11/192. Congenital synostosis of the fourth and fifth metacarpals treated by free bone grafting from the fusion site. Simultaneous correction of the alignment and the shortening of the deformed little finger in congenital synostosis of the fourth and fifth metacarpals was accomplished by insertion of a wedge-shaped bone block harvested from the fusion site following transverse osteotomy of the fifth metacarpal. Correction can be performed simply and successfully without morbidity of the donor site when this technique is applied to suitable patients. ( info) |
12/192. Congenital radioulnar synostosis in an active duty soldier: case report and literature review. Congenital radioulnar synostosis (CRS) is a developmental deformity that interferes with pronation and supination of the upper extremity. CRS often results in functional, cosmetic, and cultural limitations. The purpose of this paper is to present a patient with CRS who is currently functioning as a generator mechanic in the U.S. Army and to review the literature for current treatment options. We know of no other individual in the U.S. Army who is on active duty status with this deformity. ( info) |
13/192. Congenital synostosis between the scaphoid and the trapezium as a cause of tenosynovitis simulating de Quervain's disease. This report describes a case of congenital synostosis between the scaphoid and the trapezium resulting in tenosynovitis simulating de Quervain's disease, an association not previously reported. ( info) |
14/192. Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report. Tensor fascia lata is utilized in the management of complex soft-tissue injuries and defects, but has not been described in the literature in the use of tissue interposition with resection of talocalcaneal middle facet coalitions. This article is a case presentation of a resection of a middle facet coalition with interposition of an allograft of tensor fascia lata. At 14 months postoperative follow-up, range of motion of the subtalar joint was noted to be 20 degrees, and without pain or crepitus. There was no radiographic evidence of degenerative changes in Chopart's joint. The patient returned to all routine and sports activities without pain. He was satisfied with the outcome of the procedure. ( info) |
15/192. Herrmann multiple synostosis syndrome with neurological complications caused by spinal canal stenosis. A young man was found to have multiple synostosis syndrome type I after presenting with a neck injury causing a cervical spinal cord contusion. Neurological symptoms and signs suggested spinal cord compression. Magnetic resonance (MR) and computerized tomography (CT) imaging of the spine showed spinal canal stenosis with cord compression at C3-C6, a deformed spinal canal flattened in the anteroposterior dimension, vertebral fusions and deformed lateral processes of the vertebrae. He had a long broad nose with hypoplasia of the alae nasi, conductive hearing loss requiring hearing aids, muscular build, stiff spine, prominent acromia, pectus excavatum, ischial prominences, short fifth fingers, fusion at the proximal interphalangeal joints of the fifth fingers with indistinct overlying creases, and toe syndactyly. Spinal cord stenosis is a serious complication of multiple synostosis syndrome, that should be kept in mind in considering the risk of neck or back injury associated with certain sports or other activities. In both the multiple synostosis syndrome and the less severe proximal symphalangism deafness syndrome, mutations have been detected in the human homologue of the noggin gene on chromosome 17q21-q22. ( info) |
16/192. Non-osseous coalition of the medial cuneiform-first metatarsal joint: a case report. Isolated non-osseous tarsal coalition of the medial cuneiform-first metatarsal joint is rare. Resection of the coalition was performed in a 32-year-old patient, with excellent results. This procedure is an effective option for treatment of small lesions. ( info) |
17/192. Stress fracture of the talus following resection of a talocalcaneal coalition: a case report. We report the case of a 15-year-old male with bilateral talocalcaneal coalition. Following resection of the symptomatic coalition, the patient developed a painful ankle. MR imaging revealed a stress fracture of the talar body. In this report we discuss presentation and treatment of a symptomatic talocalcaneal coalition complicated by a later stress fracture as well as a review of the literature. ( info) |
18/192. Complete bony fusion of the mandible to the zygomatic complex and maxillary tuberosity: case report and review. Congenital craniofacial disorders represent approximately 20% of all birth defects. One of these disorders is syngnathia, of which only 24 cases have been reported since 1936. Twenty cases involved fusion of the alveolar processes of the maxilla and mandible. Only four are similar to the presented case, which includes bony fusion of the ascending ramus of the mandible to the zygomatic complex and the posterior part of the maxilla. This case report will present details from the 23rd week of gestation to 8 months of age when the infant underwent the first attempt to free the syngnathia. The literature is discussed and a causative mechanism and new classification are proposed. ( info) |
19/192. Craniofacial characteristics of klippel-feil syndrome in an eight year old female. A female eight year, one month old patient with klippel-feil syndrome has been introduced. General appearance of the patient was characterized by short neck with limited head movements, craniofacial asymmetry, low posterior hairline and a short stature. Cephalometric analysis revealed a Class I dentoskeletal pattern with an excessive mandibular plane angle and fused cervical vertebrae. Panoramic radiogram showed congenitally missing lower second premolars and right central incisor. ( info) |
20/192. Complete congenital bony syngnathia in a case of oromandibular limb hypogenesis syndrome. Congenital fusion of the maxilla and mandible (syngnathia) is rare and can present in a wide range of severity from single mucosal bands (synechiae) to complete bony fusion (synostosis). Congenital synostosis of the mandible and maxilla is even less common than synechiae, with only 19 cases reported in the literature. Most of them have presented as an incomplete, unilateral fusion. Only three of the reported cases showed more extensive but still incomplete, intermaxillary bony fusion. We present a case of complete bony fusion of the maxilla and mandible associated with a cleft palate, hypoglossia, micrognathia, unilateral choanal atresia, and limb abnormalities as a feature of oromandibular limb hypogenesis syndrome. Details of operative management are presented. ( info) |