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An assessment of treatment results achieved during two periods of observation (1953-1976 and 1976-1981) shows that chances of osseous healing are good in fractures and non-unions of the shaft of the humerus, provided the method of treatment had been correctly indicated. Preference should be given to conservative treatment in case of fresh fractures of the shaft. However, if this is not possible, surgery is indicated, as is the case if healing does not take place. Laminar osteosynthesis performed from the dorsal side should be the method of choice, since it combines the advantages of easy surveyability while performing the operation with those of biomechanical stability.  相似文献   

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Authors performed at a severe injury of the upper limb the transposition of the left hand and lower arm on the stump of the right upper arm. 10 months have passed since the operation. The present state is described.  相似文献   

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For the last 28 years condylar upper arm fractures have been treated at the Department of Surgery of Erlangen University mainly via the extention after Baumann. 182 cases out of 306 were followed up clinically. Extension treatment after Baumann is a technically simple procedure and offers the possibility of continual control and correction of repositioning. Treatment results are good. We could not observe Volkmann's contraction among our patients. Operation does not decisively improve the results, whereas the risk is increased. It should remain restricted to those cases only which cannot be successfully treated by conservative measures.  相似文献   

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A young patient who had traumatic amputation of left arm developed extensive chylothorax on right side of chest. The pathophysiology appears to be left subclavian thrombosis secondary to gross sepsis of the amputation stump which resulted in occlusion of thoracic duct opening and chylothorax. The child was successfully treated by closed chest tube drainage.  相似文献   

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The treatment of fractures of the distal humerus is very well standardized. The classification according to Müller allows for easy differentiation between the many types of fractures, helps in the determination of therapeutic guidelines and contributes to an objective comparison of results of treatment. Fractures in group A/B are treated either conservatively or with comparatively simple instrumentation using K-wires, screws, and plates. Injuries falling in group C demand a high standard of operative skill. The underlying principle of internal fixation aims primarily at reconstruction of the articular surface. The next operative step consists in the realignment of the reconstructed articular block with the proximal humeral fragment by osteosynthesis. Autologous cancellous bone is used to give a solid counterbalance for screw fixation and to re-establish osseous continuity. Sound assessment of concomitant injury to the soft tissue demands wide clinical experience. This is necessary for essential decision as to whether primary osteosynthesis, delayed, secondary reconstruction of the joint following recovery of the soft tissue or conservative treatment is indicated.  相似文献   

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G Giebel 《Der Unfallchirurg》1991,94(9):468-470
The analysis of 35 cases of delayed healing of fractures of the upper arm treated from 1981 to 1990 shows that fractures resulting from road accidents (16/35) and comminuted fractures (16/35) are particularly frequent in this group. Delayed fracture healing after conservative treatment (10 patients) was caused mainly by inadequate reduction (4/10) or by the fact that the conservative treatment performed was in fact inappropriate (4/10). Primary osteosynthesis was performed in 25 patients. Inadequate stabilization (9/25) was the most frequent reason for delayed healing, followed by the omission of bone grafting (7/25).  相似文献   

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25 subcutaneous tendon ruptures of the upper arm were operatively treated between 1982 and 1985. The long biceps tendon was ruptured fifteen times, the distal biceps tendon eight times and the triceps tendon twice. Operative procedures and the functional results are described. The follow-up investigation was undertaken on an average of 14 months after operation. Mechanism of injury and variations of histological findings in the different tendons are compared. The functional results are good. The operative treatment of subcutaneous tendon ruptures of the upper arm is therefore recommended.  相似文献   

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Musculocutaneous nerve entrapment in the upper arm   总被引:1,自引:0,他引:1  
Summary Wasting and weakness of the biceps and brachialis muscles can occur when the musculocutaneous nerve is compressed as it passes through the coracobrachialis muscle; there may also be impairment of sensation on the lateral aspect of the forearm. In our patient, symptoms appeared after strenuous exercise which included more than 500 pressups each day. Electromyography and telethermic examination confirmed the diagnosis. He was advised to stop his strenuous exercises and within 3 months muscle strength and sensation had returned.
Résumé Le nerf musculo-cutané peut être comprimé lors de son passage dans le muscle coracobrachial. Les manifestations de l'atteinte du nerf sont longtemps discrètes mais la force musculaire du biceps et du brachial antérieur est diminuée de même que le réflexe bicipital. Un déficit sensitif est retrouvé à la face antéro-externe de l'avant-bras. Chez notre malade les symptômes sont apparus à la suite d'un entraînement intensif, comportant plus de 500 contractions par jour. L'EMG du membre supérieur mettait en évidence des anomalies au niveau du biceps et du brachial antérieur. Un examen téléthermographique montrait une hyperthermie de l'avantbras dans la zone innervée par le rameau cutané antibrachial externe du nerf musculo-cutané. L'arrêt de l'entraînement, le repos et une reprise progressive de l'activité ont été un traitement efficace. En l'espace de trois mois, le volume et la force des muscles ont été récupérés, ainsi que la sensibilité de l'avant-bras.
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Multicentric giant cell tumors of bone are rare; they represent less than 1% of all giant cell tumors. We report the case of a 35-year-old right-handed man, who presented in 1985 with a giant cell tumor of the upper end of the right humerus. After failure of conservative treatment (curettage and bone grafting), resection-arthrodesis of the shoulder with a free vascularized fibular autograft was performed. Three years later, the patient developed an osteolytic lesion of the lower end of the ipsilateral radius, involving the soft tissues and the wrist joint. He was treated with resection-arthrodesis of the wrist with a free vascularized fibular graft. The histologic study confirmed the diagnosis of giant cell tumor of similar grade. After 13 years follow-up, the patient had a satisfactory function of the limb and no recurrence of the tumor was noted.  相似文献   

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Between 1973 and 1987 we applied stacked Bundle-nailing in 24 cases of pathological humerus fractures. It is a fast, low-risk technique with which a good stabilization can be obtained. Especially in patients with advanced malignant disease, a fast improvement of life-quality is significant.  相似文献   

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We present a woman who, after a modified mastectomy, underwent a breast reconstruction with a tissue expander that soon afterward developed a Baker grade 4 capsular contracture. The result was improved with a capsulotomy and a deepithelialized upper arm fasciocutaneous flap, to give fullness to the lateral aspect of the breast. We think that the upper arm fasciocutaneous flap can be a good adjunct in breast reconstruction when lack of tissue in the lateral aspect of the breast or axilla jeopardizes the aesthetic results.  相似文献   

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The author describes his surgical approach to the problems of the aging upper arm and elbow region. Surgery at an appropriate age can prevent the progressive wrinkling of the elbow which is further aggravated by aging of the upper arm. The author's operation is aimed at correcting both portions of the arm anatomy at the same time.  相似文献   

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