scholarly journals Combined Dorsal and Ulnarward Carpometacarpal Dislocation Associated with Open Fracture of the Base of First Metacarpal and Severe Degloving Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ali J. Electricwala ◽  
Jaffer T. Electricwala
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Rare Case ◽  
Open Fracture ◽  
Kirschner Wires ◽  
Degloving Injury ◽  
The Right ◽  
High Index Of Suspicion

We report a rare case of dislocation of second to fourth carpometacarpal (CMC) joints of the right hand with combined dorsal and ulnarward displacement of the second to fourth digits and fracture of the shaft of the first metacarpal associated with degloving injury. These injuries were diagnosed early and treated successfully with closed reduction and internal fixation using Kirschner wires. The functional outcome was good at follow-up at 5 years. A high index of suspicion is required to successfully diagnose and treat this condition.

scholarly journals Functional outcome of percutaneous screw fixation of intra-articular calcaneum fractures

2018 ◽  
Vol 4 (6) ◽  
pp. 857
Author(s):  
Mahaveer Meena ◽  
Saksham Sharma ◽  
Purushottam Jhanwar ◽  
Shiv Bhagwan Sharma
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Screw Fixation ◽  
Image Intensifier ◽  
Long Term Results ◽  
Calcaneal Fractures ◽  
Percutaneous Screw Fixation ◽  
Articular Fractures

<p class="abstract"><strong>Background:</strong> The treatment of displaced calcaneum fractures has been a subject of intense discussion. Displaced intra-articular calcaneum fractures gives poor result with conservative treatment and requires reduction and internal fixation for favourable long term results. Open procedures are more prone to complications regarding wound healing. Percutaneous fixation offers a middle pathway in treating simpler variety of displaced calcaneal fractures. The aim of the study was to access the functional outcome of intra articular fracture calcaneum managed with closed reduction by Essex-Lopresti technique and percutaneous screw fixation.</p><p class="abstract"><strong>Methods:</strong> This study was done in department of Orthopaedics Jhalawar medical college and SRG Hospital Jhalawar, Rajasthan from January 2015 to January 2018. 26 intra-articular calcaneal fractures treated with closed reduction and percutaneous screw fixation under image intensifier.<strong></strong></p><p class="abstract"><strong>Results:</strong> 25 cases evaluated (one patient had lost follow-up), all fractures were united, average time of union was 8 weeks. The mean AOFAS score was 80 (range from 45 to 96), 9 patients had excellent, 12 patients had good, 3 patients had fair and one patient had poor result for that subtalar arthrodesis was done after one year of follow-up. Average Bohler’s angle 24.5 and Gissane angle was 120 degree. No clinically significant varus or valgus in any case (less then 5 degree).</p><p class="abstract"><strong>Conclusions:</strong> Treatment of intra-articular fractures of calcaneum is challenging but close reduction and internal fixation with 6.5 cannulated cancellous screws yields favorable outcome in majority of cases.</p>

Outcome following coronal fractures of the hamate

2009 ◽  
Vol 35 (2) ◽  
pp. 146-149 ◽  
Author(s):  
D. M. Wharton ◽  
J. A. Casaletto ◽  
R. Choa ◽  
D. J. Brown
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Case Series ◽  
Coronal Plane ◽  
Kirschner Wires ◽  
Good Outcome ◽  
Fracture Displacement ◽  
Injury Treatment ◽  
Anatomical Outcomes

This is a case series of 14 hamate body fractures, in the coronal plane, with 12 patients having an associated metacarpal injury. Treatment was either conservative or operative and was decided according to the degree of fracture displacement and presence of carpometacarpal subluxation. Patient follow-up was 14.8 months on average, using DASH scores and postoperative radiographs to determine functional and anatomical outcomes. Undisplaced fractures were treated in a cast with good outcome. Postoperative radiographs of patients treated with Kirschner wires for displaced fractures showed incomplete reduction and the outcomes were less favourable. Rigid internal fixation gave excellent radiographic results, although these did not correlate with functional outcome in all patients.

