Appendix. Patient Information

Transcription

1 Appendix Patient Information Your child has a fracture and will be surgically treated under general anesthesia. The procedure consists in reduction of the fracture, which may necessitate an open approach, and internal fixation using flexible intramedullary nailing (FIN). Of all currently used fixation methods (screw plates, intramedullary nails, external fixators), FIN is best suited for children and adolescents, because it does not interfere with the growth process and has the lowest complication rate. Still, potential complications may occur: Complications related to general anesthesia Complications related to fracture and healing process: Pain, swelling, hematoma Skin lesions Vascular lesions, compartment syndrome, ischemia Sensory deficit (sensory loss, paresthesia, etc.) and/ or motor deficit (paralysis, paresis) Postoperative complications related to prolonged bed rest, including phlebitis and deep venous thrombosis (DVT) Joint stiffness, amyotrophia, algodystrophy Delayed union, nonunion Growth-related complications, including angular deformity and/or leg length discrepancy Refracture, recurrent fracture Malunion or bone deformity Degenerative arthritis Complications related to implantation of a medical device: Wound hematoma. Superficial and/or deep infection. Vascular and/or neurologic complications. Incomplete reduction or secondary displacement requiring surgical revision. Implant breakage. Hypertrophic scars. Complications related to hardware removal (implants intended for temporary fixation). FIN-related complications: Nail ends are left proud of the bone surface to facilitate later removal; prominent nails may break through the skin or result in painful joint motion. Prominence disappears as soon as nails are removed. In the meantime, the child must avoid excessive range of motion, and is requested to gently mobilize the skin area around the cut ends of the nails to prevent tissue adhesion. If your child experiences unusual pain or discomfort during the postoperative period, immediately consult your medical doctor or the surgeon. P. Lascombes, Flexible Intramedullary Nailing in Children, 311 DOI: / _Appendix, Springer-Verlag Berlin Heidelberg 2010

2 Subject Index A Algodystrophy, 72, 73 Anesthesia, caudal, 59 epidural, 59 in: femoral fracture, 198 in: forearm fracture, 159 in: hand fractures, 187, 190 in: humeral shaft fracture, 99 in: proximal humeral fracture, 84 in: radial neck fracture, 138 in: supracondylar humeral fracture, 117 in: tibial fracture, 231 Angioma (osseous), 272 Antalgics, 72, 73 Antegrade FIN, 29 in: femoral fracture, , 228 in: fifth metacarpal, in: supracondylar humeral fracture, in: tibial fracture, in: ulnar fracture, Antibiotics, Anticoagulants, 60 Arteriography, 16 17, , 253 Artery anterior tibial artery, 233, 238 brachial artery, 86, 102, 106, 120, 166 deep femoral artery, 209 femoral artery, 200, 209 peroneal artery, 238 popliteal artery, 233 posterior tibial artery, 238 radial artery, , 162, 170 radial recurrent artery, 166 ulnar artery, 142, 162, 170 Avascular necrosis humeral head, 92 radial head, , Awl, B Bed positioning, 76 Bending iron, Bending stiffness, 26 Bending yield load, Benign bone tumour, Biomechanics, Biphosphonates, 268 Birth trauma, 99, 197 Blood transfusion, 60 Bone lengthening, 13 18, , femur, , 286 forearm, 282, humerus, 275, 279, 283, 286 tibia, , 286 Bone weakness, 69, C C-arm, absence of c-arm, in: femoral fracture, 198 in: forearm fracture, 160 in: hand fractures, 190 in: humeral shaft fracture, 101 in: proximal humeral fracture, 84 in: radial neck fracture, 138, 139 in: supracondylar humeral fracture, in: tibial fracture, 232 positioning, 65, 71 Callus vascularisation, 16 17, 22 x rays, 9 13 Cast, 147, 239 Cerebral palsy, 72, , Child abuse, 99, 197 Compartment syndrome, 59, 70, 253 in: forearm fracture: 176, 178 in: supracondylar humeral fracture, 126, 127 in: tibial fracture, 243, Complex regional pain syndrome, Contraindications of FIN in: femoral fracture, 219 in: forearm fracture, 178 in: radial neck fracture, 149 in: supracondylar humeral fracture, 129 in: tibial fracture, 245 Corrosion,

