scholarly journals Conservative Treatment of Carpometacarpal Dislocation of the Three Last Fingers

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Hélène Jumeau ◽  
Philippe Lechien ◽  
Florence Dupriez
Keyword(s):  
Emergency Department ◽  
Conservative Treatment ◽  
Literature Review ◽  
Closed Reduction ◽  
Rare Condition ◽  
Posterior Dislocation ◽  
Chronic Instability ◽  
The Third ◽  
Physician Awareness

Posterior carpometacarpal (CMC) dislocation is a rare condition. Treatment is usually surgical though no strict consensus can be found upon literature review. If diagnosed early and no associated fractures are found, CMC dislocation could benefit from conservative treatment comprising closed reduction and splint immobilisation. We report the case of a 26-year-old man diagnosed with a posterior dislocation of the third, fourth, and fifth CMC joints after a fall of 1.5 meters, treated by external reduction under procedural sedation and immobilisation with a cast for 6 weeks. Evolution was excellent with no relapse observed during follow-up. Our aim is to increase physician awareness of CMC dislocation so that they seek this injury in the emergency department. Unrecognised CMC dislocation can lead to neurovascular injuries as well as chronic instability and early articular degeneration.

scholarly journals Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Normal Weight ◽  
Medical Community ◽  
Overweight Children ◽  
Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

scholarly journals Displaced Salter-Harris I fracture of the distal ulna physis

2019 ◽  
Vol 12 (8) ◽  
pp. e230783
Author(s):  
Kevin Clesham ◽  
Robert P Piggott ◽  
Eoin Sheehan
Keyword(s):  
Emergency Department ◽  
Clinical Assessment ◽  
Closed Reduction ◽  
Anatomical Reduction ◽  
Distal Ulna ◽  
Left Hand ◽  
Anatomy And Physiology ◽  
Image Intensification ◽  
Salter Harris

A 10-year-old girl presented to the emergency department having sustained a fall onto an outstretched left hand while playing soccer. Clinical and radiographical assessment identified a Salter-Harris I distal ulna fracture, as well as a buckle fracture of the distal radius. The injury was closed, and she had no neurovascular deficits on examination. She was brought to the operating theatre the following morning for closed reduction under general anaesthesia. Image intensification was used to confirm anatomical reduction, and an above-elbow moulded plaster-of-paris cast was applied. Follow-up clinical assessment at 6 weeks confirmed healing of the fracture, and she proceeded to make a full recovery. This case describes the anatomy and physiology of such rare injuries and outlines treatment principles and potential pitfalls based on best available evidence.

scholarly journals Primary Meningococcal Type C Arthritis: A Case Report and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Maximiliano Barahona ◽  
Jaime Catalan ◽  
Yoshiro Sato ◽  
Jaime Hinzpeter
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Neisseria Meningitidis ◽  
Functional Results ◽  
Clinical Problem ◽  
Short Term ◽  
Type C ◽  
Common Clinical Problem

Acute septic arthritis is a common clinical problem in emergency departments. Primary meningococcal arthritis (PMA) is very rare and few cases are reported in literature. D. B. M. consulted the emergency department for knee pain and fever; analysis showed that the cause was a Neisseria meningitidis type C infection. He received a treatment consisting of 2 arthroscopies and 5 weeks of antibiotics. At five weeks he returned to work and at 2 months he resumed sports (jogging and soccer) without complaints. Primary arthritis of the knee caused by Neisseria meningitidis is very rare. It has a very good response to antibiotics and arthroscopy procedure. Short-term follow-up and functional results are often good or excellent.

scholarly journals Compound dorsal dislocation of lunate with trapezoid fracture

2016 ◽  
Vol 6 (4) ◽  
Author(s):  
Bong-Sung Kim ◽  
Gerrit Grieb ◽  
Patrick Rhodius ◽  
Arne H. Böcker ◽  
Jan-Philipp Stromps ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Conservative Treatment ◽  
Satisfactory Result ◽  
Closed Reduction ◽  
Kirschner Wires ◽  
Partial Loss ◽  
X Ray ◽  
Motorcycle Accident ◽  
Loss Of Strength

