Extremity fracture characteristics in children with impulsive/hyperactive behavior

WOS: 000254177300011PubMed: 17624536Introduction To investigate which fracture characteristics were associated with impulsive/hyperactive behavior in children with extremity fractures. Materials and methods A clinical sample of 95 consecutive children with extremity fractures admitted to the Orthopaedics and Traumatology Outpatient Clinic of a university hospital were included in the study. The Conners Parent Rating Scale (CPRS) was used to assess children's symptoms. Fracture characteristics were grouped according to trauma type, fracture localization, hospitalization requirement, treatment type and history of previous fracture(s). Descriptive analyses were performed; t-tests and univariate ANOVAs were utilized to compare groups with respect to impulsivity/hyperactivity subscale scores on the CPRS. Results Mean CPRS impulsivity/hyperactivity subscale score for the whole group was 6.94 (SD = 2.69). Children with fractures which occurred during solitary activities presented with more impulsive/hyperactive behavior than those with fractures which occurred during group activities. Children with more severe fractures that required open reduction also presented with more impulsive/hyperactive behavior. Children with lower extremity fractures had showed more impulsive/hyperactive behavior than children with upper extremity fractures. Conclusion Detecting behavior problems in children admitted with fractures and referring them for treatment, is critical in preventing future serious injuries

Is there a safe area for the axillary nerve in the deltold muscle - Reply

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Children with fractures show higher levels of impulsive-hyperactive behavior

WOS: 000248076800030PubMed: 17353797Children with fractures have been reported to have impulsive-hyperactive behavior problems although whether they exhibited such behavior more often than children with other orthopaedic conditions is unknown. We investigated whether impulsivity-hyperactivity was more prominent in children with extremity fractures than in children with orthopaedic conditions not involving a fracture. From outpatient clinical intakes, we recruited 39 consecutive children with extremity fractures and 33 children with orthopaedic conditions not involving a fracture. We used the Conners' Parent Rating Scale to detect behavioral symptoms in children with and without extremity fractures. Children who were treated for extremity fractures had higher mean scores for impulsivity-hyperactivity than those treated for nontrauma-related reasons. Additionally, more children in the fracture group reached impulsive-hyperactive behavior scores high enough to warrant additional psychiatric evaluation. In terms of injury prevention, the orthopaedic surgeon should be familiar with problem behaviors of children, particularly impulsivity and hyperactivity, to be able to make appropriate referrals for psychiatric evaluation and treatment

Alçı içindeki cilt basıncı, kompartman basıncını yansıtabilirmi? Deneysel bir çalışma

ALÇI İÇİNDEKİ CİLT BASINCI, KOMPARTMAN BASINCINI YANSITABİLİRMİ? DENEYSEL BİR ÇALIŞMA Ekstremite travmaları nedeniyle alçı tedavisi gören hastalarda kompartman basıncın değerlendirilmesi çoğu zaman mümkün olamamaktadır. Bu çalışmanın amacı; alçı içindeki cilt basıncının, kompartman basıncını yansıtıp yansıtmayacağının, oluşturulan ön kol modelinde araştırılmasıdır. Volar ve dorsal kompartmanları olan bir ön kol modeli oluşturularak, alçı uygulandı. Alçı ve model arasından farklı bölgelerden alınan basınç değerleri, kompartman basıncı ile karşılaştırıldı. Yapılan ölçümler sonucu alçı içi cilt basıncı ile kompartman basıncı arasında tüm lokalizasyonlarda korelasyon saptandı. Ortalama korelasyon katsayısı .995 (P000), (Std dev: .002, Minimum .992, Maksimum .999) olarak saptandı. Alçı içi cilt basıncı, kompartman basıncının moniterizasyonunda kullanılabilecek bir seçenektir. Bu konuda yapılacak klinik çalışmalar sonucunda alçı içi cilt basıncı moniterizasyonunun, ileride günlük kullanıma girmesi, hekime ve alçı tedavisi gören hastalara takip konusunda yardımcı olması beklenebilir.Purpose: Although monitoring intracompartmental pressure under a cast is very important, it is not possible to measure it in every patient undergoing cast treatment. This study aims to answer the question, whether skin surface pressure under a cast can reveal intracompartmental pressure. Material and Methods: A plaster cast was applied to a sculpted inflatable forearm model with dorsal and volar compartments. Skin surface pressures under the cast were measured at five different localizations from both dorsal and volar sides of the model and compared to corresponding intracompartmental pressures. Results: All of the skin surface pressure measurements taken from the dorsal and volar side of the model correlated with intracompartmental pressure. Mean correlation coefficient of the measurements was .995 (P.000), (Std dev: .002, Minimum .992, Maksimum .999). Conclusion: Measuring the pressure between skin and cast can monitor intracompartmental pressure. Skin surface pressure monitoring can help the physician, patient or parents in the follow up of patients undergoing cast treatment

The relationship between Hill-Sachs lesion and recurrent anterior shoulder dislocation

