradio!raphsof 15 arthroscopic an> e fusions. In 11 patients uni atera distraction andcrossed scre# p ace"ent over the fusion area throu!h tibia and fibu a #ereused


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!roup &8 in @ patients a techniCue of bi atera distraction and para escre#p ace"ent fro" the dorsa side of the tibia into the nec> of the ta us #asused

!roup 68. In !roup & there #ere t#o cases of insufficient co"pression at thearthrodesis site( three cases of subopti"a co"pression( and five cases of

"a position of the scre#s. In a cases in !roup 6 !ood co"pression andfis in !roup 6.,unctiona resu ts #ere better in !roup 6. The initia e e fusion.

D$I7: 125@?@51 [Dub$ed inde e 'u es are "ore sensitive than 7utch in detectin! si!nificantan> efracture.

Dope '.

D$I7: 125@203G [Dub$ed as supp ied b pub isher]

101: &N + *ur!. 2002 Oct H2 108:H2@ 30.

o""ent in: &N + *ur!. 2002 Nov H2 118:HH5 A.

&n> e fractures: functiona and ifest e outco"es at 2 ears.

%ash N( 9orne )( ,ie den +( 7evane D.

7epart"ent of *ur!er ( /e in!ton *choo of $edicine( Ota!o niversit (/e in!ton( Ne# ea and.

6& )'O N7: &n> e fractures for" a hi!h proportion of the tota nu"ber offractures treated in Ne# ea and. Internationa studies sho# that there are"ied to fi in posta Cuestionnaires detai in! their current an> efunction and ifest e( t#o ears after fracturin! their an> e. The patientsBradio!raphs #ere revie#ed to c assif the t pes of an> e fractures sustained.'E* %T*: Of 1@1 patients that sustained an> e fractures( H@ #ere fo o#ed up 2

ears after their an> e fracture. & fracture t pes avera!ed O erud $o anderan> e scores of H1.1. /eber & fractures avera!ed an> e function scores of G0(/eber 6 fractures ?0( and /eber fractures H?. ,our patients 548 achievedBpoorB resu ts( 12 1A48 patients achieved a BfairB resu t( 30 @148 patients


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!ained a B!oodB resu t( 2H 3A48 patients attained Be e fractures can be e e pain.

*har"a *.

Fictoria Infir"ar ( *outh ) as!o# niversit 9ospita s N9* Trust( ) as!o#( .

The case is presented of a 2H ear o d #o"an #ith atera an> e pain after an

inversion in ur sustained #hi e dancin!. & thou!h initia radio!raphs fai edtoidentif the fracture( radio!raphs of the an> e at si< #ee>s sho#ed anunsuspected fracture of the atera process of the ta us. The fracture #astreated #ith cast i""obi isation for si< #ee>s and the patient is currentunder!oin! a!!ressive ph siotherap . & iterature revie# revea ed thatfracturesof the atera process of the ta us are freCuent over oo>ed and shou d beconsidered in the differentia dia!nosis of patients #ith acute and chronican> e pain as an ear dia!nosis and treat"ent prevent on! ter"co"p ications.

D$I7: 125333G@ [Dub$ed in process]

103: E"er! $ed +. 2003 +an 20 18:E1.

o""inuted fracture of the ta us not visib e on the initia radio!raph.

6urton T( * oan +.

7epart"ent of &ccident and E"er!enc $edicine( )enera Infir"ar ( %eeds( .

& T9O':e "ai address p ease ,ractures of the ta us are rare in uries andfractures of the bod of the ta us are particu ar rare. 7ia!nosis of thesefractures is a so difficu t as initia radio!raphs "a be nor"a ( particu ar#ith osteochondra ta ar do"e fractures. %on! ter" "orbidit is co""on afterfractures of the ta us. & case is presented of a patient #ith a co""inutedfracture of the bod of the ta us #ith non dia!nostic initia standard an> eradio!raphs. &ccident and e"er!enc doctors shou d be a#are of this in ur (andbe suspicious that patients #ith an appropriate "echanis" of in ur andpronounced pain "a reCuire further investi!ation despite nor"a standardan> eradio!raphs( as an occu t fracture of the ta us "a be present.

D$I7: 125333G3 [Dub$ed in process]

10@: in 6io"ech 6risto ( &von8. 2003 +an 1? 18:1G 2H.


