1/31. Complex regional pain syndrome.Complex regional pain syndrome is a chronic pain syndrome that is often instigated by postoperative or post-traumatic events. The disease process can progress through three stages, the first of which tends to respond best to treatment. A review of the literature is presented, followed by a report of a patient who developed symptoms of complex regional pain syndrome following a water-skiing accident.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/31. Acute injuries of the distal radioulnar joint.Distal radioulnar joint injuries can occur in isolation or in association with distal radius fractures, Galeazzi fractures, Essex-Lopresti injuries, and both-bone forearm fractures. The authors have classified DRUJ/TFCC injuries into stable, partially unstable (subluxation), and unstable (dislocation) patterns based on the injured structures and clinical findings. Clinical findings and plain radiographs are usually sufficient to diagnose the lesion, but axial CT scans are pathognomonic. Diagnostic arthroscopy is the next test of choice to visualize stable and partially unstable lesions. Stable injuries of the DRUJ/TFCC unresponsive to conservative measures require arthroscopic debridement of the TFCC tear, along with ulnar shortening if there is ulnar-positive variance. Partially unstable injuries, on the other hand, are treated with direct arthroscopic or open repair of the TFCC tear, once again, along with ulnar shortening if ulnar-positive variance is present. Unstable injuries include simple and complex DRUJ dislocations. A simple DRUJ dislocation is easily reducible but may be stable or unstable. In complex dislocation, reduction is not possible because there is soft tissue interposition or a significant tear. After the associated injury is dealt with, treatment for complex injuries requires exploration of the DRUJ, extraction of the interposed tissue, repair of the soft tissues, and open reduction and internal fixation of the ulnar styloid fracture (if present and displaced). The early recognition and appropriate treatment of an acute DRUJ injury are critical to avoid progression to a chronic DRUJ disorder, the treatment of which is much more difficult and much less satisfying.- - - - - - - - - - ranking = 3keywords = complex (Clic here for more details about this article) |
3/31. Localized pigmented villonodular synovitis as a rare cause of chronic anterolateral ankle pain in an equestrienne.An unusual case of localized pigmented villonodular synovitis of the ankle as a rare cause of chronic anterolateral ankle pain in a 16-year-old horsewoman is presented. Intra-articular nodular forms of pigmented villonodular synovitis can only be diagnosed arthroscopically, macroscopic and microscopic aspects being typical. We believe that this lesion is more likely a reactive process secondary to repetitive microtrauma rather than a true neoplasm. Our patient presented with pathology in the left ankle, the side by which one mounts and dismounts a horse, forcing, in both activities, ankle dorsiflexion. Moreover, an English saddle was used by our patient, upon which one rides with the ankle maintained in dorsiflexion. At arthroscopy, the soft-tissue mass was seen to be entrapped in the joint between the talus and the tibia at dorsiflexion of the ankle. This had caused a slowly progressive enlargement of the lesion because of fibrosis resulting from reactive inflammation associated with this repetitive microtrauma, thus causing irritation, pain, and synovitis due to impingement.- - - - - - - - - - ranking = 0.20095124851367keywords = neoplasm (Clic here for more details about this article) |
4/31. rehabilitation of a quadruple amputee subsequent to electrical burns sustained whilst hang gliding.PURPOSE: The purpose of this article is to describe the management, difficulties encountered and level of independence achieved during the initial stage of a quadruple amputee's rehabilitation. METHOD: This is a case study of the rehabilitation of the first known person losing all four limbs due to electrocution whilst hang gliding. RESULTS: The patient became a successful upper limb prosthetic user and returned to work six hours a day. Full independence in activities of daily living was not achieved nor considered practical. Independent walking was accomplished in physiotherapy. however an electric wheelchair remains the only functional means of mobility. CONCLUSION: The rehabilitation is described in detail to assist those managing such a rare and complex case.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
5/31. Esophagopericardial fistula attributed to a barogenic rupture of the esophagus. Report of a case and review of the literature.In this case we describe a fatal condition of esophagopericardial fistula secondary to barogenic rupture of the esophagus. The review of the literature disclosed only one fatal case (reported in 1968) of esophagopericardial fistula attributed to barogenic rupture of the esophagus. early diagnosis and adequate treatment including pericardiocentesis along with intermittent drainage of the pericardium, full-course antibiotic therapy and a timely, well-planned surgical intervention will substantially improve the prognosis in this type of pathology. patients similar to our case should be treated with either surgical bipolar esophageal exclusion (conservative disconnection) or esophagectomy combined with large drainage of the pericardial and mediastinal spaces. This case report reinforces the complexity of the diagnosis, and perhaps the need for clinical awareness and the inclusion of this entity in a differential diagnosis.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