scholarly journals Closed Pan-talar Dislocation with Posterior Talar Process Fracture

2015 ◽  
Vol 1 (2) ◽  
pp. 32-35
Author(s):  
M Pramod Kumar ◽  
KM Gopinath ◽  
BN Roshan Kumar ◽  
GA Gautham Balaji
Keyword(s):  
Closed Reduction ◽  
Reduction Process ◽  
Road Accident ◽  
Review Of Literature ◽  
Open Injury ◽  
Accident Victim ◽  
Talar Fractures ◽  
The Right ◽  
Steinmann Pin

ABSTRACT Total dislocation of the talus has been reported as 0.06% of all dislocations and 2% of all talar fractures. It usually occurs from considerable violence. Total dislocation of the talus is frequently an open injury, or the skin may be tented over the dislocated talus leading to skin slough. Closed total dislocation of talus with posterior process injury is rare. The functional prognosis is poor due to osteonecrosis of the talus which develops in the majority of cases. Review of literature reported successful closed reduction in cases of closed pan-talar dislocation under anesthesia. However, there were few cases where there was difficulty in closed reduction. Operative technique has also been described in different reports of similar cases. Case report We present a case of pan-talar dislocation of the left talus in a 25-year-old road accident victim, with posterior talar process fracture. Reduction of dislocation was attempted in emergency department by external manipulation. Reduction process failed, and hence planned for reduction under anesthesia. It required a open reduction after a unsuccessful closed reduction attempt. The talus after reduction was found to be unstable hence, stabilized with trans-calcaneotalar Steinmann pin. At 1-year follow-up, the right ankle was pain free and stable. Motion was satisfactory. The talus after a follow-up of 1 year did not show any signs of subluxation or avascular necrosis. Conclusion The main obstacle to closed reduction appeared to be talus had button holed through dorsal fascia. The talus after reduction was found to be unstable hence stabilized with trans-calcaneotalar Steinmann pin. The management of the associated fracture will depend on many factors, particularly displacement of the fracture fragments. How to cite this article Kumar MP, Gopinath KM, Kumar BNR, Balaji GAG. Closed Pan-talar Dislocation with Posterior Talar Process Fracture. J Med Sci 2015;1(2):32-35.

Foot Macrodactyly Associated with Klippel-Trenaunay Syndrome

2021 ◽  
Vol 23 (5) ◽  
pp. 375-380
Author(s):  
Maurizio De Pellegrin ◽  
Désirée Moharamzadeh ◽  
Giacomo Placella ◽  
Vincenzo Salini
Keyword(s):  
Functional Outcome ◽  
Congenital Malformation ◽  
Patient’S Satisfaction ◽  
Length Difference ◽  
Custom Made ◽  
The Difference ◽  
The Right ◽  
Klippel Trenaunay Syndrome

Klippel-Trenaunay syndrome is a rare congenital malformation which may be associated with macrodactyly. The main problem is the need for custom-made shoes. We describe the case of a female newborn affected by Klippel-Trenaunay syndrome, with a larger and longer right foot; the difference increased progressively and, at 5 years of age, the right foot was 50% larger and 38% longer than the left one. Due to the progression of the deformity, reduction surgery was advised to reduce the foot’s width. Resection of the second ray and 2nd cuneiform was performed. The result was excellent and there were no complications during a 10-year follow-up period with a decrease of width and length difference to 10% and 4%, respectively, in comparison to the contralateral foot. There were no gait anomalies. Abnormal foot width and length represented the main problems and guided the surgical strategy. Second ray resection was effective, without complications and with a good long-term functional outcome. Possibility of wearing fashionable conventional shoes without insoles was achieved to the patient’s satisfaction

scholarly journals Navigation-Assisted Posterior Open Reduction and Internal Fixation in a C-CLAMP Fashion for an Isolated C1 Fracture