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*e"i ri!id vs ri!id ! ass fibre castin!: a bio"echanica assess"ent.

/hite '( *churen +( onn 7'.

7epart"ent of Orthopaedics( )ra"pian )ait and $ove"ent &na sis entre(niversit of &berdeen )ra"pian niversit 9ospita s Trust( *cot and(

&berdeen(. ra .#hiteKsunder and.ac.u>

O6+E TIFE*: To deter"ine if se"i ri!id s nthetic casts provide an "easurab eadvanta!es co"pared to ri!id s nthetic casts. 6& )'O N7: ) ass fibre banda!esare no# co""on app ied i""ediate post in ur to provide ri!idi""obi isationof the i"b( for both #ei!ht bearin! and non #ei!ht bearin! casts. 9o#ever(co"posite casts that have inherent f enee #a >in! cast to a sin! e vo unteer sub ect. +ointi""obi isation and functiona "ove"ent #as assessed usin! e ectro!onio"etr

andi"b support usin! pressure transducers. 'E* %T*: *e"i ri!id o es castsprovided s i!ht !reater i""obi isation at the #rist #hi e a o#in! fufin!erfunction and !reater support to the forear" durin! hand "ove"ents. *i"i ar (se"i ri!id be o# >nee #a >in! casts produced !reater i""obi isation at thean> e#hi e a o#in! "ore forefoot "ove"ent and #ere ess of an i"pedi"ent to#a >in!.

ON % *ION*: *e"i ri!id castin! techniCues have "easurab e advanta!es co"paredto ri!id s nthetic casts and represent a further deve op"ent in theconservative"ana!e"ent of fractures and soft tissue in uries. 'E%EF&N E: *e"i ri!idcastin!is a re ative ne# techniCue that can reduce so"e of the prob e"s of ri!idcasti""obi isation and cou d potentia shorten the rehabi itation phasefo o#in!in ur . Infor"ation about the perfor"ance of these casts to assess their va uein specific app ications is ver i"ited.


D$I7: 1252H2@3 [Dub$ed inde


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conservative for a "a eo ar fracture and had not received anphar"aceuticathro"bosis proph ain!into account the different ris> factors( the indication for a proph a


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D$I7: 12512@0G [Dub$ed inde e in. 2002 *ep H 38:@G5 G.

&bsorbab e i"p ants in fracture "ana!e"ent.*troud .

7epart"ent of Orthopaedic *ur!er ( nion $e"oria 9ospita ( 3333 North a vert*treet( 6a ti"ore( $7 2121?( *&. ncKhe ie scenarios for the use of thesei"p ants in fracture "ana!e"ent of the foot and an> e inc ude s ndes"oticdisruptions( dis ocations about the "idfoot( and fractures of the "edia"a eo us.

Dub ication T pes: 'evie# 'evie# %iterature

D$I7: 12512@05 [Dub$ed inde e fractures]

[&rtic e in Tur>ish]

Pi "a E( ara>urt %( *erin E( 6u ut $.

7epart"ent of Orthopedics and Trau"ato o! Ortopedi ve Trav"ato o i &nabi i"7a i8( $edicine ,acu t of ,irat niversit ( 23200 E a i!( Tur>e .

i "a erhK ahoo.co"

O6+E TIFE*: /e eva uated the resu ts of sur!ica treat"ent for an> e fracturesand the factors that p a a ro e in these resu ts. $ET9O7*: The stud inc uded31 patients 20 "en( 11 #o"en( "ean a!e 3?.2 ears8 #ho under#ent sur!icatreat"ent for an> e fractures and had an adeCuate fo o# up. &ccordin! to the%au!e 9ansen c assification( the "echanis" of occurrence #as supinatione


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#ere !ood( "oderate( and poor in 1? 5?48( ei!ht 2A48( and five 1A48patients(respective . *ub ective eva uation ie ded !ood( "oderate( and poor resu tsin1H 5548( ei!ht 2A48( and si< 1G48 patients( respective . The resu ts #erepoor especia in pronation e