6/31. Exact moment of a gastrocnemius muscle strain captured on video.A left gastrocnemius strain was sustained by an elite cricket batsman while he was taking off to run. The exact moment of injury, captured by a camera in the middle stump, appears to correspond to the sudden appearance of a deficit in the gastrocnemius muscle, seen through the player's trousers. The strain occurred when the entire body weight was on the left foot with the centre of mass well in front of the leg. The injury probably occurred close to the time when the gastrocnemius complex was moving from an eccentric to an isometric phase.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
7/31. knee arthroplasty in post-traumatic arthritis.Post-traumatic arthritis of the knee can involve the tibiofemoral joint, patellofemoral joint, or both joints. In the tibiofemoral articulation, disabling injuries include articular crush, condylar split, shaft involvement, ligamentous injuries, or a combination. In the patella, similar injuries include articular crush, large or stellate displaced fractures, tendon disruption, or a combination. Cementless mobile-bearing knee arthroplasty principles and implants can provide satisfactory long-term results in patients with complex post-traumatic knee arthritis. Primary, resurfacing unicompartmental or total knee implants can be used for articular damage, whereas more complex modular or constrained implants and osteotomies are needed for angular or combined deformities. Bearing exchange revision may be needed for young, active patients within 20 years of their initial arthroplasty.- - - - - - - - - - ranking = 2keywords = complex (Clic here for more details about this article) |
8/31. Case series: IV regional anesthesia with ketorolac and lidocaine: is it effective for the management of complex regional pain syndrome 1 in children and adolescents?IMPLICATIONS: We report our experience with ketorolac/lidocaine IV regional anesthesia (Bier block) (IVRA) in two adolescents with complex regional pain syndrome 1. IVRA resulted in complete resolution of symptoms.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
9/31. Broadening the understanding of injury prevention: a case study.The death or injury of a loved one is tragic, especially if that injury could have been prevented. programs to reduce the incidence and severity of neurological trauma are traditionally driven by injury statistics, and the literature on neurological injury prevention often fails to capture individual experiences. Understanding community members' concerns about injury and safety efforts can move injury-prevention programs to a new level by assessing injury-related beliefs and refining interventions suited to the community. Pediatric injury is an especially complex problem that is influenced by developmental, environmental, sociopolitical, economic, geographic, parental, and child-related factors. Recognition of injury as a public health concern supports updating program development. The following case study, based on an in-depth parent interview, offers a unique perspective on pediatric injury. The audiotaped interview was transcribed verbatim following qualitative guidelines. Three main themes emerged from the analysis: (a) sources of parental concern for children's safety, (b) private versus public safety influences, and (c) behaviors making children vulnerable to injury. As this case study illustrates, parents may consider children susceptible to injury as a result of factors often not considered by injury prevention programs, for example, being "injury prone." parents also have access to resources, grandparents, for example, not typically considered when programs are marketed. The challenge is to identify how programs become an accepted public safety influence and to address real-life parental concerns.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
10/31. Imaging of fractures of the lateral process of the talus, a frequently missed diagnosis.Although if fractures of the lateral process of the talus (LPT) have been considered rare the widespread diffusion in snowboard practice has resulted in a dramatic increase in their frequency. If unrecognized they can result in secondary osteoarthritis of the ankle and/or talo-calcaneal joints and chronic pain and stiffness. Due to the complex anatomy of the region, these fractures are difficult to detect by standard radiographs. A high degree of suspicion is then necessary to diagnose them. Once suspected on the basis of physical examination and/or non concluding radiographs, computed tomography (CT) is the best modality to confirm the diagnosis and accurately appreciate the number of the fragments and their position which have therapeutic consequences (medical vs. surgical treatment). A better knowledge of these lesions seems necessary to the general radiologist to allow an early diagnosis in order to avoid chronic sequel. The purpose of this article is to report three additional cases of LPT fractures and discuss their pathogenesis, diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
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