1/5. osteogenesis imperfecta: a case with hand deformities.In a 51-year-old woman with a history of fractures and dislocations after low intensity trauma in childhood, intensive blue sclera, short stature, and hearing loss, the diagnosis of osteogenesis imperfecta (OI) was suspected. She was referred to our clinic with hand deformities and left knee pain and stiffness. She had difficulty in walking and reported a history of immobilization for 6 months because of knee pain. She had bilateral flexion contracture of the elbows which occurred following dislocations of the elbows in childhood. She had Z deformity of the first phalanges, reducible swan-neck deformity of the third finger of the left and the second finger of the right hand, flexion contracture of the proximal interphalangeal joint of the fifth finger of the left hand, and syndactyly of the third and fourth fingers of the right hand. Flexion contractures of both knees were observed. Pes planus and short toes were the deformities of the feet. Acute phase reactants of the patient were normal. She had no history of arthritis or morning stiffness. Bone mineral density evaluated by dual-energy X-ray absorptiometry (DEXA) showed severe osteoporosis of the femur and lumbar vertebrae. She had radiographic evidence of healed fractures of the left fibula, the third metacarpal, and the fourth and fifth middle phalanges of the right hand. OI, affecting the type I collagen tissue of the sclera, skin, ligaments, and skeleton, presenting with ligament laxity resulting in subluxations and hand deformities may be misdiagnosed as hand deformities of rheumatoid arthritis.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
2/5. Hand splinting for infants in the intensive care and special care nurseries.Infants in intensive care nurseries often have hand deformities and hand dysfunction. The traditional therapeutic approaches to hand care used in the treatment of adults, young children, and older infants are not always adequate to prevent progressive deformity in preterm and neonatal infants. Medical instability, time constraints, lack of family participation in the therapeutic program, the complexity of the treatment program, and fear of harming the infant are considerations that may indicate the need for splinting as an adjunctive therapeutic intervention. A number of factors are particularly important in making splints for infants, including splint alignment and padding, strap attachment, and thermoplastic malleability.- - - - - - - - - - ranking = 0.5keywords = deformity (Clic here for more details about this article) |
3/5. An 11-year-old boy with swelling and progressive deformity of his finger.The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. Initial history, physical findings, and roentgenographic examinations are found on the first two pages. The final clinical and roentgenographic differential diagnoses are presented on the following pages.- - - - - - - - - - ranking = 2keywords = deformity (Clic here for more details about this article) |
4/5. Epiphysiodesis for bilateral irregular closure of the distal radial physis in a gymnast.wrist pain is a common complaint in gymnasts. Repetitive stress on the distal radial physis may lead to either gradual slipping of the epiphysis or growth disturbances. In some cases growth disturbances of the distal radial physis lead to triangulation of the distal radius and secondary ulnar overgrowth, and eventually a Madelung-like deformity. The present case report is the first to describe the outcome of epiphysiodesis of the distal radial and ulnar growth plates in a skeletally immature gymnast as a surgical treatment to prevent Madelung's deformity.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
5/5. Bilateral radial ray hypoplasia with multiple epiphyseal dysplasia.We describe a 5-4/12-year-old girl with the unique combination of bilateral radial ray hypoplasia and multiple epiphyseal dysplasia (MED). Radial ray hypoplasia was diagnosed at birth. MED was documented at age 4-3/12 years when she presented with leg pain and short stature and was found to have femoral anteversion and tibial torsion giving rise to severe genu valgum deformity and intoeing. She has no facial anomalies and is developmentally normal. family history is unremarkable and chromosomal analysis was normal. Investigation of mineral metabolism showed idiopathic hypercalciuria. Surgical lengthening of her severely hypoplastic left radius at age 19 months was successful. Bilateral femoral and tibial osteotomies at age 5-4/12 years corrected her lower limb deformities. This combination of two distinctive but rare skeletal abnormalities may represent a new syndrome.- - - - - - - - - - ranking = 0.5keywords = deformity (Clic here for more details about this article) |