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four point bend and shear at ti"e interva s up to 12 #ee>s. In vitro stren!thoss profi es de"onstrated pea> stren!th retention f es( #ith 504 of properties re"ainin! b 12 #ee>s. The initiaPoun!Bs"odu us of the pins #as appro e and tibia #ere ana ed. The patients #ere radio o!ica studiedusin! the contra atera side as contro . 'epresentative radio o!ic findin!s#eredista "i!ration of the fibu a head in H54 but #ithout c inica re evance8(thic>enin! of the e


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#ire8. Thirt patients #ere treated #ith secondar f ap operation. &"on! the"(1G patients received pedic e !astrocne"ius "usc e f aps( G free vastus

atera is"usc e f aps( and 2 free atissi"us dorsi "usc e f aps. 'E* %T*: Threepatientsof t pe III6 #ere sub ected to a"putation because of advanced a!e and

associatedcerebra or thoraco abdo"ina in ur . ,ive patients of t pe III hada"putationbecause of insufficient postoperative b ood supp and necrosis. The ruptureofother 13? patients #as #e reduced( and fir" fis( and the avera!e ti"e for re"ova of fis. The "otion of >nee oint ran!ed fro" 0 to 120 de!ree in 110 patientsfro" 0 to 100 de!rees in 25( and fro" 0 to G0 de!rees. The "otion of an> e

oint

#as appro fur nfa und /iederherste un!schirur!ie entra >ran>enhaus*an>t +ur!en *trasse( 6re"en. $ichae Dau .9ahnK >h bre"en "itte.de

D$I7: 12@?A5?0 [Dub$ed indee chan!es fo o#in! an> e fracture in a patient #ith nounder in! disease: report of a rare case.

u"a!ai $( Po>ota ( Endoh T( Ta>e"oto 9( Na!ata .

7epart"ent of Orthopaedic *ur!er ( uru"e niversit *choo of $edicine( AH&sahi "achi( uru"e( ,u>uo>a ?30 0011( +apan.

harcot oint is a disease that often occurs in patients #ith diabetes"e itus(tabes dorsa is( s rin!o" e ia( chronic a coho is"( epros ( trau"a( orinfectionafter fractures and dis ocations. The treat"ent for harcot oint has various


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co"p ications( such as s>in esions( infections( and de a ed union. /e presentour e e fracture due to"inor trau"a.

D$I7: 12@?A@H5 [Dub$ed indeo! u ( 'odop O.

)u hane $i itar $edica &cade" ( 9a darpasa Trainin! 9ospita ( 7epart"ent ofOrthopaedics and Trau"ato o! ( Istanbu ( Tur>e . o ipehKe >o a .net

In this paper( a case of c osed "edia subta ar dis ocation and acco"pan in!

ta ar head fracture in a 22 ear o d "an #hich occurred #hi e #a >in! on ado#nhi road is reported. osed reduction under !enera anesthesia #asunsuccessfu . The obstac e for c osed reduction #as deter"ined at sur!er foropen reduction and interna fienhaus( *tutt!art( )er"an .dr>innerKao .co"

6& )'O N7: The treat"ent of disp aced intra articu ar ca canea fracturesre"ains controversia ( because of difficu ties in assessin! the outco"e. The!oa of this stud ( therefore( #as to co"pare different outco"e "easure"ents#ith !ait ana sis( usin! d na"ic pedo!raph . $ET9O7*: T#ent patients #ithoperative treated disp aced intra articu ar ca canea fractures #erefo o#edup c inica and radio!raphica . In addition( foot pressure #as "easuredusin! d na"ic pedo!raph . 'E* %T*: No si!nificant difference #as found bet#eenthe t#o c inica outco"e scores used p S 0.0?8 both revea ed !ood resu ts.7 na"ic pedo!raph ( ho#ever( sho#ed a shift of the "a


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11?: *ports $ed. 2003 33 18:H5 ?1.

Overvie# of in uries in the oun! ath ete.

&diri" T&( hen! T%.7ivision of E"er!enc $edicine( hi drenBs Nationa $edica enter(/ashin!ton(7 20010( *&. tadiri"Kcn"c.or!

