Presence of an intracompartmental septum detected by ultrasound is associated with the failure of ultrasound-guided steroid injection in de Quervain's syndrome.

UNLABELLED: The purpose of this study was to find clinical or ultrasound characteristics that might predict the failure of conservative treatment in de Quervain's syndrome. A total of 42 ultrasound-guided injections have been performed in 41 patients after clinical and ultrasound examination. Patients were immobilized for 3 weeks with a spica splint cast, and clinically evaluated at 3 and 6 weeks and by phone call at the end of the study. Ultrasound showed a septum between the tendons of the first comportment in 34% of the wrists. At last follow-up (mean 15.6 months after the injection) ten patients (24%) had undergone surgery. When comparing ultrasound and clinical characteristics of the operated and non-operated wrists, we found that patients with a high baseline visual analogue scale, with all positive clinical tests and with a persistent intracompartmental septum, had a significantly higher risk of failure following conservative treatment. LEVEL OF EVIDENCE: III.

[Dorsal radiocarpal joint dislocation for an 85-years-old woman]. / Luxation dorsale de l'articulation radiocarpienne chez une femme de 85ans.

The authors report the case of a dorsal, closed, radiocarpal dislocation with a small posterior marginal fracture of the radius, in an 85-year-old woman, without violent trauma (fall from her height). The dislocation was reduced by traction and the wrist immobilized in a plaster cast for 6 weeks. Six months after the accident, the patient had resumed her activities without pain with a diminished range of motion. This dislocation is exceptional at this age. In our case, the functional outcome was good after orthopaedic treatment.