We report about a dorsal dislocation of the lunate accompanied by a trapezoid fracture in a 41-year old male patient after a motorcycle accident. The lunate dislocation with no dorsal or volar intercalated segment instability (DISI, VISI) was diagnosed by x-ray whereas the trapezoid fracture was only diagnosable by computed tomography. A closed reduction and internal fixation of the lunate by two Kirschner wires was performed, the trapezoid fracture was conservatively treated. Surgery was followed by immobilization, intense physiotherapy and close follow-up. Even though complaints such as swelling and pain subsided during the course of rehabilitation, partial loss of strength and range of motion remained even after 16 months. In conclusion, a conservative treatment of trapezoid fractures seems to be sufficient in most cases. Closed reduction with Kwire fixation led to an overall satisfactory result in our case. For dorsal lunate dislocations in general, open reduction should be performed when close reduction is unsuccessful or DISI/VISI are observed in radiographs after attempted close reduction.

Pisiform dislocation

2021 ◽  
Vol 14 (1) ◽  
pp. e237482
Author(s):  
Faisal Mahmood ◽  
Milind Mehta ◽  
Rahul Kakkar
Keyword(s):  
Emergency Department ◽  
Closed Reduction ◽  
Case Reports ◽  
Dominant Male ◽  
Significant Morbidity ◽  
Right Hand

A pisiform dislocation is an uncommon injury which can lead to significant morbidity if missed. The literature regarding pisiform dislocation is limited and largely from case reports. In this case, we present a 51-year-old right-hand dominant male who sustained the injury after a fall. He attended the emergency department on the same day and a closed reduction was able to be performed under a haematoma block. On review in follow-up clinic the patient’s symptoms had completely resolved.

scholarly journals Perinephric urinoma following spontaneous renal rupture in the third trimester of pregnancy: a case report and brief review of the literature

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ya Chen ◽  
Yun Fang Yan ◽  
Ying Zhang ◽  
Xianming Carroll ◽  
Hui Rong Li ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urine Analysis ◽  
Rare Condition ◽  
Percutaneous Nephrostomy ◽  
Third Trimester ◽  
The Third ◽  
Appropriate Treatment ◽  
Perinephric Space ◽  
Renal Rupture

Abstract Background Spontaneous formation of urinoma is a rare condition, especially for pregnant women. We report a patient in the third trimester of pregnancy with a spontaneous renal rupture who then develops a urinoma from urine leaking into the perinephric space. Case presentation A 23-year-old primagravida was diagnosed with a spontaneous renal rupture and acute left loin pain accompanied by hematuria when she was 35 weeks pregnant. A sub-capsular perinephric cyst then developed to a size of 319 × 175 × 253 mm, and because of discomfort to the patient, we performed Cesarean section. After a healthy male newborn was delivered, fluid was suctioned from a large perirenal cyst that had an estimated size of 300 × 200 × 300 mm. A percutaneous nephrostomy tube was left in the cyst until CT showed no remaining fluid. In the six-month follow-up, the patient showed no perirenal extravasation according to an ultrasound scan, and the urine analysis and renal function tests were normal. Conclusion Close follow-up should be recommended for the patient who has renal rupture after conservative therapy, especially for pregnant woman. CT or MRI should be considered in addition to utilizing ultrasound in the management of pregnant women who present with urinomas. Percutaneous nephrostomy is suggested as an appropriate treatment for large urinomas.

scholarly journals Flecainide toxicity: a presentation to the emergency department with literature review

2020 ◽  
Vol 13 (2) ◽  
pp. e232691 ◽  
Author(s):  
Rashpal Ghataoura ◽  
Shashank Patil
Keyword(s):  
Patient Outcome ◽  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Ecg Changes ◽  
Alter Patient ◽  
Cardiovascular Instability ◽  
Successful Recovery ◽  
Flecainide Overdose

