Background Open elbow dislocations are rare injuries. Most of the evidence related to these dislocations is found in case reports or in series with closed injuries. We reviewed the experiences of three centers in the treatment of open elbow dislocations. Question/purposes We compared the results after operative treatment of simple and complex open dislocations in terms of (1) ROM, (2) functional score, and (3) complications. Methods Eighteen patients were retrospectively included in this study: 11 with simple open elbow dislocations and seven with complex open elbow dislocations. Mean age was 40 years. Thirteen were men. Eight patients presented neurovascular injuries. Evaluation included ROM of the elbow and forearm as measured by hand-held goniometer. We then classified the results using the 100-point Broberg and Morrey functional rating index based on ROM, grip strength, elbow stability, and pain. Scores of 95 to 100 were considered excellent, 80 to 94 good, 60 to 79 fair, and less than 60 poor. Complications were recorded. Minimum followup was 6 months (mean, 25 months; range, 6-72 months). Results We found no differences between simple and complex open elbow dislocations related to ROM (median flexion/extension: 117°versus 110°, p = 0.12; forearm rotation: 160°versus 170°, p = 0.67). According to the Broberg and Morrey score, four patients had excellent results, five good, and one fair in the simple dislocation group, whereas in the complex dislocation group, four patients had excellent results, two good, and one fair (p = 0.8). No difference in complication rate was found between groups (p = 0.63). All complications in the simple dislocation group were neurovascular. In the complex dislocation group, there was one case of brachial artery occlusion, two cases of heterotopic ossification, one case of infection and nonunion, and one case of infection. No patients had recurrent elbow instability.
HAND 11(1S) operations. Materials and Methods: Those 47 cases included 44 males and 3 females with an age range of 15 to 65 at the time of operation (mean age: 27.8). Focal curettage and bone graft for the nonunion site were applied in 40 cases excluding 7 with scaphoid nonunion advanced collapse (SNAC) wrist. As the methods of bone graft, Russe procedure was applied in 4 cases and Herbert procedure was applied in the other 36 cases. As the internal fracture fixation materials, K-wires were used in 6 cases, Herbert screw in 8 cases, Bold screw in 5 cases, Whipple screw in 3 cases, and Acutrak mini screw in 18 cases. Meanwhile, the proximal part of the scaphoid was resected with tendon ball graft, 4-corner fusion, or modified Graner procedure was applied in the 7 cases with SNAC wrist. Postoperative follow-up periods were 2 to 10 years (mean: 4 years 7 months). Results: Bone union was observed in 28 out of 40 cases. The remaining 12 cases included the following: 5 cases which went untreated for at least 15 years, 3 with the application of Herbert-Whipple screw, 2 with the application of Bold screw, 1 with the inadequate insertion of Acutrak mini screw, and 1 with repeat nonunion caused by broken Acutrak screws. Revision surgery was conducted for the all cases: 1 with Russe procedure, 1 with Herbert procedure, and other 10 with vascularized bone graft procedure (2 with Zaidemberg procedure and 8 with the second metacarpal bone graft). As a result, bone union was observed in 10 cases. As the final treatment outcome, the ratio of grip strength of an operated hand to that of nonaffected hand was 50% to 114% (mean: 89%) and flexion-extension arc was 60° to 180° (mean: 121°). Conclusions: We had a satisfactory outcome for our treatment of the scaphoid nonunion. However, it should be noted that pedicle vascularized bone graft procedure needed to be applied to long-term untreated or repeat nonunion cases.
Esta Revista está bajo una Licencia Creative Commons Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional. (CC-BY-NC-SA 4.0).
El día 13 de marzo de 2020 murió, en la ciudad de Tucumán, José María Rotella, sorprendiéndonos la noticia de manera muy particular, dejando en nosotros un vacío existencial inexplicable. Su partida deja huérfana a la comunidad científica de uno de los más destacados ortopedistas del país.Mencionar los logros médicos y académicos de José es una redundancia, ya que los tuvo todos, pero en esta oportunidad, me parece importante destacarlos para resaltar la talla intelectual de nuestro amigo.Estudió Medicina en la UNT donde se graduó en el año 1975. Al poco tiempo, decidió irse a Buenos Aires para hacer su educación de posgrado en Ortopedia y Traumatología. Ingresó en el Instituto Nacional de Rehabilitación, cuyo jefe era el Dr. Eduardo A. Zancolli, comenzando a partir de entonces una formación integral y un contacto personal, del cual surgirá una amistad que duraría hasta el final de sus días.En el año 1981, junto con Eduardo Rafael Zancolli, su compañero y amigo, viaja a Estados Unidos para continuar sus estudios en el Instituto Du Pont en Wilmington, Delaware y en el Hospital for Special Surgery de Nueva York. De regreso de este viaje, vuelve a la provincia de Tucumán para establecerse definitivamente en ella.Fue miembro fundador del Sanatorio Norte de la ciudad de Tucumán, donde ejerció su actividad profesional y formó a más de veinte promociones de residentes. El día de su fallecimiento fue despedido por una enorme cantidad de colegas y personal del establecimiento, quienes lo despidieron con un cálido y emotivo aplauso.Recibió numerosas distinciones académicas y premios a su labor científica durante toda su carrera, entre ellos, el Premio de la Academia Nacional de Medicina, en 1985, por su trabajo: "Microcirugía del miembro superior" en colaboración con otros autores.Ha publicado gran cantidad de capítulos en textos de la especialidad y varios libros, entre ellos y recientemente, uno dedicado a la evolución del miembro superior ("Evolución de la especie humana. El éxodo del tacto: cuando la sensibilidad migró del hocico a la mano"), obra absolutamente original y que será referencia obligada de quienes deseen leer o estudiar sobre el tema.En el ámbito de la Cirugía de la Mano y Reconstructiva del Miembro Superior, se destacó siempre por su actividad científica. Con su pensamiento singular, desarrolló técnicas y procedimientos quirúrgicos de amplia difusión nacional e internacional. Su dedicación a las ciencias básicas fue fundamental en su formación general y fue puesta de manifiesto en sus excelentes presentaciones y publicaciones sobre el tema. Fue presidente
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.