WOS: 000254244600004PubMed: 17515227The relationship between the number of shoulder dislocations and the depth and percent of head involvement of the Hill-Sachs lesions was investigated in this study. Thirty patients with recurrent anterior dislocation of the shoulder were divided into three groups according to the numbers of dislocations they had presented : Group 1 : 1 to 5 dislocations; Group 2 : 6 to 20 Group 3 : over 20. The mean percentage of head involvement was 11.9% in the first group, 25.4% in the second group and 26% in the third group of patients with Hill-Sachs lesions. The average depth of the Hill-Sachs lesions was 4.14 mm in the first group, 5.13 mm in the second group and 4.38 mm in the third group. Based on these findings, it appears that there is a correlation between the number of dislocations and the extent and depth of the Hill-Sachs lesions. Surgical treatment should therefore be performed as early as possible in patients with recurrent anterior dislocation of the shoulder, in order to prevent progression of the Hill-Sachs lesion which can become by itself a cause of instability

Arthroplasty in extraarticular deformity of tibia

Sol dizde osteoartrozu ve aynı taraf tibiada ekstraartiküler deformitesi olan 70 yaşında kadın hastaya düzeltici osteotomi ve total diz protezi ameliyatı aynı seansta uygulandı. Yere paralel bir eklem yüzeyi sağlamak için artroplasti uygulamasından önce ekstraartiküler deformitenin düzeltilmesi gereklidir. Osteotomi hattının sadece uzun stemle stabilize edilmesi yeterli değildir. Sunulan olguda olduğu gibi ek bir stabilizasyona gerek vardır. Ekstraartiküler deformitelerin düzeltilmesi artroplasti ameliyatından önce mutlaka göz önüne alınmalıdır.A 70 year old female with an extraarticular deformity of the tibia and gonarthrosis at the same side was treated with a corrective osteotomy and total knee arthroplasty. Extraarticular deformities should be corrected in order to achieve a parallel joint line to the ground before performing total knee arthroplasty. Long tibial stems are not capable to stabilize the osteotomy site and additional stabilization is necessary. Extraarticular deformities should be corrected prior to total knee arthroplasty

Localized pigmented villonodular synovitis of the knee: acute onset in pregnancy

WOS: 000240536900020PubMed: 16708212A pregnant patient in the first trimester presented with acute onset knee pain and effusion. As the clinical status was mimicking septic arthritis, surgery was performed. Arthroscopy demonstrated a local synovial tumor and excision was performed with arthrotomy. Microscopic evaluation revealed localized pigmented villonodular synovitis. Due to the presence of necrosis and hematoma in the tumor, we hypothesize that, that torsion or bleeding of the tumor in the presence of physiological pregnancy- related metabolic changes might have been the cause of acute presentation

Etiology of senile osteoporosis - A hypothesis

Osteoporosis is a major health problem characterized by compromised bone strength predisposing patients to an increased risk of fracture. It may cause morbidity and mortality in elderly men and women. The etiologic factors that lead to senile osteoporosis still are unclear

A case of Larsen sydrome with joint and fascial anomaly

Larsen sendromu doğan bebeklerin 100.000'de birinde görülen nadir bir genetik hastalıktır. Prenatal tanıdan ultrasonografinin önemi vardır. Yenidoğan döneminde tipik yassı yüz şekli, eklemlerde doğuştan dislokasyonlar, spinal deformite ile karakterizedir. Otozomal dominant formu ve daha ciddi klinik formu olan otozomal resesif tipi tanımlanmıştır. Bu çalışmada Larsen sendromlu bir vaka literatürdeki vakalar araştırılarak tartışılmıştırLarsen syndrome is a rare genetic disorder, with an incidence of 1/ 100000. Ultrasonography is important in prenatal diagnosis. Joint hypermobility, spinal deformity, congenital joint dislocations, distinctive facial features are characteristic findings in newborn. An autosomal dominant form and a more severe autosomal resesive form have been described. Larsen syndrome is discusessed with a review of literatur

Is there a safe area for the axillary nerve in the deltoid muscle? A cadaveric study

Comert, Ayhan/0000-0002-9309-838XWOS: 000241769800011PubMed: 17079396Background: Several authors have defined a variety of so-called safe zones for deltoid-splitting incisions. The first aim of the present study was to investigate the distance of the axillary nerve from the acromion and its relation to arm length. The second aim was to identify a safe area for the axillary nerve during surgical dissection of the deltoid muscle. Methods: Twenty-four shoulders of embalmed adult cadavers were included in the study. The distance from the anterior edge of the acromion to the course of the axillary nerve was measured and was recorded as the anterior distance. The same measurement from the posterior edge of the acromion to the course of the axillary nerve was made and was recorded as the posterior distance for each limb. Correlation analysis was performed between the arm length and the anterior distance and the posterior distance for each limb. The ratios between arm length and the anterior and posterior distances were calculated for each case and were recorded as an anterior index and a posterior index. Results: The average arm length was 30.40 cm. The average anterior distance was 6.08 cm, and the average posterior distance was 4.87 cm. There was a significant correlation between arm length and both anterior distance (r = 0.79, p < 0.001) and posterior distance (r = 0.61, p = 0.001). The axillary nerve was not found to lie at a constant distance from the acromion at every point along its course. The average anterior index was 0.20, and the average posterior index was 0.16. Conclusions: The present study describes a safe area above the axillary nerve that is quadrangular in shape, with the length of the lateral edges being dependent on the individual's arm length. Using this safe area should provide a safe exposure for the axillary nerve during shoulder operations