We reviewed 83 consecutive patients with unilateral Colles' fracture in order to identify factors that predict poor functional outcome. All fractures were treated by closed reduction and cast immobilization, and followed-up for at least 2 years. Our results showed that only final dorsal angulation was correlated to loss of flexion. In contrast to other reports, we could not find any relationship between radial shortening and loss of grip strength or loss of range of motion. In addition, the severity of initial displacement, involvement of radio-carpal or distal radio-ulnar joints, and the presence of ulnar styloid fractures or their non-union did not affect the functional outcome.
In order to elucidate the cause of osteonecrosis of the femoral head in spontaneously hypertensive rats (SHRs), which resembles the osteonecrosis of Perthes' disease, we observed the three-dimensional structure of vascular casts of the blood vessels feeding the femoral head using both optical and scanning electron microscopes. During the period of 9-15 weeks after birth, when osteonecrosis of the femoral heads in SHRs occurred frequently, the lateral epiphyseal vessels (LEVs), which were the main feeding vessels, entered from the lateral of the femoral heads. Anastomosing branches of LEVs between the epiphysis and the femoral neck were scarce even in the femoral heads showing normal ossification. It seemed that the development of LEVs in SHRs did not proceed normally in this period. Furthermore, remarkable segmental stenosis and the obstruction of LEVs were often recognized near the lateral of the femoral heads. These results suggest that LEVs in growing SHRs have the vascular structure that could cause an interruption of the blood supply to the femoral heads.
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