1/79. Meralgia paresthetica secondary to limb length discrepancy: case report.Meralgia paresthetica consists of pain and dysthesia in the lateral thigh caused by entrapment of the lateral femoral cutaneous nerve (L2-L3) underneath the inguinal ligament. Abdominal distension, tight clothing, and hip hyperextension are all described causes of this condition. To our knowledge this has never been attributed to a limb length discrepancy. We present a 51-year-old man with a long-standing history of right sided meralgia paresthetica. history and physical and radiological examination were unrewarding except that his left leg was shorter than the right by 2 cm. Nerve conduction studies of the lateral femoral cutaneous nerve on the left had a normal latency and amplitude but were absent on the right. To prove the hpothesis that the limb length discrepancy was responsible for the condition, a single subject study was performed. The presence or absence of pain and dysesthesia in the right thigh was the observed behavior. Intervention consisted of wearing a 1.5-cm lift in the left or right shoe for 2 weeks each with an intervening 2-week lift-free period. Pain was recorded on a numeric scale and numbness as being present or absent. There was continuing pain without and with the lift in the right shoe but no pain or numbness with the lift in left shoe. It was concluded that the limb length discrepancy was responsible for the meralgia paresthetica. Pertinent literature and possible pathomechanics are discussed.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/79. Traumatic L5-S1 spondylolisthesis.We report a case of traumatic spondylolisthesis in a 31-year-old man struck by a steel I-beam. Although most reported traumatic spondylolisthesis cases are from low-energy trauma, this was a high-energy trauma case. The initial examination revealed no signs of cauda equina syndrome, and the patient's spinal injury was primarily capsuloligamentous. We present this rare case, with a review of pertinent literature and treatment mechanisms for traumatic spondylolisthesis.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
3/79. Transient peroneal nerve palsies from injuries placed in traction splints.Two patients thought to have distal femur fractures presented to the emergency department (ED) of a level 1 trauma center with traction splints applied to their lower extremities. Both patients had varying degrees of peroneal nerve palsies. Neither patient sustained a fracture, but both had a lateral collateral ligament injury and one an associated anterior cruciate ligament tear. One patient had a sensory and motor block, while the other had loss of sensation on the dorsum of his foot. After removal of the traction splint both regained peroneal nerve function within 6 hours. Although assessment of ligamentous knee injuries are not a priority in the trauma setting, clinicians should be aware of this possible complication in a patient with a lateral soft tissue injury to the knee who is placed in a traction splint that is not indicated for immobilization of this type of injury.- - - - - - - - - - ranking = 3keywords = ligament (Clic here for more details about this article) |
4/79. ligamentum flavum hematoma in the lumbar spine.A patient who presented with symptoms suggestive of nerve root compression secondary to an extradural mass was found to have a hematoma in the ligamentum flavum. Pathological examination of surgical specimens revealed an old hemorrhage, and hemosiderin deposits around organized granulation tissue within the ligamentum flavum. Vessels within the ligamentum flavum had, presumably, ruptured during minor trauma when the patient stood up.- - - - - - - - - - ranking = 3keywords = ligament (Clic here for more details about this article) |
5/79. Suprascapular nerve entrapment at the spinoglenoid notch in a professional baseball pitcher.Suprascapular nerve injuries at the spinoglenoid notch are uncommon. The true incidence of this lesion is unknown; however, it appears to be more common in athletes who participate in sports involving overhead activities. When a patient is being evaluated for posterior shoulder pain and infraspinatus muscle weakness, electrodiagnostic studies are an essential part of the evaluation. electromyography will identify an injury to the suprascapular nerve as well as assist in localizing the site of injury. In addition, imaging studies are also indicated to help exclude other diagnoses that can mimic a suprascapular nerve injury. The initial management should consist of cessation of the aggravating activity along with an organized shoulder rehabilitation program. If the patient fails to improve with 6 months to 1 year of nonoperative management, surgical exploration of the suprascapular nerve should be considered. Release of the spinoglenoid ligament with resultant suprascapular nerve decompression may result in relief of pain and a return of normal shoulder function.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
6/79. Bilateral median nerve compression at the level of Struthers' ligament. Case report.Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of the median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.- - - - - - - - - - ranking = 8keywords = ligament (Clic here for more details about this article) |
7/79. Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft.A case report of saphenous neuralgia following arthroscopically assisted anterior cruciate ligament reconstruction with hamstring tendons is presented. The patient complained of paresthesia in the anteromedial region of the lower leg and tenderness at the medial side of the knee without motor or reflex abnormalities. Because saphenous neuralgia can mimic disorders of the knee, peripheral vascular disease, and lumbar nerve root compression, diagnosis can be confirmed by anesthetic blockade. The patient underwent saphenous neurolysis. Six months after surgery, the patient had normal cutaneous sensation at the medial aspect of the lower leg and ankle and she no longer complained of any painful dysesthesia. To minimize the risk of damaging the saphenous nerve when harvesting hamstring tendons, the knee should be flexed and the hip external rotated.- - - - - - - - - - ranking = 5keywords = ligament (Clic here for more details about this article) |
8/79. Entrapment of the lingual nerve due to an ossified pterygospinous ligament.During a routine dissection course at the University of Muenster (germany) an unusual course of the lingual nerve was found with entrapment of the nerve between a widely ossified pterygospinous ligament and the medial pterygoid muscle. Furthermore, the nerve's mobility was restricted by a more distal anastomosis with the inferior alveolar nerve. Although incomplete or complete ossification of the pterygospinous ligament is not uncommon, the combination with a medial course of the lingual nerve has not been described before. Besides practical importance for surgeons and anesthetists, the entrapment of the lingual nerve may lead to lingual numbness and pain associated with speech impairment.- - - - - - - - - - ranking = 6keywords = ligament (Clic here for more details about this article) |
9/79. Intraspinal cervical degenerative cyst. Report of three cases.The authors report three cases of cervical degenerative cysts causing medullary or radiculomedullary compression. Anatomicopathological examination confirmed the fibrous nature of the cyst wall and the absence of a synovial layer. One of the cysts was embedded in the ligamentum flavum, whereas the other two were most lateral and adherent to the facet joint. The physiopathogenesis of these cysts is discussed.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
10/79. ligamentum flavum hematoma in the thoracic spine.We report a case of a hematoma of ligamentum flavum at T11-12 in a 66-year-old man who presented with progressive weakness of the right foot and numbness of both legs. Past history was negative and no precipitating episode of lower back sprain or trauma. The resected T11 and T12 laminas showed old hematoma with degenerative changes in the ligamentum flavum. hematoma occurring in the thoracic spine has never been reported previously.- - - - - - - - - - ranking = 2keywords = ligament (Clic here for more details about this article) |
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