Comminuted fractures of the olecranon treated by the Weber-Vasey technique.
Summary Eleven patients with comminuted fractures of the olecranon have been treated by the Weber-Vasey technique. The operation, complications, and results are discussed.
THE EFFECT UPON THE INFERIOR RADIO-ULNAR JOINT OF EXCISION OF THE HEAD OF THE RADIUS IN ADULTS.
1. Fifty-eight adult patients who had been treated for radial head fractures by excision of the head of the radius have been reviewed at periods varying between two and nineteen years after operation. 2. Symptoms referable to the inferior radio-ulnar joint were present in half of the patients and the mechanisms of the disorder in these patients are discussed in the light of a radiographic study. 3. We feel it justifiable to conclude from our observations that this complication of surgical treatment of radial head fractures deserves greater attention than has been given to it in the past, and that it is of sufficient importance to be taken into consideration when planning the management of these fractures, especially the less severe injuries. 4. Prosthetic replacement of the proximal end of the radius is the logical and, indeed, the only way in which the distal radio-ulnar joint subluxation can be avoided, but no clearly defined indications for the routine use of a prosthesis as a primary procedure can be suggested on the basis of this investigation.
Adult injuries of the radial head and neck; importance of time element in treatment.
Abstract A total of 261 injuries to the radial head and neck in adults have been reviewed of which 113 are sufficiently documented to report. All patients presented have been followed a minimum of six months and an average of two years, six months. Three groups are classified according to their essential pathologic condition. Group 1 comprises 81 per cent, Group 11, 14 per cent and Group 111, 5 per cent of total injuries reported. Group 1 injuries with fracture undisplaced and hemarthrosis the outstanding pathologic disorder are best treated by aspiration of the elbow joint and active motion within pain limits in twenty-four hours. Group 11 injuries with fracture displaced and joint capsule intact are best treated by early excision of the entire head and early active motion. Group 111 injuries with fracture displaced and joint capsule torn anteriorly by an associated dislocation at the elbow require immediate action. Fifty per cent of such patients operated upon later than twenty-four hours following injury through a lateral operative approach developed myositis ossificans. All patients in this series were operated upon an average of six hours after injury through an anterior approach; all avoided this complication. Statistical summaries of total cases reported substantiate these views.