2020 ◽  
Author(s):  
Daniele Starnoni ◽  
Timo Ecker ◽  
Juan Barges-Coll
Keyword(s):  
Neck Pain ◽  
Internal Fixation ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Lateral Displacement ◽  
Lateral Mass ◽  
Transverse Ligament ◽  
Alar Ligament ◽  
The Right

AbstractC1 fractures with an intact transverse ligament are usually treated conservatively. Patients who present with a progressive diastasis of bone fragments and a progressive articular subluxation mainly attributed to progressive lengthening of the transverse ligament (TAL) fibers can be treated with a C1 “C-clamp” fusion.A 75-year-old male who sustained a motor vehicle accident was neurologically intact. A computed tomography (CT) imaging demonstrated a Jefferson's type-C1 fracture with a slight lateral displacement of the C1 left lateral mass (LM) and a rotatory subluxation on the right. MRI showed an intact TAL and demonstrated an isolated rupture of the left alar ligament. Conservative treatment was chosen. Radiographic follow-up showed, at 3 months, progressive lateral mass displacement, most likely due to elongation of the TAL fibers; this was also associated with a persistent mechanical neck pain. For this reason, we performed a posterior reduction and internal fixation in a C-clamp fashion by placement of C1 lateral mass screws and posterior compression sparing the C1–2 joint. Using navigation, a 3.5-mm screw was inserted into the LM bilaterally. The screw heads were then connected with a rod and compression was applied before tightening. Postoperative CT scan demonstrated a satisfying reduction and further imaging will be made during the follow-up. The patient had a considerable relief of neck pain. Simple lateral mass fixation with C-clamp technique is a reasonable option in case of isolated C1 fractures in patients who have failed conservative management while preserving the range of motion (ROM) at the atlanto–axial joint.The link to the video can be found at: https://youtu.be/x8bsVwzCt_M.

scholarly journals Rare Case of Servelle Martorelle Syndrome

2014 ◽  
Vol 10 (4) ◽  
pp. 91-94
Author(s):  
A Bhatnagar ◽  
M Deshpande
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Rare Case ◽  
Prompt Treatment ◽  
Congenital Vascular Malformation ◽  
History Of ◽  
The Right ◽  
Scapular Region

Servelle Martorelle Syndrome is a congenital vascular malformation associated with soft tissue hypertrophy and bony hypoplasia. This rarely involves whole of an extremity, with involvement of part of limbs reported in literature. We present a case of a twelve year boy who presented to the Department of Plastic Surgery SGPGIMS in April 2011 ,with history of circumferential soft tissue hypertrophy involving whole of left upper limb, scapular region and axilla since birth. The entire left upper limb length was lesser than the right upper limb. Hence this is a very rare case of Servelle Martorelle Syndrome having extensive limb involvement at a very young age. Highlighted is the role of conservative treatment and close follow-up to understand the natural history of the diseases, with prompt treatment of complications. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11011 Kathmandu Univ Med J 2012;10(4):91-94

scholarly journals Comparison of outcome of closed reduction and percutaneous pinning and, open reduction and internal fixation with k-wire in Gartland extension type III supracondylar fracture of distal humerus in pediatric population

2018 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Bhogendra Bahadur KC ◽  
Norman Lamichhane ◽  
Chandra Bahadur Mishra ◽  
Bharat Bahadur Khatri ◽  
Sabita Dhakal
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Open Reduction ◽  
Operative Procedure ◽  
Distal Humerus ◽  
Supracondylar Fracture ◽  
P Value ◽  
Percutaneous Pinning ◽  
Type Iii

