Subject(s)
Tendons/abnormalities , Tendons/surgery , Thumb/injuries , Thumb/surgery , Female , HumansABSTRACT
This case reports another cause of delayed rupture of the extensor pollicis longus tendon in children following radial fracture management, due to attrition over a protruding nail end after elastic stable intramedullary nailing using the technique recommended to allow nail removal.
Subject(s)
Bone Nails/adverse effects , Fracture Fixation, Intramedullary/adverse effects , Radius Fractures/surgery , Tendon Injuries/etiology , Thumb/injuries , Titanium , Ulna Fractures/surgery , Child , Device Removal , Equipment Design , Female , Follow-Up Studies , Fracture Fixation, Intramedullary/instrumentation , Humans , Reoperation , Risk Factors , Tendon Injuries/surgery , Tendon Transfer , Thumb/surgeryABSTRACT
Upper extremity infection caused by aquatic pathogens on fish is a well recognized clinical entity. We report five consecutive cases of upper extremity infections, ranging from a simple localized reaction to a life-threatening systemic illness, which developed after handling common carp fish (Cyprinus carpio). In four cases, infection occurred following a penetrating injury by either the bones or the fin spines of the fish. Vibrio vulnificus was isolated from wound aspirates in four cases. Early broad-spectrum antibiotic therapy is mandatory. Deterioration in the clinical condition or a poor response to conservative treatment requires a meticulous surgical drainage and excision of both infected and necrotic tissues.
Subject(s)
Carps/microbiology , Hand Injuries/microbiology , Vibrio Infections/etiology , Vibrio/isolation & purification , Wound Infection/microbiology , Aged , Aged, 80 and over , Animals , Female , Hand Injuries/therapy , Humans , Male , Middle Aged , Vibrio Infections/therapy , Wound Infection/therapy , Wounds, Penetrating/microbiology , Wounds, Penetrating/therapyABSTRACT
Fractures of the base of the fifth metacarpal bone are relatively uncommon injuries. In contrast to similar fractures of the first metacarpal bone, various methods of treatment have been advocated. Some believe that cast immobilization or immediate unrestricted motion is a reliable method, while others recommend surgery and pinning or plate fixation. Fractures of the base of the fifth metacarpal bone are inherently unstable and inadequate reduction may result in pain, functional disability and osteoarthritic changes. We retrospectively reviewed 14 cases with intra-articular or extra-articular fractures of the base of the fifth metacarpal bone between the years 1991-1998. Patient treatment included closed reduction and percutaneous pinning using an image intensifier. Open reduction with multiple Kirschner pinning was implied in comminuted fractures and in cases when closed restoration of the articular surface was unfeasible. On follow-up examinations, all patients had good functional outcomes with no arthritic changes. We recommend reduction, restoration of the articular surface and pinning as the method of choice in the treatment of these fractures.
