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Pediatric variants of the transolecranon fracture dislocation: recognition and tension band fixation: report of 3 cases.
Butler MA, Martus JE, Schoenecker JG
(2012) J Hand Surg Am 37: 999-1002
MeSH Terms: Accidental Falls, Accidents, Traffic, Bone Screws, Bone Wires, Child, Child, Preschool, Elbow Joint, Female, Fracture Fixation, Internal, Fractures, Bone, Humans, Joint Dislocations, Male, Radiography
Show Abstract · Added May 28, 2014
Anterior transolecranon fracture dislocation of the elbow is relatively uncommon in children. We reviewed the experience over the past 5 years at our institution in treating this injury to identify pediatric variants and outline a rational treatment strategy. We found 2 pediatric variants to the injury pattern and determined that tension band constructs can successfully be used to treat certain pediatric transolecranon fracture dislocations. The pediatric variants identified in this report are fracture dislocations with associated medial epicondyle fracture and radial neck fracture. We recommend a heightened vigilance in looking for a fracture through the ulna when an anterior dislocation is present, as physeal injuries can be challenging to see on plain radiographs.
Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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1 Members
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14 MeSH Terms
Thrombosis of the brachial artery after closed dislocation of the elbow.
Garrigues GE, Patel MB, Colletti TP, Weaver JP, Mallon WJ
(2009) J Bone Joint Surg Br 91: 1097-9
MeSH Terms: Accidental Falls, Brachial Artery, Elbow Joint, Female, Humans, Joint Dislocations, Middle Aged, Radiography, Recovery of Function, Thrombosis, Treatment Outcome
Show Abstract · Added June 14, 2016
The brachial artery is rarely injured after closed dislocation of the elbow. We describe an unusual variation of this injury, namely, a delayed thrombosis of the brachial artery after a closed dislocation sustained during a low-energy fall. This has not previously been described in the English literature, but may be more common than this suggests. We stress the importance of a thorough neurovascular examination and vigilance in regard to this potentially disastrous complication.
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11 MeSH Terms
MRI features of three paediatric intra-articular synovial lesions: a comparative study.
Kan JH, Hernanz-Schulman M, Damon BM, Yu C, Connolly SA
(2008) Clin Radiol 63: 805-12
MeSH Terms: Adolescent, Adult, Cartilage Diseases, Cartilage, Articular, Child, Child, Preschool, Contrast Media, Elbow Joint, Female, Gadolinium DTPA, Humans, Infant, Joint Diseases, Knee Joint, Magnetic Resonance Imaging, Male, Retrospective Studies, Sarcoma, Synovial, Synovitis, Pigmented Villonodular
Show Abstract · Added December 10, 2013
AIM - To determine reliable magnetic resonance imaging (MRI) features differentiating three paediatric intra-articular congenital or neoplastic synovial lesions that contain blood products, from post-traumatic or haemorrhagic inflammatory processes.
MATERIALS AND METHODS - This was a retrospective review of MRI findings of 22 paediatric intra-articular congenital or neoplastic synovial lesions, including venous malformation (VM) (n=12), pigmented villonodular synovitis (PVNS; n=8), and synovial sarcoma (SS; n=2). These MRI features were compared with 22 paediatric post-traumatic or inflammatory intra-articular processes containing blood products and producing mass effect. The following imaging features were assessed: presence of a discrete mass, extension, extra-articular oedema, susceptibility, joint effusion, and size. Fisher's exact test was used and results were considered statistically significant when p<0.05.
RESULTS - The three intra-articular synovial lesions, compared with controls, were more likely to directly invade osseous structures when a discrete mass was present (13/16, 81.3% versus 1/9, 11.1%; p<0.002) and extend into extra-articular soft tissues (13/21, 61.9% versus 2/17, 11.8%; p<0.003), but were less likely to show extra-articular oedema (3/22, 13.6% versus 13/22, 59.1%; p<0.004), a joint effusion (10/22,45.5% versus 19/22, 86.4%, p<0.01), susceptibility within a joint effusion (0/22, 0% versus 11/22, 40.9%; p=0.00), osseous oedema (3/16, 18.8% versus 7/9, 77.8%; p<0.009), and synovial enhancement (8/21, 38.1% versus 14/16, 87.5%; p<0.003). VMs had characteristic tubular vessels with internal fluid-fluid levels (11/12) that extended into bone (10/12) and extracapsular soft tissues (11/12).
CONCLUSION - Our study indicates that, despite the overlapping presence of haemorrhagic products, intra-articular VM, PVNS, and SS show MRI features that permit distinction from acquired post-traumatic and haemorrhagic inflammatory lesions.
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19 MeSH Terms