Irreducible Elbow Dislocation Associated with Hill-Sachs-like Lesion over the Capitellum

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

A cross-sectional study into the correlation of common household risk factors and allergic rhinitis in Taiwan's tropical environment

OBJECTIVE@#To discuss the effect of lesser-known potential risk factors, such as bedroom showers, on the prevalence of allergic rhinitis.@*METHOD@#A cross-sectional, population-based study was performed using both survey and fungal culturing in southern Taiwan. There were 998 participants enrolled in the survey, and 513 sets of fungal culture obtained. With score for allergic rhinitis (SFAR) more than 7, the patient was defined to have allergic rhinitis. Risks of allergic rhinitis were calculated as odds ratios for various predicted risk factors by logistic regression. Correlation between predicted risk factors and fungal level were examined with linear regression.@*RESULTS@#The adjusted odds ratio of frequently using bedroom shower to having allergic rhinitis was 1.572 (95% confidence interval: 1.090-2.265), and 0.962 for people with older age to have AR (95% confidence interval: 0.949-0.976). As to the 24-hour fungal level, the standardized coefficient was 0.254 for frequent use of bedroom shower, and 0.106 for window open hours.@*CONCLUSIONS@#Use of bedroom shower is a potential risk factor for allergic rhinitis development.

A cross-sectional study into the correlation of common household risk factors and allergic rhinitis in Taiwan's tropical environment

Objective To discuss the effect of lesser-known potential risk factors, such as bedroom showers, on the prevalence of allergic rhinitis. Method A cross-sectional, population-based study was performed using both survey and fungal culturing in southern Taiwan. There were 998 participants enrolled in the survey, and 513 sets of fungal culture obtained. With score for allergic rhinitis (SFAR) more than 7, the patient was defined to have allergic rhinitis. Risks of allergic rhinitis were calculated as odds ratios for various predicted risk factors by logistic regression. Correlation between predicted risk factors and fungal level were examined with linear regression. Results The adjusted odds ratio of frequently using bedroom shower to having allergic rhinitis was 1.572 (95% confidence interval: 1.090–2.265), and 0.962 for people with older age to have AR (95% confidence interval: 0.949–0.976). As to the 24-hour fungal level, the standardized coefficient was 0.254 for frequent use of bedroom shower, and 0.106 for window open hours. Conclusions Use of bedroom shower is a potential risk factor for allergic rhinitis development.