Fracture of the humerus in arm wrestling: An uncommon mechanism for a common fracture

A case of a healthy young patient which had a spiral fracture of humerus shaft during an arm-wrestling game. Various differential diagnosis should be assessed. Treatment is the same as a fracture of humerus shaft from any other mechanism.

Lower tibial shaft spiral fracture concurrent with distal tibial triplane fracture

Background: The clinical and imaging features of lower tibial shaft spiral fracture, concurrent with distal tibial triplane fracture, are not clear. Introduction: Consequently, this study was aimed to investigate these features for correct diagnosis, treatment, and prevention of possible premature physeal arrest or angular deformation. Method: Patients with lower tibial shaft spiral fracture concurrent with distal tibial triplane fracture were enrolled, and the clinical, imaging, treatment, and follow-up data were analyzed. Result: Five patients with lower tibial shaft spiral fracture concurrent with distal tibial triplane fracture were found, including four men and one woman with an age range of 12-15 years (mean 13.6). Injury to the distal tibial epiphysis was missed in the diagnosis in plain radiography reports, but careful reevaluation confirmed distal tibial epiphysis fracture in four cases, including Salter-Harris type II in three cases and type III in one case. The remaining case had no apparent distal tibial epiphysis injury in the plain radiograph. CT scan revealed that all five patients had distal tibial triplane fracture of the lateral type, including two fragments in three cases and three fragments in two cases. The fracture was divided into type I(within the articular weight-bearing line) in three cases, type II (outside the articular weight-bearing line) in two cases that were based on the involvement of the articular surface by the fracture line. For the lower tibial fracture, one patient was treated with closed reduction and fixation with an elastic nail, three patients had internal plate fixation, and the remaining patient had cast immobilization. Having followed up for 3-11 months (mean 7), all the distal tibial fractures and the triplane fractures were healed without varus or valgus deformity in the ankle. Conclusion : Distal tibial triplane fracture can be readily missed in plain radiography and should be suspected in patients with distal tibial spiral fracture, which should be evaluated with a computed tomographic scan.

POSTOPERATIVE RECOVERY OF SPYROID TIBIA FRACTURE

This paper is a topical issue among people diagnosed with spiral fracture third diaphyseal tibia, because following the survey conducted by the College of Physiokinetotherapists in Romania over 50% of athletes licensed to sports clubs are suffering from pathologies in the lower limbs, 20% of these at the tibia. In this paper are found some methods and ways of early and methodical application of kintetotherapy means and processes through which to restore as much as possible the functionality or loss of the patient diagnosed with spiral fracture middle third diaphyseal tibia. This paper aims to demonstrate that the proposed physiotherapy model helps to improve the functional capacity and quality of life in people with spiral fracture average third diaphyseal tibia.

Coaptation and functional bracing of adolescent humeral shaft spiral fracture: a case report and review of literature

<p class="abstract">Adolescent humerus shaft fractures are uncommon. Direct injuries lead to transverse fractures and indirect injuries lead to spiral and most oblique fractures. There is fracture displacement, angulation and internal rotation of the proximal fragment. There is difficulty in maintaining reduction after closed manipulation of spiral fractures. Paediatric humeral shaft fractures are treated by elastic intramedullary nails more often nowadays. We present a case of isolated spiral fracture of the middle1/3rd and distal 1/3rd junction of the humerus shaft with displacement and angulation treated successfully with closed reduction, coaptation U slab followed by functional orthosis.</p>