ABSTRACT
All limb injuries should be examined with complete documentation of neurovascular assessment as they are often ignored in the busy emergency department setup. This may lead to delay in such diagnosis during the treatment of limb injuries at a follow-up in orthopaedic clinics. Early diagnosis can help orthopaedic team to investigate and start treatment which may help in the recovery of such neurovascular injuries. We report a case of missed neurovascular assessment in the emergency department on a patellar dislocation of a young person leading to foot drop and sensory numbness in the deep peroneal nerve distribution, which improved completely within three and a half months with conservative treatment. This is also the first reported case of foot drop in association with patellar dislocation.
Subject(s)
Knee Injuries/complications , Patella/injuries , Patellar Dislocation/complications , Peroneal Nerve/injuries , Peroneal Neuropathies/etiology , Diagnosis, Differential , Follow-Up Studies , Humans , Knee Injuries/diagnosis , Knee Injuries/therapy , Male , Patellar Dislocation/diagnosis , Patellar Dislocation/therapy , Peroneal Nerve/physiopathology , Peroneal Neuropathies/diagnosis , Peroneal Neuropathies/therapy , Physical Therapy Modalities , Recovery of Function , Young AdultABSTRACT
Carpal tunnel decompression is the most commonly performed procedure in hand surgery. This study was done to assess the effectiveness and acceptability by patients of open carpal tunnel release under local anaesthetic. We compare our results with both the literature and those of our previous study, after which were made alterations to improve the surgical and anaesthetic technique. These alterations included (a) injecting local anaesthetic with a dental syringe and a 27G needle in two stages along the proposed line of the incision and (b) omitting the use of a tourniquet, relying on the local anaesthetic with adrenaline to maintain a bloodless field during the procedure.
