1/165. Transverse carpal ligament disruption associated with simultaneous fractures of the trapezium, trapezial ridge, and hook of hamate: a case report.Traumatic disruption of the transverse carpal ligament associated with fractures of the trapezial ridge and hook of hamate is a known entity. Only one report of a coronal fracture of the trapezium has been mentioned in the literature. We report a combination of these two injury patterns. diagnosis was aided by computed tomography. Treatment involved excision of the trapezial ridge and hook of hamate fragments with lag screw fixation of the trapezial body fracture.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/165. Wire-loop fixation of volar displaced osteochondral fractures of the distal radius.We describe the technique of wire-loop fixation to treat 4 young men with a unique variant of Melone's type 4 articular fracture of the volar lunate facet, characterized by a displaced rotated articular fragment supported by a limited amount of subchondral bone. This is an unusual injury that threatens the integrity of both the radiocarpal and distal radioulnar joints. It is the result of a compressive force to the wrist and may require trispiral computed tomography for delineation. Open reduction and internal fixation is recommended to maintain stability and articular congruity. The displaced volar-articular fragment, however, may be relatively small; therefore, direct manipulation could lead to soft tissue stripping and osteonecrosis. We have found the technique of wire-loop fixation to be a simple, reproducible, and effective alternative method of internal fixation for these difficult fractures. Malunion, nonunion, loss of fixation, tendon rupture, infection, arthrosis, or pain caused by hardware has not occurred. Use of this technique is not recommended in patients with osteoporotic bone.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
3/165. Simultaneous ipsilateral avulsion of the extensor carpi radialis longus and brevis tendon insertions: case report and review of the literature.Avulsion injuries of the radial wrist extensors are rare. We present a case of simultaneous ipsilateral avulsion of the extensor carpi radialis longus and brevis tendons resulting from a fall on an outstretched upper extremity. At the time of surgery the tendons were found retracted and not attached to avulsion fragments. Both tendons were repaired with the aid of suture anchors within 24 hours of the injury. After surgery, the patient regained full function with some loss of grip and wrist extension strength.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
4/165. Missed isolated volar dislocation of distal radio-ulnar joint: a case report.We report a case of isolated volar dislocation of the distal radio-ulnar joint in a young man who injured his left wrist while playing rugby. Initially, this injury was missed in the emergency department; however, a true lateral view radiograph later revealed volar dislocation of the distal radio-ulnar joint. The dislocation was subsequently reduced under general anesthesia with a good end result. The importance of thorough clinical examination and a true lateral view radiograph of the wrist is stressed.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
5/165. Volar dislocation of the capitate.In this report we describe a case of volar dislocation of the capitate associated with dislocation of the ulnar side of the carpometacarpal joint. Forced dorsiflexion of the wrist caused the rotation and volar displacement of the proximal portion of the capitate. Dislocation of the capitate is rare and may be seen in more complex injuries. An awareness of this type of injury may contribute to prompt diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
6/165. A study of post-traumatic shingles as a work related injury.BACKGROUND: After chicken pox, the herpes varicella-zoster (HVZ) virus may remain dormant in the dorsal root ganglion until later reactivation causes shingles, characterized by painful dysesthesias and cutaneous vesicular eruptions along a unilateral dermatome. Shingles as a work-related injury has not been previously addressed in the medical literature. Case history We present a 50-year old female hospital employee who, while working, sustained an acute, traumatic hyperextension injury to her right wrist, hand, and fingers. Although she initially responded to treatment for flexor tendinitis, she suddenly developed shingles in the right C5-C6 dermatomes. She was treated with famcyclovir and her skin lesions resolved, but post-herpetic neuralgia persisted. CONCLUSIONS: It was felt that her shingles was causally related to her occupational injury since trauma (previously reported to precipitate shingles) was her only risk factor and the timing and location of the lesions corresponded closely to the occupational injury. In addition to appropriately diagnosing and treating their patients, workers' compensation physicians often must determine if a particular condition was caused by the original work-related incident. Clinicians who treat trauma patients and injured workers should be aware of post-traumatic shingles and understand the causal relationship of this uncommon but clinically important phenomenon.- - - - - - - - - - ranking = 8keywords = injury (Clic here for more details about this article) |
7/165. A trans STT, trans capitate perilunate dislocation of the carpus. A case report.We report a case of carpal injury not previously described, associating three lesions of the carpus secondary to a hyperextension mechanism: fracture of the capitate, scapho-trapezio-trapezoid sprain and lunotriquetral ligament rupture. The patient was operated by percutaneous pinning after closed reduction. The capitate fracture was not fixed. At follow-up, the patient had no restriction of his everyday activities and was very satisfied.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
8/165. 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 = 2keywords = injury (Clic here for more details about this article) |
9/165. Isolated palmar dislocation of the distal radioulnar joint in a football player.Palmar dislocation of the distal radioulnar joint without concomitant fracture of the radius or ulna is an uncommon injury. We report one case in a college football player. This case was unusual in that open reduction was required 2 days after the injury because of an unsuccessful closed reduction.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
10/165. sports-specific concerns in the young athlete: basketball.basketball is played by millions of athletes throughout the world and is the most popular team sport in American high schools. basketball is the leading cause of sports-related injury in the united states. Acute basketball injuries most often involve the extremities, especially the hands, wrists, ankles, and knees. This article reviews the history, epidemiology, and common injury patterns that occur in this sport. We include several case reports to emphasize diagnostic dilemmas frequently encountered by emergency physicians.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
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