Cases reported "Sprains and Strains"

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11/150. Tibiofibular syndesmosis and ossification. Case report: sequelae of ankle sprain in an adolescent football player.

    Heterotopic ossification development within the interosseous membrane of the ankle is an uncommon occurrence after routine ankle sprains. We present a case of a high school football player who sustained a syndesmosis ankle sprain. After 4 weeks, he continued to have pain, swelling, and range of motion restriction despite being treated with cryotherapy, NSAIDs, supportive taping, and progressive rehabilitation. The radiographs revealed a heterotopic ossification within the interosseous membrane of the distal extremity. The patient was initially treated conservatively and went on to have surgical excision with an excellent result. Symptomatic patients will require definitive surgery even without frank synostosis. ( info)

12/150. rotator cuff injuries.

    Different types of rotator cuff injuries frequently present to Accident and Emergency departments and minor injury units but can be difficult to differentiate clinically. This brief case study describes the examination and diagnosis of related shoulder injuries, specifically rotator cuff tears/disruption and calcifying supraspinatus tendinitis. The relevant anatomy and current therapies for these injuries is also discussed to enable the emergency nurse practitioner to have a greater understanding of the theory surrounding their diagnosis and treatments. ( info)

13/150. sports related hamstring strains--two cases with different etiologies and injury sites.

    Hamstring strains are common injuries in sports. knowledge about their etiology and localization is, however, limited. The two cases described here both had acute hamstring strains, but the etiologies were entirely different. The sprinter was injured when running at maximal speed, whereas the hamstring strain in the dancer occurred during slow stretching. Also the anatomical localizations of the injuries clearly differed. magnetic resonance imaging (MRI) revealed pathological changes in the distal semitendinosus muscle in the sprinter and the proximal tendon of the semimembranosus muscle in the dancer. Subjectively, both athletes severely underestimated the recovery time. These case observations suggest a possible link between etiology and localization of hamstring strains. ( info)

14/150. neck pain after minor neck trauma--is it always neck sprain?

    We report a patient who had headache and neck pain after whiplash injury and subsequently developed cerebellar infarction due to vertebral artery dissection. This patient's pain was out of proportion to his apparent injury and it was a clue to the final diagnosis. Gross motor examination for cord injury may not be adequate for patients with minor neck trauma. Detailed cranial nerve and cerebellar examination should be performed for detection of circulatory insufficiency. Discharge advice for patients should also include that of stroke or transient ischaemic attack. ( info)

15/150. Pure dislocation of the ankle: three case reports and literature review.

    ankle dislocation without fracture is an extremely rare injury. The results of treatment are reported for three patients who had a posteromedial open dislocation, a lateral open dislocation, and a posterior closed dislocation of the ankle. Management consisted of immediate reduction, debridement and capsular suture in the open dislocations, and immobilization with a short leg cast in all patients. At followup no patient had tibiotalar joint instability; a 10 degrees to 15 degrees loss in the range of dorsiflexion was observed in two patients. One patient reported paresthesia in the area of the superficial peroneal nerve. The three patients achieved good long-term functional and radiographic results. Predisposing factors that contribute to the pathogenesis of this lesion are internal malleolus hypoplasia, ligamentous laxity, weakness of the peroneal muscles, and previous ankle sprains. Among the three patients, medial malleolus hypoplasia was present in one patient and previous sprains were seen in the clinical history of another patient. ( info)

16/150. Fracture of the hook of the hamate, often misdiagnosed as "wrist sprain".

    A patient with fracture of the hook of the hamate is described, in whom the diagnosis was delayed for 1 year after the initial trauma. This delay in correct diagnosis is often seen, as routine anteroposterior and lateral roentgenograms of the wrist are unlikely to show the fracture. The trauma is often misinterpreted as a "wrist sprain." Nevertheless, with a careful trauma history and a detailed clinical examination and with minimal additional roentgenographic views, it should be possible to correctly diagnose the fracture. Relief of the disabling pain can then be offered by removal of the un-united fracture fragment. ( info)

17/150. An unusual case of vascular dysplasia related to knee arthroscopy.

    Acquired or traumatic arteriovenous fistula (AVF) following arthroscopic surgery is a rare complication. This case presents a patient who developed symptoms suggestive of an AVF following arthroscopic partial menisectomy and anterior cruciate ligament reconstruction. Evaluation and diagnostic procedures of choice as well as treatment alternatives are discussed herein. ( info)

18/150. Peroneus longus and brevis rupture in a collegiate athlete.

    Peroneal tendon injuries should be considered in the differential diagnosis of lateral ankle pain and instability. The spectrum of injury to the peroneal tendons includes tenosynovitis, tendinitis, subluxation, dislocation and tears. The mechanism, presentation and treatment of isolated peroneal brevis and longus injuries has been described in the literature. This is a case study of a rare combined peroneus brevis and longus injury in a young healthy collegiate athlete. ( info)

19/150. Pseudoaneurysm as a complication of ankle arthroscopy.

    We describe a case of pseudoaneurysm of the anterior tibial artery as a complication after arthroscopic ankle synovectomy, in which standard anterolateral and anteromedial portals were used. Pseudoaneurysm has been previously reported as a complication in ankle arthroscopy with the use of the anterocentral portal. Previously described anatomic variations of the tibial artery and its close relationship with the anterior ankle capsule may complicate arthroscopic surgery, especially when aggressive synovectomy is performed. Anterior tibial artery aneurysm is a rare complication of ankle arthroscopy, but its potential catastrophic sequelae must not be underestimated. ( info)

20/150. A case of superficial peroneal nerve injury during ankle arthroscopy.

    We report a case of superficial peroneal nerve (SPN) injury caused by ankle arthroscopy. A 20-year-old woman underwent arthroscopy on her right ankle because of chronic ankle pain after a sprain. After arthroscopy, the patient complained of pain on the dorsum of her right foot and felt a radiating pain from the anterolateral portal to the dorsomedial aspect of her foot. Eight months after arthroscopy, we found that a neuroma had developed on the intermediate dorsal cutaneous nerve, and performed neurolysis of the SPN. Her symptoms gradually decreased after surgery, and had disappeared by 45 months. To avoid such an injury of the SPN, the safest placement of the anterolateral portal is necessary and is, according to our previous anatomic study, 2 mm lateral to the peroneus tertius tendon. ( info)
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