It is esti"ated that 30 "i ion chi dren in the * participate in or!anisedsports pro!ra""es. &s "ore and "ore chi dren participate in sports andrecreationa activities( there has been an increase in acute and overusein uries. E"er!enc depart"ent visits are hi!hest a"on! the schoo a!e to

oun!adu t popu ation. Over one third of schoo a!e chi dren #i sustain an in ursevere enou!h to be treated b a doctor or nurse. The ear costs have been

esti"ated to be as hi!h as 1.? bi ion * do ars. There are ph sica andph sio o!ica differences bet#een chi dren and adu ts that "a cause chi drentobe "ore vu nerab e to in ur . ,actors that contribute to this difference invu nerabi it inc ude: chi dren have a ar!er surface area to "ass ratio(chi dren have ar!er heads proportionate ( chi dren "a be too s"a forprotective eCuip"ent( !ro#in! carti a!e "a be "ore vu nerab e to stresses andchi dren "a not have the co"p e< "otor s>i s needed for certain sports untiafter pubert . The "ost co""on in ured areas of the bod inc ude the an> eand>nee fo o#ed b the hand( #rist( e bo#( shin and ca f( head( nec> andc avic e.

ontusions and strains are the "ost co""on in uries sustained b oun!ath etes.In ear ado escence( apoph sitis or strains at the apoph ses are co""on. The"ost co""on sites are at the >nee Os!ood *ch atter disease8( at the hee

*everBs disease8 and at the e bo# %itt e %ea!ue E bo#8. Non trau"atic >neepain is one of the "ost co""on co"p aints in the oun! ath ete. Date ar,e"oraDain * ndro"e D,D*8 has a conste ation of causes that inc ude overuse( poortrac>in! of the pate ar( "a a i!n"ent prob e"s of the e!s and foot prob e"s(such as pes p anus. In the chi d( hip patho o! can present as >nee pain so acarefu hip enee pain. Other co""on in uries in oun! ath etes discussed inc ude anteriorcruciate i!a"ent in uries( an> e sprains and an> e fractures. Drevention ofsports and recreation re ated in uries is the idea . There are si< potentia#a s to prevent in uries in !enera : i8 the pre season ph sica e


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ifesavin! activities.

&shton %&( )ru ic %.

$ona Fa e 9ospita ( &ustra ia.

Inf atab e 'escue 6oats I'6s8 are uti ised b the *urf %ife *avin!&ssociation*%*&8 in &ustra ia to perfor" rescue operations and in re!iona co"petitions

bet#een surf c ubs. These activities have resu ted in a nu"ber of serious footand an> e in uries #hich ref ect the hi!h i"pact of this activit in heav andunpredictab e surf. /e have retrospective revie#ed 12 si!nificant in uriesre atin! to I'6 usa!e presented to our re!iona hospita e"er!enc depart"entover a 3 ear period. These inc ude A %isfranc fracture dis ocations of the"idfoot( @ an> e fracture variants( one tibia shaft fracture( and onetrau"aticrupture of the peronea retinacu u" eadin! to peronea tendon dis ocation.&na sis of I'6 footstraps in current usa!e sho#s the are direct re ated tothe patterns of in ur seen. /e have reco""ended "odifications to footstraps

andhand!rips current in use #ith the ai" of "ini"isin! or preventin! thesein uries.

D$I7: 12@A??@2 [Dub$ed as supp ied b pub isher]

120: Int Orthop. 2002 2A A8:3HH ?0. Epub 2002 +u 0A.

Tibia reconstruction usin! a non vascu arised fibu ar transfer.

$orsi E.

,acu t of $edicine( $enoufia niversit ( 25 E "ohtsb *treet( $ohr" 6a>(& e e stiffness in one. Thisprocedure is successfu and si"p e #hen co"pared to "icrovascu ar and I i arovtechniCues.

D$I7: 12@AA?H3 [Dub$ed inde


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s "pto"s #as nine "onths 1.5 to @?8. The dia!nosis #as based on c inica andradio o!ica investi!ations. /e describe a ne# sur!ica techniCue forpercutaneous scre# fi scre#. & thepatients #ere assessed before and after sur!er usin! the &"erican Orthopaedic,oot and &n> e *ociet 9a u< *core &O,&*8. There #as a statisticasi!nificant i"prove"ent in the "ean score fro" @A.G to ?0.H p S 0.00038 after

fiins niversit ( +ohns 9op>ins6a vie# $edica enter( @G@0 Eastern &venue( 6a ti"ore( $7 2122@ 2H?0( *&.ebu sonK h"i.edu

,ractures of the an> e and foot are co""on in the #or>er. Droper initiaassess"ent and treat"ent can resu t in a functiona recover that is pro"ptandco"p ete in "an cases. $an fractures( ho#ever( have a poor on! ter"pro!nosisand pro on!ed recover . ,ran> initia discussions #ith the patient and case"ana!er can he p the s ste" better "ana!e the patientBs future.