3 314 Subject Index Cubitus valgus, 127 Cubitus varus, 127 Cutter (nail), 37, 38 D Delayed union, 47 in: femoral fracture, 217 in: forearm fracture, 176 in: tibial fracture, 244 Diaphyseal fracture, 3, 20, 22, 29 Dogs, Doppler echography, 126 Dosimeters, 66 radiothermoluminescent 66, 67 E Elastic deformation, Elastic modulus, 26 Elasticity, 27 Enchondromatosis, 285 End cap, 46, 89 Ender, 3 Equilibrium, 3, 4 External fixator, , 288, 291, femur, 214, 215 tibia, 245, 246 F F-tool (reduction), 36, 38 Familial hypophosphatemic rickets, Femoral fracture, bilateral fracture, distal third, 197, middle third, 197, neck of the femur, 54 56, 197, 212, osteogenesis imperfecta, proximal third, 197, supracondylar, 211, 212 Fibrous dysplasia, 272 Fibular nailing, 235, 239, 241 Fixation elastic, 21 rigid, 3, 21 Floating joint, Forceps (locking), 40, 54 Forearm congenital anomaly, 284, 285 Forearm fracture, , 256, 265 osteogenesis imperfecta, 265, 266 Fracture table, 198 Fractures buckle, 19 hairline, 19, 197, 231 plastic bowing, 19, 159, 231 G Gait analysis, 302 Galeazzi fracture, 159 Gartland classification, 116 Genu valgum, 281, 291 Genu varum, 291 Growth disturbance, 128, 148 H Hackethal, 3, 4, 309 Hammer (slotted), 36, 38 Healing index, 286, 287 Histology, 11 13, 17 History, 7 Hospital discharge, 77 Humerus fracture, , 256 distal third, osteogenesis imperfecta, 265 proximal humerus, proximal third, 105 shaft, supracondylar, Hydroxy apatite coated titanium nails, 297 I Ilizarov, 3, 13 18, , Impaction of the fracture in: femoral fracture, in: tibial fracture, 236 Impaction of the nails in: femoral fracture, 206 in: forearm fracture, 167 in: radial neck fracture, 145 in: tibial fracture, Impactor 37 38, 44 Implant removal in: femoral fracture, , 218 in: forearm fracture, 173, 177 in: hand fracture, 190 in: humeral shaft fracture, 107 in: proximal humeral fracture, 91 in: radial neck fracture, 147 in: supracondylar humeral fracture, 124 in: tibial fracture, , 244 Implant selection, in: femoral fracture, 199 in: forearm fracture, in: humeral shaft fracture, 101 in: metacarpal fractures, 191 in: proximal humeral fracture, 85 in: radial neck fracture, in: supracondylar humeral fracture, 119 in: tibial fracture, 232 in: thumb fracture, 189 Indications of FIN in: femoral fracture, 219, 229 in: forearm fracture, , 183, , 97 in: radial neck fracture, 149, 157 in: supracondylar humeral fracture, in: tibial fracture, 245, 250 Infection, 285 in: femoral fracture, , in: forearm fracture, 176, 178

4 Subject Index 315, in: tibial fracture, 243, Inserter, 36, Instability, 3 4 Instability of FIN in: femoral fracture, , in: forearm fracture, in: proximal humeral fracture, in: supracondylar humeral fracture, Intrameduallary locking nail, 219, , 245 Intramedullary nail guide, Intrathecal Baclofen, 301 Ipsilateral fractures lower limb, 219, upper limb, , Irreducibility in: femoral fracture, 214 in: forearm fracture, 173, 175 in: proximal humeral fracture, Ischemia, , 253 J Jeffery classification (radial neck), 137 Jeffery type II, 150 Joint stiffness, 69, 92 in: femoral fracture, 216 in: forearm fracture, 176 in: supracondylar humeral fracture, in: tibial fracture, 244 Judet classification (radial neck), 137 K Kapandji, 187 Küntscher, 3 L Langrange and Rigault classification, Langerhans cell hystiocytosis, 272 Larsen syndrome, 268 Leg length discrepancy, in: tibial fracture, 245, 248 Ligier Jean-Noël, 3, 310 Load deformation, 26 Lymphangiomatosis, 272 M Malunion, 47, , 227 in: forearm fracture, in: radial neck fracture, 148 in: supracondylar humerus fracture, , Management (post operative), in: femoral fracture, 213, 229 in: forearm fracture, 171, 173, 183 in: hand fractures, 190, 192 in: humeral shaft fracture, 106, 113 in: proximal humeral fracture, 89, 91, 97 in: radial neck fracture, 147, 157 in: supracondylar humeral fracture, 122, 134 in: tibial fracture, 239, 249 Metacarpal fractures, fifth metacarpal, fourth metacarpal, second metacarpal, 193 Metaphyseal fracture, 3, 20, 23, 30 Medullar diameter, 25 Métaizeau classification (radial neck), Métaizeau Jean-Paul, 3 5, Monteggia fracture, 159, Multiply Injury, 69, 177, 219, 245, Muscles, 23 Myopathy, 269 N Nail diameter, 25 radius of curvature, tip, 33, 35 Nancy, 3 5, 63, 66, 304, 309 Neer classification, 81 Nerve common fibular nerve, 233 deep branch of radial nerve, 166 deep peroneal nerve, 238 femoral nerve, 209 medial antebrachial cutaneous nerve, 120 medial sural cutaneous nerve, 233 median nerve, 86, 102, 106, 120, 142, 162, 166, 170 musculocutaneous nerve, 120 posterior interosseous nerve, 142, 162, 170 radial nerve, 86, 102, 106, 120 saphenous nerve, 233, 238 sciatic nerve, 209 superficial branch of radial nerve, , 162, 166, 170 superficial peroneal nerve, 238 superior lateral branchial cutaneous nerve of axillary nerve, 120 sural nerve, 238 tibial nerve, 200, 233, 238 ulnar nerve, 86, 102, 106, 120, 142, 162, 166, 170 Nerve block axillary, 59 femoral, 59, , 231 iliofascial, 59 infraclavicular, 59 proximal sciatic, 59 popliteal sciatic, 59 Nerve palsy anterior interosseous branch, 70, 125 axillary nerve, 91 median nerve, 70, 125

