Fixation of unstable distal radius fractures with palmar locking plates provides a stable reduction and early return of function, but complications arising from unrecognized dorsally prominent screws penetrating the extensor compartments are increasingly reported. Standard radiographs and fluoroscopy may not adequately visualize screw lengths, owing to the complex shape of the dorsum of the distal radius. We examined 46 distal radius fractures treated with palmar locking plates by ultrasound. Of the total 230 locking screws, 59 protruded from the dorsal cortical surface by 0.5 mm or more (range 0.5-6.1 mm). The first extensor compartment was violated by one screw, the second compartment by 22 screws, the third compartment by 15 screws, and the fourth compartment by 21 screws. Asymptomatic tenosynovitis was detected in four and symptomatic tenosynovitis in 14 of the 59 prominent screws. Ultrasound imaging may be useful in cases where intra-articular and/or comminuted fractures require distal plate placement and engagement of screws in the dorsal cortex.
Ulnar neuropathy is a common complication after medial collateral ligament injury and prophylactic release will facilitate overall results and postoperative patient satisfaction.
The transfer of direct-flow island flaps, from the same finger, causes minimal morbidity on the donor site and appears to be a safe method, providing satisfactory functional and aesthetic results in the reconstruction of pulp defects.
With the newly established universities, as well as training and research clinics, the approach of increasing number of orthopedics and traumatology clinics and specialists to scientific activities would be more fruitful in the light of these data.
Popliteal artery injuries are frequently seen with fractures, dislocations, or penetrating injuries. Concern about arterial injury and early recognition of the possibility of arterial injury is crucial for the salvage of the extremity. This article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating injury, knee dislocation, fracture, or high-velocity trauma mechanism. The importance of a detailed vascular examination of a blunt trauma patient is emphasized.
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