D$I7: 12@A2113 [Dub$ed inde


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125: ,oot &n> e Int. 2002 Nov 23 118:GG2 5.

Eva uation of co"pression in intra"edu ar hindfoot arthrodesis.

6erson %( $c)arve / ( anton TO.

The )reater 9artford Orthopedic )roup( D ( 9artford( T( *&."berKhi!hstrea".net

o"pression #as eva uated in an intra"edu ar hindfoot arthrodesis cadaver"ode usin! an e


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fien #ith the patient standin!he psthe sur!eon reproduce a nor"a "echanica anee arthrop astisun>no#n. The purpose of the current stud #as to eva uate #hether apreoperative

on! e! radio!raph he ps to restore nor"a i"b a i!n"ent after tota >neearthrop ast . Ninet four patients 12@ pri"ar tota >nee arthrop asties8#ererando"i ed to either receive or not receive a preoperative on! e! standin!radio!raph. Datients #ith previous hip or an> e sur!er ( fe"ora or tibiafracture( defor"it of 15 de!rees or !reater( or those #ho #ere obese bod#ei!ht inde< M @0 >! "28 #ere enee center. No si!nificant difference inthepostoperative "echanica a


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12?: + Orthop Trau"a. 2002 Nov 7ec 1A 108:H0G 1A.

Trabecu ar bone strain chan!es associated #ith subchondra co""inution of thedista tibia.

$c in e TO( a endar D/( 6a 6 .

7epart"ent of Orthopaedic *ur!er ( niversit of Io#a 9ospita and inics(Io#a

it ( Io#a 522@2( *&. todd "c>in e Kuio#a.edu

O6+E TIFE: To "easure trabecu ar bone strain chan!es resu tin! fro" threeincreasin! subchondra bone defects in the dista tibia. 7E*I)N: adavericbio"echanica "ode . *ETTIN): ontact radio!raphs #ere "ade fro" sa!ittasections of hu"an cadaveric dista tibia under no oad and oaded to @00 N.7i!ita i"a!es( "ade fro" contact radio!raphs of un oaded speci"ens( #ereco"pared to correspondin! di!ita i"a!es of oaded speci"ens usin! custo"

soft#are that "easures trabecu ar defor"ation and ca cu ates trabecu ar bonestrain. INTE'FENTION: T#e ve speci"ens #ere initia oaded intact inco"pression. Testin! #as repeated after creatin! three increasin! circu arsubchondra bone defects in the center of a sa!itta cross section of thedistatibia. 7efects #ere 104( 204( and 304 of the sa!itta dia"eter of the distatibia. $&IN O T O$E $E&* 'E*: $a


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o""ent in: Nurs *tand. 2003 $a H 13 1H 3@8:22.

&ssess"ent and "ana!e"ent of foot and an> e fractures.

%arsen 7.&QE 7epart"ent( 6ro" e 9ospita ( ent. dorthe. arsenKbro" e hospita s.nhs.u>

In uries to the foot and an> e are co""on presentations in &QE( and #hi etheseare rare ife threatenin!( incorrect dia!nosis and "ana!e"ent can haveseriousconseCuences for patients. This artic e discusses the causes( assess"ent andtreat"ent of patients #ith these fractures.

Dub ication T pes: 'evie#

'evie#( TutoriaD$I7: 12@3@H@G [Dub$ed inde.net


D$I7: 12@2GH?H [Dub$ed inde e fo o#in! "a eo ar fracture repair in ahi!h fide it cadaver "ode .

$iche son +7( 9a"e &+( 6uc e> ,%( *har>e N&.

enter for %oco"otion *tudies( The Denns vania *tate niversit ( 2G'ecreation6ui din!( niversit Dar>( D& 1A?02( *&.

