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The elbow
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Post-traumatic radioulnar synostosis sometimes follows internal fixation of fractures of the radius and ulna. It is treated by resection when the synostosis has matured, followed by diligent physiotherapy.
Congenital radio-ulnar synostosis
Published in Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode, Paediatric Orthopaedics, 2016
Rotational osteotomies of the forearm for congenital radio-ulnar synostosis are associated with high complication rates; these are nerve palsies, vascular compromise, compartment syndrome and malunion.1,5,6 Owing to the adaptation of most patients in compensatory rotation through both the carpus and shoulder, and the associated high complication rate of surgery, the risks of surgery rarely outweigh the benefits.3
Individual conditions grouped according to the international nosology and classification of genetic skeletal disorders*
Published in Christine M Hall, Amaka C Offiah, Francesca Forzano, Mario Lituania, Michelle Fink, Deborah Krakow, Fetal and Perinatal Skeletal Dysplasias, 2012
Christine M Hall, Amaka C Offiah, Francesca Forzano, Mario Lituania, Michelle Fink, Deborah Krakow
Radiographic features: the upper limbs are more commonly affected than the lower limbs, and in the upper limbs the mesomelic segment more commonly affected than the rhizomelic. Findings include radial aplasia/hypoplasia (the humerus and ulna may also be involved), preaxial polydactyly/thumb duplication, triphalangeal thumb, and 2/3 syndactyly. Proximal radioulnar synostosis has been described. A broad hallux and clubfeet are recognised features. Limb changes may be bilateral, but not necessarily symmetrical. The malar and mandibular bones are hypoplastic.
Brachial distal biceps injuries
Published in The Physician and Sportsmedicine, 2019
Drew Krumm, Peter Lasater, Guillaume Dumont, Travis J. Menge
Distal biceps ruptures are rare injuries that can significantly impact arm strength and range of motion. A proper history and physical exam are vital in diagnosing this injury. Imaging modalities such as MRI can assist in making the diagnosis if the physical exam is equivocal. Definitive treatment of biceps ruptures typically involves surgery for young active patients, while non-operative management is reserved for lower demand patients. Single and dual-incision techniques may be used, with a variety of different fixation methods available. Suspensory cortical buttons have been shown to be very effective and resist high forces on the biceps postoperatively. Care must be taken to protect surrounding soft tissue structures during surgery, especially the LABCN. Meticulous dissection is important in avoiding heterotopic ossification and radio-ulnar synostosis.