Hidetoshi Onoue

Treatment of Flexion Supracondylar Fractures of the Humerus in Children: Four Case Report.

We treated four children with flexion supradondylar fractures of the humerus. One child was treated by traction for 14 days and an extension cast after closed reduction. One child was treated by closed reduction and fixation with percutaneous Kirschner wires. Reduction by the closed method was difficult in the other two children due to completely displaced fracture, and open reduction was required. Two of the four fracture were in cubitus rectus, but none had joint stiffness.

2 Cases Reports of an Open Fracture of the Lower Leg due to an Indirect Force during Sports Activity

Case 1. A 22 year old male fractured his lower leg when landing on a baseball court. On that day after the diagnosis of open lower leg fracture we executed osteosynthesis with an interlocking nail (Gustilo type II, A0 type A3). Case 2. A 37 year old female fractured her lower leg when falling on a badminton court. On that day we executed irrigation and debridement after the diagnosis of lower leg open fracture (Gustilo type II, A0 type A1). 17 days after the first operation we executed plate osteosynthesis.Discussion. In a gymnasium players occasionally lose their balances. To prevent falling to the court, a strong force between the sole of their sports shoes and the court may be transmitted to the bone causing fracture.This report describes 2 cases of an open fracture of the lower leg due to indirect forces, and a discussion about the generation of indirect forces from the interaction of the sole of a sports shoe with the gymnasium floor.

Study of Pin Track Infection During Use of External Fixatioin System

The external fixation system is used for the treatment of fracture, limb lengthening, deformity corrections, etc. Some complications are however seem, of which one especially serious one is pin track infection. In order to reduce pin track infection, we develop a new postoperative dressing method details of which and the infection rate are reported in the following.Since use of the external fixation system from 1995, postoperative pin site care has been performed basically by cleaning the affected part twice a week, then the pins and the skin around the pin sites were disinfected with hibitane pledget while removing secreta and eschar. After disinfecting the affected limb and the entire external fixator using hibitane spray, and filling with univalve gauze, the affected area and the external fixation system were convered with a sponge pad at the same time, and made airtight with bandages.Pin track infection was observed in 1 out of 24 cases (4.2%), which had a open femoral shaft fracture. Results show that above method helps prevent pin track infection.

Five Cases of Car Accident Injuries with Tibial Fractures

Five pediatric cases with tibial fractures which occurred by being run over by a car are reported. All patients were male between ages 5 and 7 years. There were three open fractures of the tibial shaft in which osteosynthesis was performed using K-wires. Three of the five cases also required the use of Neomatrix (artificial dermis) to cover full thicknes skin defects.The artificial dermis formed satisfactory granulation on the bone surface in all three cases. Free skin graft was performed in all five cases. All five fractures healed without infection, with good bone union and a successful skin graft.

Clinical Use of Absorbable Screws for Posterior Dislocation of Acetabular fracture

5 patients with posterior rim acetabular fractures were treated with absorbable screws. Open reduction and internal fixation were performed on these patients due to the instability of the fracture following closed reduction. All 5 patients healed without complications and showed good results, indicating that the absorbable screws provided sufficient stability for the fixation of this type of fracture. In addition, the absorbable implants did not require removal and produced no artifacts in postoperative CT and 3-DCT images, permitting excellent analysis of the fracture aligment and union. These results indicate that the absorbable screws may be a viable alternative to metalic implants for the treatment of unstable posterior rim acetabular fractures.