6& )'O N7: Drevious studies invo vin! a e cadaver speci"ensunder!oin! a passive ran!e of "otion after fracture have de"onstrated rotatorinstabi it patterns consistin! of e


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a fracture had a si!nificant i"pact on subseCuent "obi it .

D$I7: 12@1?HG5 [Dub$ed inde


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Fanhoenac>er ,$( 6ernaerts &( )ie en +( *chepens E( 7e *chepper &$.

7epart"ent of 'adio o! ( niversit 9ospita &nt#erp( Ede!e"( 6e !iu".

This artic e presents a brief overvie# of the in uries to the an> e and footencountered in chi dren and ado escents. Trau"a to the an> e or foot "a

resu tfro" acute( chronic( or repetitive forces. The ro e of the different i"a!in!"oda ities in the assess"ent of an> e and foot trau"a in the !ro#in! patientisdiscussed. D ain radio!raphs re"ain the "ainsta in the dia!nosis of "ostacutetrau"as( #hereas T "a be he pfu to unrave the co"p e< anato" of certainfractures i>e the trip ane or uveni e Ti au< fracture. In the eva uation ofchronic in uries( inc udin! osteochondrosis dissecans and osteonecrosis( $'Iisevo vin! as the "oda it of choice.

D$I7: 12@033G2 [Dub$ed inde e *ur!. 2002 *ep Oct @1 58:335 H.

I i arov rin! fi e s ndes"osis disruption.

'e #ani +( %ahoti O( Ora>#e *.

%e#isha" niversit 9ospita ( %ondon( .

* ndes"otic stabi i ation is reco""ended for tibiofibu ar diastasis( a$aisonneuve fracture( or s ndes"otic instabi it after fi


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interna fiateboard associated in ur #ere studied for the 12 ear period 1G?H to 1GG?for participants a!ed H ears or o der. The Nationa E ectronic In ur*urvei ance * ste" provided in ur esti"ates for s>ateboardin! and these ectedadditiona sportin! activities. The Nationa *portin! )oods &ssociation annuasurve of nationa representative househo ds provided participationesti"ates.& participation based rate of in ur #as ca cu ated fro" these data sets forthese ected sports for the ear 1GG?. 'E* %T*: The 1GG? rate of e"er!encdepart"ent treated s>ateboard associated in uries ?.G in uries per 1(000participants G54 confidence interva [ I]( A.2( 11.A8 #as t#ice as hi!h asin ine s>atin! 3.G [G54 I( 3.1( @.?]8 and ha f as hi!h as bas>etba 21.2[G54 I( 1?.3( [email protected]]8. The rate of s>ateboard associated in uries dec inedfro"1G?H to 1GG3 but is a!ain increasin!: the 1GG? rate #as t#ice that of 1GG3

@.5[G54 I( 1.A( H.@] and ?.G [G54 I( A.2( 11.A]( respective 8. Increases


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occurred pri"ari a"on! ado escent and oun! adu t s>ateboarders. The "ostfreCuent in uries in 1GG? #ere an> e strain sprain and #rist fracture: 1.2

G54I( 0.?( 1.A8 and 0.A G54 I( 0.@( 0.?8 per 1(000( respective .

*>ateboard associated in uries reCuirin! hospita i ation occurred in 2.G4 and#ere 11.@ G54 I( H.5( 1H.58 ti"es "ore i>e to have occurred as a resu t

ofa crash #ith a "otor vehic e than in uries in those patients not hospita i ed.ON % *ION: This stud is the first to re ate s>ateboardin! and other sport

in uries to participation eateboardin! is aco"parative safe sport ho#ever( increased rates of in ur are occurrin! inado escent and oun! adu t s>ateboarders. The "ost co""on in uries are"uscu os>e eta the "ore serious in uries resu tin! in hospita i ationt pica invo ve a crash #ith a "otor vehic e. This ne# "ethodo o! that usesparticipation based in ur rates "i!ht contribute to "ore effective in urcontro initiatives.

D$I7: 123G@?AH [Dub$ed inde e ru es for the use of dia!nostic = ra in after hours "edicacentres in Ne# ea and.

/ nn Tho"as *( %ove T( $c%eod 7( Ferna *( a>ovic $( 7o#e &( 7urha" +.

7epart"ent of )enera Dractice( /e in!ton *choo of $edicine and 9ea th*ciences.

