ABSTRACT
Many anomalies of the ulnar nerve and artery within the wrist have been described. We report the first known case of the ulnar nerve and artery overlying the midportion of the transverse carpal canal, leaving Guyon's canal empty. This anomaly has considerable consequences for surgeons considering endoscopic carpal release, because the ulnar nerve and artery are at significant risk of injury.
Subject(s)
Compartment Syndromes/surgery , Radius Fractures/surgery , Ulnar Artery/abnormalities , Ulnar Nerve/abnormalities , Accidental Falls , Adult , Humans , Male , Radiography , Radius Fractures/diagnostic imaging , Ulnar Artery/anatomy & histology , Ulnar Nerve/anatomy & histologyABSTRACT
The results of free fat autotransplantation for the correction of first web space atrophy were reviewed for 25 patients who sustained war injuries resulting in ulnar nerve palsies. In anticipation of partial graft resorption, a 30% overcorrection of the first web space deformity was performed compared with the normal hand. Average follow-up was 5 years. All patients were satisfied with their cosmetic results. Whereas 21 patients (84%) demonstrated less bulk when compared to their normal side, 4 (16%) retained slight overcorrection of the web space. After 1 year of follow-up, there was no further evidence of graft resorption. There were no long-term complications. We conclude that free fat autotransplantation for the cosmetic correction of atrophy of the first web space is a safe and effective procedure. Although graft resorption was encountered, overcorrection provided patients with dramatic cosmetic improvement.
Subject(s)
Adipose Tissue/transplantation , Hand/surgery , Surgery, Plastic/methods , Adolescent , Adult , Atrophy , Follow-Up Studies , Humans , Male , Paralysis/complications , Transplantation, Autologous , Ulnar NerveABSTRACT
A case presentation of shoulder dislocation with ipsilateral humeral shaft fracture is presented along with a review of the literature regarding nine reported cases. In the current case, closed treatment of the humeral shaft fracture was undertaken with an unsuccessful attempt at closed reduction of the anterior shoulder dislocation, resulting in a radial nerve deficit. Successful treatment required open reduction of the humeral fracture with compression plating followed by closed reduction of the shoulder dislocation. We compare this treatment (with outcome) to other methods of treatment.
Subject(s)
Humeral Fractures/complications , Humeral Fractures/surgery , Nerve Compression Syndromes/etiology , Radial Nerve , Shoulder Dislocation/complications , Shoulder Dislocation/therapy , Adult , Fracture Fixation, Internal/methods , Humans , Humeral Fractures/diagnostic imaging , Male , Radiography , Range of Motion, Articular , Shoulder Dislocation/diagnostic imagingABSTRACT
Regional nerve block anesthesia has been less commonly used and less successful in surgery on the lower extremity than on the upper extremity because of anatomic difficulties associated with lower-extremity nerve blockade. The authors have developed a technique that combines two peripheral nerve blocks with a nerve stimulator. This has provided sufficient anesthesia for the performance of arthroscopic surgery on the knee. It simplifies earlier techniques by decreasing the discomfort associated with the procedure and increasing its accuracy. The technique has also facilitated rapid patient discharge from the same-day unit. No significant complications have been encountered.
Subject(s)
Arthroscopy/methods , Knee Joint , Nerve Block/methods , Humans , Knee Joint/innervation , Sciatic Nerve/anatomy & histologyABSTRACT
Three different distraction devices were investigated for the treatment of leg-length discrepancy caused by poliomyelitis in 144 patients. The average leg-length discrepancy was 5.2 cm and lengthening obtained 4.8 cm. For tibial leg-lengthening. Anderson's apparatus was used in 50 patients; an external fixator device (developed in Shafa Rehabilitation Hospital) was used in 40 patients; and the Wagner apparatus was used in 51 patients. The incidence of major complications was low in all 3 groups. The overall failure rate was 4%. There were no significant differences in the final results among the 3 groups. However, preference is given to the Wagner device because of its practical advantages.