5 316 Subject Index radial nerve, 70, 99, 107, 125, 129 suprascapular nerve, 91 ulnar nerve, 70, 125 Neuromuscular disease, 60, 69, 72, Non union, 47 in: femoral fracture, 216, in: forearm fracture, 176 in: radial neck fracture, 149, in: tibial fracture, 244 O Olecranon fracture, 148, 151 Ollier s disease, 285 Open fracture in: forearm fracture, 159, 174, 177 in: humeral shaft fracture, 203 in: proximal humeral fracture, 202 in: supracondylar humeral fracture, in: tibial fracture, 231, 243 Open reduction, in: femoral fracture, 211 in: forearm fracture, 159, in: proximal humeral fracture, 85, 87 Orthosis, Ossification (anarchic), 147 Osteogenesis imperfecta, 60, 72, , Osteoma, 69 Osteomyelitis, 47 Osteoporosis, 268 Osteosarcoma, Osteotome (curved), 40 Osteotomy, 279, 288 femur, , forearm, , humerus, 279 tibia, , Overgrowth in: femoral fracture, in: tibial fracture, 246 P Pain, 59 61, 72, 91 Parents, 75 Patient positioning in: femoral fracture,197 in: forearm fracture, in: hand fractures, 187, 190 in: humeral shaft fracture, 99, in: proximal humerus fracture, 84 in: radial neck fracture, in: supracondylar humerus fracture, in: tibial fracture, 231 Pathological fracture, 263 Periosteum, 22, 115, 145 Phalangeal fractures, Plasticity, 27 Polytraumatism, Prévot Jean, 3, 309 Prominent nail end, 46, 47 Proximal humeral fracture, Q Quadriceps muscle, 71 R Rabbits, 9 18 Radial head dislocation, Radial nerve injury, 99, 106 Radiation doses, 66 Radiation exposure, 63, Radiological protection, 64 Radiosensitivity, 64 Radius fracture, diaphysis, distal third, 165, 168 radial neck, Recurrent fracture, 47 in: forearm fracture, 169, Recurvatum, 43, 205, 236, 245 Reduction with punch, Refracture, 47 in: femoral fracture, 216, in: forearm fracture, osteogenesis imperfecta, 263 Removal of nails, and fracture, 54 impossibility, 54 in: femoral fracture, , 218 in: forearm fracture, 171, 177 in: humeral shaft fracture, in: supracondylar humeral fracture, , 243 Retrograde FIN, 29 in: femoral fracture, in: humeral shaft fracture, in: proximal humeral fracture, in: radial fracture, 167, 179 in: radial neck fracture, , 243 in: thumb fracture, Rhizotomy, 301 Rickets, 18, Rush, 3 S Salter classification in: hand fractures, 187 in: proximal humeral fracture, 81, in: radial neck fracture, 137 School activity in: femoral fracture, 211 in: forearm fracture, 169 in: humeral shaft fracture, 105 in: radial neck fracture, 145 in: supracondylar humeral fracture, 134

6 Subject Index 317 Secondary displacement in: femoral fracture, 216 in: forearm fracture, 170, 174 Skin impingement in: forearm fracture, in: proximal humeral fracture, 90 in: radial neck fracture, 145 in: supracondylar humeral fracture, in: tibial fracture, Sliding FIN, Spinal amyotrophy, 269 Sport activity in: femoral fracture, 211, 227 in: forearm fracture, 171, 181 in: humeral shaft fracture, 105, 113 in: proximal humeral fracture, 89, 95 in: radial neck fracture, 145, 155 in: supracondylar humeral fracture, 122, 135, 245 Stability, 3 4, 23 Stainless steel, Supracondylar humeral fracture, extension type, flexion type, 116, 122 Supracondylar femoral fracture, 212 T T handle, 38, 42 Talus fracture, 253 Tendons abductor pollicis longus tendon, 141, 161 extensor pollicis brevis tendon, 141, 161 extensor pollicis longus tendon, 141, 161 Thumb fracture, Tibial fracture, diaphyseal fracture, , 255 distal fourth, 237 osteogenesis imperfecta, 266, 268 proximal fourth, 238, 255 Tissue protective sleeve, 34, 44 Titanium, Torsional malalignement, 291, 294 U Ulnar fracture, Unicameral bone cyst, 270, 272 V Valgus, 42, 235 Varus, 202 Vascular complication in: forearm fracture, 177 in: proximal humerus fracture, 91 in: supracondylar humerus fracture, Vascular injury, 253, 256 Vein basilic vein, 84, 99, 104, 118, 164 cephalic vein, 84, 99, 104, 118, 164, 168 femoral vein, 206 great saphenous vein, 200 lesser saphenous vein, 236 Vitamine D resistant, 291, 297, 298 W Weight bearing, 71 in: femoral fracture, 206 Wound care, 77 Y Young modulus, 26