1/238. Communicating defects of the triangular fibrocartilage complex without disruption of the triangular fibrocartilage: a report of two cases.Perforations or communicating defects of the triangular fibrocartilage complex have been more commonly identified after Palmer published his classification system (J hand Surg 1989;14A:594-606). To his variants of class 1B (traumatic) ulnar avulsion with or without distal ulnar fracture, a third category may be added: defects of the ulnar collateral ligament without any associated disruption of the triangular fibrocartilage. The ulnar collateral ligament can be defined as an ulnar capsular structure between the more discrete elements of the triangular fibrocartilage and the ulnar ligaments, with the defect or perforation being distal to the intact triangular fibrocartilage and exiting into the floor of the extensor carpi ulnaris sheath. We present 2 cases that illustrate the diagnosis, the use of both magnetic resonance imaging and arthrography to confirm the diagnosis, the associated dorsal ulnar cutaneous nerve pain distribution, and the open direct and retinacular flap repair.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
2/238. Transverse carpal ligament disruption associated with simultaneous fractures of the trapezium, trapezial ridge, and hook of hamate: a case report.Traumatic disruption of the transverse carpal ligament associated with fractures of the trapezial ridge and hook of hamate is a known entity. Only one report of a coronal fracture of the trapezium has been mentioned in the literature. We report a combination of these two injury patterns. Diagnosis was aided by computed tomography. Treatment involved excision of the trapezial ridge and hook of hamate fragments with lag screw fixation of the trapezial body fracture.- - - - - - - - - - ranking = 1397.6623805815keywords = injury (Clic here for more details about this article) |
3/238. Wire-loop fixation of volar displaced osteochondral fractures of the distal radius.We describe the technique of wire-loop fixation to treat 4 young men with a unique variant of Melone's type 4 articular fracture of the volar lunate facet, characterized by a displaced rotated articular fragment supported by a limited amount of subchondral bone. This is an unusual injury that threatens the integrity of both the radiocarpal and distal radioulnar joints. It is the result of a compressive force to the wrist and may require trispiral computed tomography for delineation. Open reduction and internal fixation is recommended to maintain stability and articular congruity. The displaced volar-articular fragment, however, may be relatively small; therefore, direct manipulation could lead to soft tissue stripping and osteonecrosis. We have found the technique of wire-loop fixation to be a simple, reproducible, and effective alternative method of internal fixation for these difficult fractures. Malunion, nonunion, loss of fixation, tendon rupture, infection, arthrosis, or pain caused by hardware has not occurred. Use of this technique is not recommended in patients with osteoporotic bone.- - - - - - - - - - ranking = 1397.6623805815keywords = injury (Clic here for more details about this article) |
4/238. The role of emergency free flaps for hand trauma.Primary closure of a wound with free flap requires minimizing the risk of infection in an effort to cover vital exposed structures. Careful patient selection, radical debridement of the wound, and an experienced microsurgical team are important for the routine application of this technique. Primary reconstruction of all injured structures is an extension of this technique that enables efficient management of severe upper extremity problems in a single setting.- - - - - - - - - - ranking = 4keywords = trauma (Clic here for more details about this article) |
5/238. Simultaneous ipsilateral avulsion of the extensor carpi radialis longus and brevis tendon insertions: case report and review of the literature.Avulsion injuries of the radial wrist extensors are rare. We present a case of simultaneous ipsilateral avulsion of the extensor carpi radialis longus and brevis tendons resulting from a fall on an outstretched upper extremity. At the time of surgery the tendons were found retracted and not attached to avulsion fragments. Both tendons were repaired with the aid of suture anchors within 24 hours of the injury. After surgery, the patient regained full function with some loss of grip and wrist extension strength.- - - - - - - - - - ranking = 1397.6623805815keywords = injury (Clic here for more details about this article) |
6/238. Missed isolated volar dislocation of distal radio-ulnar joint: a case report.We report a case of isolated volar dislocation of the distal radio-ulnar joint in a young man who injured his left wrist while playing rugby. Initially, this injury was missed in the emergency department; however, a true lateral view radiograph later revealed volar dislocation of the distal radio-ulnar joint. The dislocation was subsequently reduced under general anesthesia with a good end result. The importance of thorough clinical examination and a true lateral view radiograph of the wrist is stressed.- - - - - - - - - - ranking = 1397.6623805815keywords = injury (Clic here for more details about this article) |
7/238. wrist arthroscopy and dislocation of the radiocarpal joint without fracture.The authors report a rare case of dorsal dislocation of the radiocarpal joint without any bony lesion associated. The traumatic cause was a high energy motorbike accident. Fractures of the other limbs were associated. The authors report the clinical, radiological, and arthroscopic features. wrist arthroscopy showed a complete tear of all the extrinsic ligaments, a radial avulsion of the triangular fibrocartilage complex, and the integrity of the intracarpal ligaments, which guided the treatment. The dislocation was treated by closed reduction and radiocarpal pinning. The authors propose wrist arthroscopy in radiocarpal dislocation for diagnosis of soft tissue and cartilaginous lesions to guide the treatment (close or open).- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
8/238. Avulsion of both extensor carpi radialis tendons: a case report.Closed traumatic avulsion of both extensor carpi radialis tendons is reported in a young healthy patient. early diagnosis important because the tendons tend to retract and anatomic repositioning is more difficult to perform with passing time. Diagnostic markers are the inability to actively extend the wrist and the presence of dorsal bone fragments on the lateral radiograph of the wrist. We recommend fixation of the avulsed fragments to restore the length and strength of the wrist extensors.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
9/238. Volar dislocation of the capitate.In this report we describe a case of volar dislocation of the capitate associated with dislocation of the ulnar side of the carpometacarpal joint. Forced dorsiflexion of the wrist caused the rotation and volar displacement of the proximal portion of the capitate. Dislocation of the capitate is rare and may be seen in more complex injuries. An awareness of this type of injury may contribute to prompt diagnosis and treatment.- - - - - - - - - - ranking = 1397.6623805815keywords = injury (Clic here for more details about this article) |
10/238. A study of post-traumatic shingles as a work related injury.BACKGROUND: After chicken pox, the herpes varicella-zoster (HVZ) virus may remain dormant in the dorsal root ganglion until later reactivation causes shingles, characterized by painful dysesthesias and cutaneous vesicular eruptions along a unilateral dermatome. Shingles as a work-related injury has not been previously addressed in the medical literature. Case history We present a 50-year old female hospital employee who, while working, sustained an acute, traumatic hyperextension injury to her right wrist, hand, and fingers. Although she initially responded to treatment for flexor tendinitis, she suddenly developed shingles in the right C5-C6 dermatomes. She was treated with famcyclovir and her skin lesions resolved, but post-herpetic neuralgia persisted. CONCLUSIONS: It was felt that her shingles was causally related to her occupational injury since trauma (previously reported to precipitate shingles) was her only risk factor and the timing and location of the lesions corresponded closely to the occupational injury. In addition to appropriately diagnosing and treating their patients, workers' compensation physicians often must determine if a particular condition was caused by the original work-related incident. Clinicians who treat trauma patients and injured workers should be aware of post-traumatic shingles and understand the causal relationship of this uncommon but clinically important phenomenon.- - - - - - - - - - ranking = 11189.299044652keywords = injury, trauma (Clic here for more details about this article) |
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