Reviving the Grasp: A Case Report on a Pioneering Approach to Managing Crush Syndrome and Unveiling the Occult Compartment Syndrome.

A crush injury results directly from a crushing force, while crush syndrome, or traumatic rhabdomyolysis, manifests as systemic consequences stemming from the breakdown of muscle cells. Hand crush injuries present intricate challenges involving damage to multiple structures, tissue loss, and potential digit amputation, often caused by high-energy trauma. Each case demands a unique management plan, with the critical decision between limb salvage and amputation. Early intervention to restore vascularity is pivotal for preserving hand function. The complexity is heightened by the occult compartment syndrome, characterized by increased pressure causing neurovascular compromise without external signs. A patient with an insensate limb due to ipsilateral pan brachial plexus injury (BPI) adds an additional layer of complexity to the management journey, emphasizing the need for a multidisciplinary approach. This case is unique and underscores the importance of prioritizing reconstruction, identifying crush syndrome and the occult compartment syndrome, and employing a strategic, decisive approach that includes various surgical techniques for optimal outcomes in complex hand injuries.

Acrometastases: The nasty alter ego of fingertip infections.

Fingertip infections are commonly diagnosed in primary care. There is a serious condition, acrometastases, that is often mistaken for these infections. Acrometastases are defined as metastases located distal to the elbow or knee. We present a case of a malignant phyllodes tumour with acrometastases to the distal phalanx of the left middle finger that was misdiagnosed as a fingertip infection on 2 separate occasions, highlighting the need for vigilance regarding acrometastases.

A Case of Non-Union of Ulna Fracture Managed with Tibial Strut Cortico-Cancellous Bone Grafting in a Paediatric Patient.

Forearm fractures in children complicated with non-union are uncommon. Various methods have previously been reported to manage this condition. Well documented techniques would include iliac crest grafting, cancellous insert grafting, ulnar segment grafting, cortical tibial grafting, vascularized fibular grafting and bone transport by ring fixation. The authors present a case of a child with an atrophic non-union of the ulna who was successfully treated with a cortico-cancellous tibial strut bone graft.