1/11. Recurrent palmar dislocation of the distal radioulnar joint. A case report.Recurrent palmar dislocation of the distal radioulnar joint is not a common injury. We report one case in a 73-year-old female. This injury was incorrectly diagnosed at the first presentation because there has been no distinct deformity at the wrist and extension-flexion was normal. The need for proper physical examination and accurate radiographic positioning is stressed. Distal diaphysis resection combined with distal radioulnar arthrodesis (modified Sauve-Kapandji procedure) was the preferred method of treatment in an old patient. Two years after the injury, the patient was asymptomatic.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. Flexor carpi radialis tendon rupture following chronic wrist osteoarthritis: a case report.A patient is reported with a history of multiple tendon ruptures including biceps, flexor hallucis longus and achilles tendons. He presented with closed rupture of the flexor carpi radialis tendon following long standing tendonopathy and scapho-trapezio-trapezoid arthrosis. Non-operative treatment was elected because of low physical demands on the upper extremity. Early management of scapho-trapezio-trapezoid arthritis can prevent flexor carpi radialis tendon rupture.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. Hamate hook fracture in a 17-year-old golfer: importance of matching symptoms to clinical evidence.OBJECTIVE: To describe the importance of correlating symptoms with objective clinical findings and appropriate diagnostic imaging in a patient with traumatic wrist pain. CLINICAL FEATURES: A 17-year-old golfer had persistent left wrist pain of 4 months' duration that began while playing golf. Approximately 1 week after injury, he was diagnosed with a scaphoid fracture and was splinted. He reported that his pain did not decrease with splinting or with subsequent physical therapy, and on dismissal from orthopedic care he could not use the wrist well enough to return to golf. INTERVENTION AND OUTCOME: The patient was found to have marked point tenderness at the hamate. Although plain-film radiography was negative, secondary computed tomography of the wrist showed a fracture to the hook of the hamate. A referral was made to an orthopedic surgeon and surgical excision of the hook of the hamate was recommended because of the failure of union at the fracture site. CONCLUSION: This case shows the significance of follow-up diagnostic imaging in a patient who does not respond as expected. In addition, it stresses the importance of the doctor of chiropractic in the diagnostic process, although the patient may have been treated and released by another physician.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/11. Understanding and meeting the needs of farmers with amputations.BACKGROUND: Despite the hazardous nature of the occupation, farmers who sustain serious permanently disabling injuries return to the physical labor of production agriculture. It is estimated that amputations account for 11% of all major farm-related injuries. PURPOSE: This report describes the process of reentry to farm work of farmers across the united states who experienced above-the-wrist traumatic amputations. SAMPLE: Interviews with 16 farmers revealed the unique features of the work and world view of these workers who labor in the fields. FINDINGS: The occupational recovery process included questioning, analyzing, and "getting along." Prostheses and formal rehabilitation programs were viewed as minimally helpful. Suggestions and resources that may be helpful for the orthopaedic nurse to assist this high-risk work group are included.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/11. Obvious radiographic scapholunate dissociation: X-ray the other wrist.Obvious radiographic scapholunate dissociation seen on plain radiographs may seem to establish the diagnosis in a patient who presents with wrist pain. This diagnosis, however, is based on the assumption that scapholunate dissociation is caused only by trauma. In questioning this assumption, we present 6 cases of obvious radiographic scapholunate dissociation with similar radiographic findings in both wrists. These cases illustrate the pitfalls of using unilateral wrist radiographs to diagnose traumatic scapholunate dissociation. We chose these cases as representative of more than 75 bilateral cases we are studying. We describe medical histories, physical findings, radiographs, other diagnoses, treatments, and outcomes. These patients' injury histories and clinical presentations were not necessarily suggestive of wrist instability. All the patients were asymptomatic in the contralateral, uninjured wrist, despite similarity in radiographic findings. Traumatic scapholunate dissociation cannot be diagnosed with unilateral radiographs, no matter how obvious the findings or suggestive the history of trauma.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/11. An unusual rupture of the flexor carpi radialis tendon: a case report.We present the unusual case of a flexor carpi radialis tendon that ruptured after extended strenuous physical activity by a patient with paralysis of the opposite limb secondary to poliomyelitis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/11. Dorsal dislocation of the distal end of the ulna in a judo player.A 32-year-old policeman injured his left wrist while engaged in judo training. A distal radio-ulnar dislocation, ulna dorsal, was reduced under general anesthesia, but, as the distal radio-ulnar joint was unstable, a Liebolt's ligamentous reconstruction procedure and a partial excision of the triangular fibrocartilage complex were carried out. The patient could resume his job eight weeks after the operation, and light training after a further six months. The need for proper physical examination and accurate radiographic positioning is stressed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/11. Distal radio-ulnar joint dislocation, ulna volar in a female body builder.A 23-yr-old female body builder injured her right wrist while training. A correct diagnosis of pure distal radio-ulnar dislocation, ulnar volar, was made, and reduction was successfully carried out. After removal of plaster, the patient complained of wrist pain and clicking. Surgical exploration revealed a ruptured triangular fibro-cartilage complex, which was partially excised. The need for proper physical examination and accurate radiographic positioning is stressed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/11. Irreducible fracture-dislocation of the distal radioulnar joint secondary to entrapment of the extensor carpi ulnaris tendon.Entrapment of the extensor carpi ulnaris (ECU) tendon between the ulnar head and the sigmoid notch of the radius occurred in a 12-year-old boy. This led to an irreducible dorsal dislocation of the distal radioulnar joint (DRUJ). Irreducible DRUJ dislocations are uncommon, and the entrapped ECU has not been previously described in a skeletally immature patient. The physical and roentgenographic findings of a dorsally displaced ulna, a widened DRUJ, and the inability to obtain a closed reduction should alert the examiner to the need for exploration. A dorsal exposure is required to free the ECU and reconstruct the triangular fibrocartilage complex.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/11. The role of arthroscopy in the diagnosis and management of cartilaginous lesions of the wrist.Cartilaginous lesions in the wrist may be fairly common. diagnosis of these lesions remains difficult, and the determination of when to operate is not always clear. Careful attention to the history and physical examination can make this diagnosis easier, and appropriate surgical intervention can be useful in alleviating symptoms and returning the patients to normal activities. Although short-term results are promising, long-term studies are needed before the efficacy of arthroscopic management of chondral lesions of the wrist is known.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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