1/38. Entrapment of the index flexor digitorum profundus tendon after fracture of both forearm bones in a child.Entrapment of the index FDP tendon in a radius fracture callus occurred after fracture of both forearm bones in a 4-year-old boy. Surgical release of the FDP tendon, three months after fracture, resulted in normal index finger motion. This clinical problem can be avoided by a detailed physical examination of children with forearm fractures, verifying full passive range-of-motion of the hand after cast immobilization. Prompt supervised active range-of-motion should be done to prevent adhesions at the fracture site.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/38. Migration of a K-wire from the distal radius to the heart.K-wires and Steinmann pins are used to provide internal fixation for fractures or osteotomies. In some instances, removal of the implant is planned and the implant is left long to facilitate its removal. In other instances, implant removal is not planned and the implant is cut off at the level of the bone. Migration of these implants to solid organs or body cavities has been reported. Extravascular migration may occur along tissue planes assisted by muscle motion. Large vessel penetration can occur and has been reported with subsequent migration of the implant to the heart. This case report documents the loosening of a K-wire used in the distal radius to supplement the fixation of a complex intra-articular fracture, migration of the implant along tissue planes, penetration into a peripheral vein, and continued migration of the implant to the heart. There are multiple reports documenting wandering bullets, venous catheter tips, and invasive monitoring devices in the extremities. This is only the second case report that the authors are aware of that confirms migration of an implant from the distal extremity to the heart.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
3/38. Postoperative management of functionally restrictive muscular adherence, a corollary to surgical tenolysis: a case report.After a surgical release of adhered nongliding tendons, early active mobilization is encouraged to prevent the reformation of unfavorable adhesions that would limit functional tendon excursion. These restricting adhesions can also occur in non-synovial regions, such as within the flexor mass in the forearm. A "myolysis," or release of muscle fibers from tethering adhesions, can be performed surgically to restore the muscle's gliding and lengthening properties. Postoperative management consists of treatment techniques that include low-load prolonged stress, differential tendon gliding, and active-resistive exercises, all of which are effective in restoring and maximizing a patient's active and passive range of motion to allow optimal mobility and performance. This case study demonstrates the successful management of a patient following a surgical myolysis, utilizing treatment techniques conceptually derived from postoperative tenolysis rehabilitation.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
4/38. Three epiphyseal fractures (distal radius and ulna and proximal radius) and a diaphyseal ulnar fracture in a seven-year-old child's forearm.SUMMARY: The authors report a rare case of fracture separations at both ends of the radius combined with an epiphyseal and diaphyseal fracture of the ipsilateral ulna. A seven-year-old girl fell one story and sustained a closed injury of her forearm. A closed reduction was unsuccessful, and an open reduction was performed with three of the four fractures being secured with Kirschner wires. These wires were removed one month later, and range-of-motion exercises were started. Thirty months after surgery, both forearms were equal in length, although the proximal radial epiphyseal line appeared partially closed. Joint motions, including forearm rotation, were normal. Radiologically, the ulnar diaphysis and the radial neck were posteriorly convex 20 degrees and 18 degrees, respectively.- - - - - - - - - - ranking = 0.66666666666667keywords = motion (Clic here for more details about this article) |
5/38. Secondary ulnar nerve palsy in adults after elbow trauma: a report of two cases.Secondary ulnar nerve palsy, an unusual condition in which the onset of ulnar nerve dysfunction occurs 1 to 3 months after elbow trauma, can be the cause of sudden deterioration of elbow function. Initially recognized in 1899, this condition has not been reported often. We describe 2 patients who had no subjective or objective evidence of ulnar nerve dysfunction after elbow trauma but had a sudden loss of motion, pain, and clinical and electrophysiologic evidence of ulnar nerve compression at the elbow 4 to 5 weeks after trauma. Marked improvement occurred after ulnar nerve subcutaneous transposition and contracture release.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
