RESUMO
Extensor digitorum brevis manus (EDBM) is a rare variation of the extensor muscle of the dorsum of the hand, which is found incidentally during surgery or magnetic resonance imaging (MRI). EDBM arises from the wrist capsule inferior to the extensor retinaculum, which frequently goes into the ulna side of the basis of the proximal phalanx between the 2nd and 3rd fingers. The aim of this report is evaluate to investigate the symptomatic mass on the dorsum of the hand and wrist using an image study (MRI or ultrasonography) to confirm whether it is a tumor or EDBM. Surgical excision was chosen as a treatment.
Assuntos
Dedos , Mãos , Imageamento por Ressonância Magnética , Ulna , PunhoRESUMO
PURPOSE: To evaluate the effectiveness of posterior lumbar interbody fusion (PLIF) using a single cage and unilateral posterolateral fusion (PLF) with local bone, and to compare the clinical and radiological results with those of posterolateral lumbar fusion (PLF) with autologous iliac bone. MATERIALS AND METHODS: Fifty patients with single segment degenerative lumbar disease were treated with spinal fusion. Twenty six patients, who underwent PLIF with single cage and local bone without autologous iliac bone, were classfied as the "cage group". The other 24 patients, who underwent PLF using autologous iliac bone, were classified as the "PLF group". The fusion rate, lumbar lordortic angle, segmental angle, and intervertebral disc height were compared in the radiograph between the two groups. The clinical outcomes were evaluated by the Oswestry Disability Index. Statistical analysis was performed using a T-test and Chi-Square test. RESULTS: The bony fusion rate was 80.8% in the cage group and 83.3% in the PLF group. The intervertebral disc height was restored better in the cage group, but there was no statistical difference between the two groups (p=0.10). Average intraoperative blood loss was similar in the two groups (565 ml in the cage group vs 567 ml in the PLF group). The average operation time was longer in the cage group but the difference was not significant (146.7 min vs 134 min). In the PLF group, 22 patients experienced pain at the iliac graft donor site in the early postoperative period that persisted for more than 6 months in 5 patients. CONCLUSION: PLIF using a single cage and local bone for single segment degenerative lumbar disease produced satisfactory bony fusion with none of the donor site morbidity at the iliac bone.
Assuntos
Humanos , Disco Intervertebral , Período Pós-Operatório , Fusão Vertebral , Doadores de Tecidos , TransplantesRESUMO
Hip dislocation represents 2 to 5% of all joint dislocation whereas bilateral hip dislocation occurring as a result of trauma is rarely reported, accounting for 0.025 to 0.050% of hip dislocation cases. It is known that the simultaneous occurrence of traumatic dislocation with one anterior and the other posterior is even rarer. The case described showed a bilateral hip dislocation which occurred anteriorly at the right hip and posteriorly at the left with both femoral heads fractured as a result of a traffic accident. The right hip of the patient was dislocated in the anteroinferior direction of the right acetabulum, and the left hip in the posterosuperior direction of the left acetabulum. Both hip fractures were accompanied by fragments above the fovea centralis. The patient was treated by immediate reduction followed by skin traction. Partial weight bearing was performed after 6 weeks of bed rest and full weight bearing began on the 10th week. No complications such as avascular femoral head necrosis or traumatic arthritis occured.