Subject(s)
Hand/surgery , Plastic Surgery Procedures , Quadriplegia/rehabilitation , Adult , Humans , Male , Quadriplegia/classification , Tendon TransferABSTRACT
We assessed the precision of 2 widely used radiographic classification systems for patients with Kienböck's disease by repeated staging of 76 radiographic examinations by 3 independent observers. The intraobserver reproducibility was strong but the interobserver reliability was fair or moderate.
Subject(s)
Osteochondritis/diagnostic imaging , Humans , Observer Variation , Osteochondritis/classification , RadiographyABSTRACT
A case of total dorsal luxation of the lunate, combined with an avulsion of the radial styloid is recorded. Radiographs did not reveal any other signs of carpal collapse. We suggest that a concurrent hyperflexion, ulnar deviation and pronation of the wrist joint may reasonably be regarded as the etiology of this lesion, which was treated by delayed, open reduction and partial intracarpal arthrodesis. Similar cases have not been reported.
Subject(s)
Joint Dislocations/diagnostic imaging , Radius Fractures/diagnostic imaging , Wrist Injuries/diagnostic imaging , Adult , Bone Wires , Casts, Surgical , Fracture Fixation, Internal , Humans , Joint Dislocations/therapy , Male , Radiography , Radius Fractures/therapy , Wrist Injuries/therapyABSTRACT
A case of median nerve paralysis due to intra-articular entrapment occurring after closed reduction of a dislocation of the elbow joint is reported. In the present case, as in most other reported cases, diagnosis and treatment was delayed. If median nerve paralysis occurs following elbow dislocation and is accompanied by an unusual amount of pain, or if it occurs following reduction, entrapment should be suspected and the nerve explored without delay.
Subject(s)
Elbow Injuries , Joint Dislocations/therapy , Median Nerve , Nerve Compression Syndromes/etiology , Adolescent , Humans , Male , Nerve Compression Syndromes/complications , Paralysis/etiologyABSTRACT
Twenty-six patients with scaphoid nonunion were reexamined 22 to 39 years after Bentzon's soft tissue interposition arthroplasty was performed. All but one were satisfied, although three still had moderate pain. Mobility of the wrist was reduced by 20% to 25% and grip strength by 8%. The nonunion remained open and unstable in 16 of 25 radiologically reexamined cases. Carpal collapse, which had increased over time, was found in 15 cases, nine of which presented an unstable nonunion. Osteoarthritis had developed in five of 15 wrists with carpal collapse and in two of 10 without it. No significant osteoarthritis was found in any case earlier than 27 years after the operation. Thus, the risk of disability that is due to late degenerative changes of the wrist is small, even in the presence of carpal collapse.
Subject(s)
Arthroplasty/methods , Carpal Bones/injuries , Fractures, Ununited/surgery , Adolescent , Adult , Carpal Bones/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Osteoarthritis/etiology , Pseudarthrosis/surgery , Time FactorsABSTRACT
Tardy palsy of the posterior interosseous nerve after a malunited Monteggia fracture with an unreduced dislocation of the radial head is considered to be extremely rare. Four earlier cases were treated by excision of the radial head or by tendon transfers. Another two cases have been reported, both treated successfully by decompression of the nerve in the radial tunnel between the two heads of the supinator. This simple operation should be given a trial before tendon transfers are considered, even if the palsy has been of long duration.
Subject(s)
Joint Dislocations/complications , Monteggia's Fracture/complications , Nerve Compression Syndromes/surgery , Radial Nerve/surgery , Radius/injuries , Ulna Fractures/complications , Adult , Female , Humans , Middle Aged , Nerve Compression Syndromes/etiologySubject(s)
Finger Injuries/etiology , Accidents, Occupational , Adolescent , Adult , Humans , Male , Middle AgedABSTRACT
The open palm technique for Dupuytren's contracture in connection with a midlateral ulnar incision on the fifth finger was used in selected cases of severe contracture with skin shrinkage (13% of all cases during a 2 1/2 year period). Special attention was drawn to the "cornerflap" of the incision, but no vascular problems were found. All wounds closed spontaneously in 3--6 weeks. The finger release was as good as in other series of patients with similar severity of the disease. We propose this technique only in cases with severe contracture and in good physical and mental condition.
Subject(s)
Dupuytren Contracture/surgery , Female , Follow-Up Studies , Humans , Male , MethodsABSTRACT
Several methods of reduction and fixation of subcapital fractures of the four ulnar metacarpals have been suggested. All current methods deal with the volar angulation of the fracture; but in 133 consecutive cases angulation in this direction was of little clinical consequence. The more serious sequelae must be ascribed either to rotary deformity or to ulnar angulation at the fracture-site. These deformities were usually the result of bad bandaging technique and not due to the initial trauma. A new principle of conservative treatment is suggested.