6/38. Combined Monteggia and Galeazzi fractures in a child: a case report and review of the literature.We present an unusual case in which a combination of Monteggia and Galeazzi fractures occurred in the same forearm. The patient was a 10-year-old male who climbed up the pole of a basketball net, caught hold of the net, then lost his grip, and fell onto his right hand. On physical examination, a complete paralysis of the radial ulnar and median nerves was recognized. x-rays showed an olecranon fracture and lateral dislocation of the radial head in the elbow joint, a dorsal dislocation of the distal bone fragments due to a fracture of the distal third of the radius, and a palmar dislocation of the distal end of the ulna at the wrist joint. The injuries were diagnosed as a combination of a Bado type III Monteggia fracture and a palmar-type Galeazzi fracture of the same arm. Manual reduction and immobilization in a plaster cast were performed. Three years after the injury, both the distal and proximal radioulnar joints were maintained in the reduction position. Range of motion was reduced minimally in extension at the patient's elbow, and there was complete recovery of all three nerves. A combination of Monteggia and Galeazzi fractures in the same arm has been reported in only two pediatric patients worldwide and in eight cases total when adult patients are included, indicating that this is an extremely rare trauma.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
7/38. Nonunion as a complication of an open reduction of a distal radial fracture in a healthy child: a case report.Nonunion of a distal radial fracture is rare in children. We report one referred case of a nonunion of the distal radius after an open reduction. The patient is a 10-year-old healthy male with a displaced bicortical fracture of the distal radius and an undisplaced ulnar fracture. This fracture was initially treated by the referring orthopedist with open reduction and single Kirschner wire fixation, as closed reduction was thought to be difficult to achieve. The patient was seen with a distal radius nonunion at 14 months following the initial procedure. A complete workup revealed a healthy child with no general or local pathologies. He was treated with open reduction of the nonunion site, correction of angular deformity, and plate fixation. This resulted in bony union with no limitation of motion. Potential reasons for the development of nonunion and suggestions to avoid this complication are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
8/38. Posttraumatic radioulnar synostosis treated with a free vascularized fat transplant and dynamic splint: a report of two cases.Two cases of posttraumatic radioulnar synostosis are presented. The patients were treated with excision of the cross-union and interposition of a free vascularized fat transplant. A newly devised pronation-supination dynamic splint was employed for 3 months postoperatively in both patients. After a 1-year postoperative follow-up, an increased range of motion was restored in both cases, and there was no evidence of recurrent synostosis formation in subsequent radiographs. We suggest that an interposed vascularized fat graft may be an ideal biologic barrier to fill the space created by cross-union excision.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
9/38. Internal fixation of radial neck fracture in a fracture dislocation of the elbow. A case report.A 27-year-old manual laborer presented with dislocation of the right elbow, complete separation of the radial head at the neck level, and avulsion of the coronoid process. Closed reduction of the elbow resulted in ulnohumeral instability. As an alternative to silastic implant, the radial head was reduced, internally fixed, and used as a spacer to restore elbow stability. The radial head fracture healed with no sequelae. At two years follow-up examination, the patient had a stable elbow with nearly full range of motion.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
10/38. Entrapment of the flexor digitorum superficials in the radius fracture site.Entrapment of the flexor tendon after fracture of both forearm bones is very rare. This report describes entrapment of the middle finger flexor digitorum superficialis (FDS) tendon alone in the radius fracture site. A 13-year-old boy fractured both forearms and had closed reduction and a long-arm cast. After the cast was removed he had full middle finger motion with the wrist flexed but was unable to extend the proximal interphalangeal or metacarpophalangeal joints and could extend only the distal interphalangeal joint of the middle finger with the wrist in the neutral or extension position. Entrapment of the middle finger FDS tendon was suspected. After surgical release of the FDS tendon at the fracture site the patient had good functional results.- - - - - - - - - - ranking = 0.33333333333333keywords = motion (Clic here for more details about this article) |
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