Flecainide toxicity can result in increased cardiovascular instability which can significantly alter patient outcome if not recognised early. In this case report, the management of a 68-year-old woman who took an unintentional overdose of flecainide is detailed. We look at the management she received in the emergency department and her successful recovery and follow-up since the admission. In addition, the case report outlines the ECG changes that are most commonly documented in flecainide overdose and reviews the frequently used treatment methods for the overdose as summarised in current literature.

scholarly journals Acute abdomen due to an infarction of wandering spleen: case report

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Ragheb Assaf ◽  
Baraa Shebli ◽  
Ayham Alzahran ◽  
Ahmad Rami Rahmeh ◽  
Ali Mansour ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Acute Abdomen ◽  
Rare Condition ◽  
Wandering Spleen ◽  
Ectopic Spleen ◽  
Threatening Condition ◽  
Life Threatening ◽  
Displaced Spleen

Abstract Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all spleen ligaments that fixate the spleen in the left upper quadrant. Many different terms refer to wandering spleen like dislocated spleen, ectopic spleen and displaced spleen. We report in this case a 13-year-old Syrian girl presented to the emergency department complaining of acute generalized abdominal pain with fever, anorexia and vomiting started 2 days prior to presentation. A splenectomy was performed, with uneventful postsurgical follow-up. Wandering spleen is prone to torsion and infarction resulting in acute abdomen and a life-threatening condition with high mortality rate reaching 50%. We advise the investigation of any recurrent episodes of chronic pain keeping up within mind this diagnosis.

scholarly journals Tropheryma whipplei Endocarditis: Case Presentation and Review of the Literature

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Michael McGee ◽  
Stephen Brienesse ◽  
Brian Chong ◽  
Alexander Levendel ◽  
Katy Lai
Keyword(s):  
Heart Failure ◽  
Rare Condition ◽  
Tropheryma Whipplei ◽  
Review Of The Literature ◽  
Case Presentation ◽  
Gastrointestinal Manifestations ◽  
Presenting Symptoms ◽  
Physician Awareness ◽  
Culture Negative

Abstract Whipple’s disease is a rare infective condition, classically presenting with gastrointestinal manifestations. It is increasingly recognized as an important cause of culture-negative endocarditis. We present a case of Whipple’s endocarditis presenting with heart failure. A literature review identified 44 publications documenting 169 patients with Whipple’s endocarditis. The average age was 57.1 years. There is a clear sex predominance, with 85% of cases being male. Presenting symptoms were primarily articular involvement (52%) and heart failure (41%). In the majority of cases, the diagnosis was made on examination of valvular tissue. Preexisting valvular abnormalities were reported in 21%. The aortic valve was most commonly involved, and multiple valves were involved in 64% and 23% of cases, respectively. Antibiotic therapy was widely varied and included a ceftriaxone, trimethoprim, and sulfamethoxazole combination. The average follow-up was 20 months, and mortality was approximately 24%. Physician awareness is paramount in the diagnosis and management of this rare condition.

A Unique Case of Isolated Lateral Epicondyle Fracture in an Adolescent Boy

2020 ◽  
Author(s):  
Monir Najafi Pirasteh ◽  
Ehsan Seif ◽  
Arvin Najaf ◽  
Salman Azarsina
Keyword(s):  
Closed Reduction ◽  
Treatment Approach ◽  
Rare Condition ◽  
Fracture Dislocation ◽  
Kirschner Wires ◽  
Unique Case ◽  
Lateral Epicondyle ◽  
K Wires ◽  
The Stability

Background: The lateral epicondyle fracture in children is a rare condition and only few cases have been reported in the literature. The isolated fracture without concomitant fracture/dislocation is even more uncommon, with unclear outcome and treatment approach. Case Report: We present a case of an 11-year-old boy with restricted right elbow range of motion (ROM) after falling. The radiograph and computed tomography (CT) scan showed a displaced lateral epicondyle fracture without accompanying fracture or dislocation. Due to the stability of the joint and patient’s compliance, a closed reduction with Kirschner wires (K-wires) was selected for treatment. Follow-up results were satisfactory and showed no complications. Conclusion: Closed reduction of dislocated lateral epicondyle fracture in children can result in acceptable outcomes.

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