&I$*: The ai"s of this stud #ere to "easure base ine use of Otta#a an> eru es

O&'8( va idate the O&' and( if appropriate( e


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D$I7: 123?AAA3 [Dub$ed inde( $I@?0H3(

*&. "cea1Kao .co"

Drevious iterature has identified prehospita pain "ana!e"ent as an i"portant

e"er!enc "edica services E$*8 function( and fe# patients transported b E$*#ith "uscu os>e eta in uries receive prehospita ana !esia D&8. O6+E TIFE*:18To describe the freCuenc #ith #hich E$* patients #ith o#er ee to receive D&. It is unc ear #hether current E$* s ste" desi!n "a

adverse i"pact ad"inistration of D&. ,urther #or> is needed to c arif#hetherpatient need or E$* practice patterns resu t in o# rates of D&.

D$I7: 123?5A0H [Dub$ed inde


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[&rtic e in )er"an]

%osch &( $e boh" D( *ch"a T( ,uchs $( Fa"vu>a>is ,( 7resin! ( 6 u"entritt*(*tur"er $.

niversitats> ini>u" )ottin!en( &btei un! fur nfa chirur!ie( D astische und/iderherste un!schirur!ie( )er"an .

'etrospective 20 patients #ith a sur!ica treated an> e fracture caused bhobb accidents #ere eab e resu t of the !aitana sis.The chan!es of !ait pattern are interpreted as an adapted and interna i ed"otion pattern caused b pain and behaviour of rest at an ti"e #hi e the"obi isation phase #as !oin! on. It cou d not docu"ent an si!nificantcorre ation bet#een sub ective and c inica para"eters and para"etersre!isteredb !ait ana sis. 9o#ever( a si!nificant corre ation of !ait ana sedpara"eters#as found bet#een the in ured and unin ured side. 6 d na"ica !ait ana sisitis possib e to Cuantif re"ar>ab e !ait chan!es( to obtain ob ective data( buta so to de"onstrate as ""etrica oadin! and "otion that #ere not c inicadetectab e previous . It fo o#s that it can be re evant to patients #ithco"p aints b eadin! the" to specific ph siotherapeutica treat"ent and !aittrainin! so that the #ou d be ab e to carr on their sports activities a!ain.


D$I7: 123?21?2 [Dub$ed inde e in. 2002 $ar H 18:1G1 20A.

*a va!e after co"p ications of tota an> e arthrop ast .

$ erson $*( $i er *7.

7epart"ent of Orthopaedic *ur!er ( nion $e"oria Orthopaedics( +ohnstonDrofessiona 6ui din!( @00( 3333 North a vert *treet( 6a ti"ore( $7 2121?(

*&. ncKhe i


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'evie# 'evie# %iterature

D$I7: 123?03?G [Dub$ed inde e in. 2002 $ar H 18:10H 20.

&rthrodesis as sa va!e for ca canea "a unions.

'obinson +,( $urph )&.

6rid!er Orthopedic and *ports $edicine( G31 9i!h and 6ou evard( *uite 3210(6o e"an( $T 5GH15( *&.

Even #ith !reater e"phasis on anato"ic reduction( outco"es after ca caneafractures continue to be unsatisfactor in "an patients. %atera #ai"pin!e"ent( subta ar arthrosis #ith pain and stiffness( nerve co"pression

s ndro"es( and hindfoot "a a i!n"ent a can cause disab in! s "pto"s. Ifconservative treat"ent fai s to re ieve s "pto"s( subta ar arthrodesis canprovide a pain ess( stab e hindfoot in "ost patients. ,or severe defor"it#ithanterior an> e i"pin!e"ent and oss of the ta ar an! e of dec ination(distraction bone b oc> arthrodesis throu!h a posterior approach is preferred.

Dub ication T pes: 'evie# 'evie# %iterature

D$I7: 123?03?@ [Dub$ed inde D( /i he " 9.

reis>ran>enhaus )runstadt( hirur!ische &btei un!( )runstadt Dfa .

7urin! a scientific ee eton revea ed interestin!patho o!icachan!es. ,e# ears before his death the count had the accident to !et run overb a heav #a!on #hich crushed the dista part of his e!s. The fractureshea ed( but !ave hi" an anc otic and shortened eft e!( #hich "ust havecausedhi" a ot of sufferin! in his ast ears.