Background: Supracondylar fracture of the distal humerus is one of the commonest fracture in pediatric age group. Though there is consensus of treating type III fracture operatively, no study has compared the outcome between Closed Reduction and Percutaneous Pinning (CRPP) and Open Reduction and Internal Fixation (ORIF) with k-wire in our setup. Materials and Methods: Retrospective comparison study was done on eighty seven cases of Type III supracondylar fracture of distal humerus underwent operative procedure. Fifty four (54) cases underwent CRPP and 33 cases were managed with ORIF with k-wire, and they were followed up till 6 months post-operatively. Results : The mean time for radiological union in patient who underwent CRPP was 4.37±0.94 weeks and that for the patient who underwent ORIF was 4.45±0.13 weeks, the difference of which was statistically insignificant (p-value >0.05). 83.3% of CRPP group and 78.8% in ORIF group had excellent functional outcome and only 3% in ORIF group had poor functional outcome. Conclusion: Though both the group don’t have significant advantage of functional outcome among each other CRPP with limited attempt should be preferred to ORIF with k-wire for the advantage of avoiding surgical scar and reducing surgery time and exposure to anaesthetic agents.

scholarly journals Nasal Cavity Paraganglioma: Literature Review and Discussion of a Rare Case

2017 ◽  
Vol 2 (2) ◽  
pp. 1-15 ◽  
Author(s):  
Juliana Maria de Almeida Vital ◽  
Terence Pires de Farias ◽  
Fernando Luiz Dias ◽  
Juliana Fernandes de Oliveira ◽  
José Gabriel Miranda da Paixão ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Literature Review ◽  
Nasal Cavity ◽  
Rare Case ◽  
Bleeding Risk ◽  
Preoperative Embolization ◽  
Long Period ◽  
Radiologic Investigation ◽  
The Right

Paragangliomas can be found from the skull base to the sacrum. Sinonasal paragangliomas are infrequent. A 16-year-old female reported spontaneous discrete bilateral epistaxis once a month beginning when she was 3 years of age. Computed tomography showed an expansive hypervascular mass occupying the right nasal cavity and nasopharynx. Sinonasal paragangliomas usually occur in middle-aged women. Radiologic investigation is essential for the diagnosis of sinonasal paragangliomas and evaluating extension of the lesion. Endoscopic and conventional approaches are effective, and preoperative embolization is paramount for reducing bleeding risk. Histopathological features cannot differentiate benign from malignant paragangliomas, and since metastasis may eventually occur, follow-up must be carried out for a long period of time.

scholarly journals Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hai Zhou ◽  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Distal Humerus ◽  
Cubitus Varus ◽  
Radiographic Outcomes ◽  
The Mean ◽  
Low Incidence ◽  
The Right ◽  
Successful Reduction

Abstract Background To evaluate the clinical and radiographic outcomes of ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus (TFDH). Methods Twenty-seven patients with displaced TFDH were successfully treated by the ultrasonography-guided closed reduction during January 2012 to December 2016 and were retrospectively reviewed. After the mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbows was also assessed at the latest follow-up. Results The successful rate of ultrasonography-guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 males and 7 females included in the study, and the mean age at treatment was 15.39 ± 3.10 months; seventeen fractures occurred in the right side elbow and ten in the left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P = 0.027) and range of motion (5°, P = 0.003) between the injured and uninjured elbow, respectively, whereas no difference in elbow extension was detected (P = 0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angles at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treatment was 7.4% at the last follow-up. Conclusion The ultrasonography-guided closed reduction in the treatment of displaced TFDH is an effective procedure; the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with a low incidence of postoperative cubitus varus.

A Rare Case of Reverse Oblique Ulnar Head and Neck Fracture

Hand Surgery ◽  
2015 ◽  
Vol 20 (03) ◽  
pp. 477-478 ◽  
Author(s):  
Li June Tay ◽  
Howard Cottam ◽  
Jonathan Compson
Keyword(s):  
Internal Fixation ◽  
Head And Neck ◽  
Rare Case ◽  
Fracture Pattern ◽  
Ulnar Head ◽  
Neck Fracture

Isolated distal ulnar head and neck fractures are rare. Undisplaced fractures are normally treated non-operatively. We report a case of a reverse oblique ulnar head and neck fracture, which despite the initial undisplaced configuration, was unstable and displaced over the subsequent weeks. We believe that, though this particular fracture pattern could have been treated in a cast, it requires careful follow up, especially early on, or to undergo early internal fixation.

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