Dub ication T pes: 6io!raph 9istorica &rtic e


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Dersona Na"e as *ub ect: 9er"ann )

D$I7: 123H?HGH [Dub$ed inde factors for #e e! acute co"part"ents ndro"e.

$e er '*( /hite ( *"ith +$( )roppo E'( $ubara> *+( 9ar!ens &'.

7epart"ent of Orthopaedic *ur!er ( niversit of a ifornia at *an 7ie!o$edica

enter( *an 7ie!o( a ifornia G2123 @22?( *&. rs"e erKucsd.edu

6& )'O N7: &cute co"part"ent s ndro"e has been #ide reported in e!spositioned in the ithoto" position for pro on!ed !enera sur!ica ( uro o!ic(and ! neco o!ic procedures. The orthopaedic iterature a so contains reportsofthis co"p ication in e!s positioned on a fracture tab e in the he"i ithoto"position. The purpose of this stud #as to identif the ris> factors fordeve op"ent of acute co"part"ent s ndro"e resu tin! fro" this t pe of e!positionin!. $ET9O7*: Ei!ht hea th vo unteers #ere positioned on a fracturetab e. Intra"uscu ar pressures #ere continuous "easured #ith a s it catheterin a four co"part"ents of the eft e! #ith the sub ect supine( in thehe"i ithoto" position #ith the ca f supported( and in the he"i ithoto"position #ith the hee supported but the ca f free. 6 ood pressure #as"easuredinter"ittent #ith use of auto"ated pressure cuffs. 'E* %T*: han!in! fro"thesupine to the ca f supported position si!nificant increased theintra"uscu arpressure in the anterior co"part"ent fro" 11.A to 1G.@ "" 9!8 and in the

atera co"part"ent fro" 13.0 to 25.? "" 9!8. han!in! fro" the ca fsupportedto the hee supported position si!nificant decreased intra"uscu ar pressureinthe anterior( atera ( and posterior co"part"ents to 2.?( 3.@( and 1.G "" 9!(respective 8. The "ean diasto ic b ood pressure in the an> e avera!ed A3.G ""9! in the supine position( #hich si!nificant decreased to [email protected] "" 9! in theca f supported position. han!in! to the hee supported position had nosi!nificant effect on the diasto ic b ood pressure in the an> e "ean( 32.? ""9!8. The "ean difference bet#een intra"uscu ar pressure and diasto ic b oodpressure in the supine position #as appro


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s ndro"e of the #e e!. %eavin! the ca f free( instead of usin! a standard#e e! ho der( increases the difference bet#een the diasto ic b ood pressureand the intra"uscu ar pressure and "a decrease the ris> of acute co"part"ents ndro"e.

D$I7: 123HHG15 [Dub$ed inde


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va !us defor"it occurrin! in ten of t#e ve cases8( #hether or not the fibu aeventua hea ed.

D$I7: 123HHG11 [Dub$ed inde '( Date )( %ei!hton '( Detrie 7( )a pin '.

a far )enera 9ospita ( a !ar ( & berta( anada. buc>c inKuca !ar .ca

6& )'O N7: Open reduction and interna fi


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Dub ication T pes: inica Tria 'ando"i ed ontro ed Tria

D$I7: 123HHG02 [Dub$ed inde.T#o patients #ere treated conservative #hi e the third had a distatibio fibu ar fusion in vie# of severe va !us defor"it . & three patientssho#ed !ood ear resu ts after 1 to 2 ears. /e advocate ear distatibio fibu ar fusion to prevent va !us defor"it in these chi dren.

D$I7: 123H05?0 [Dub$ed indei $+( /iater +)( DasCua ')( o"pton *( *#or '&( +ac>son 'E.

7epart"ent of E"er!enc $edicine( /i ia" 6eau"ont 9ospita ( & /a ne *tateniversit &ffi iated Dro!ra"( 'o a Oa>( $I @?0AH( *&.

Our pri"ar ob ective #as to co"pare use of ana !esia for patients #ith and#ithout fracture as a resu t of iso ated o#er e


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because these patients had contacts #ith "u tip e ph sicians and i

fractura_tobillo_medline

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