ABSTRACT
BACKGROUND: The distal radioulnar joint (DRUJ) is frequently involved in inflammatory diseases, both de-generative and notably traumatic, resulting in pain, wrist motion and strength loss, and severe functional impairment. DRUJ dysfunction can be highly incapacitating. The Sauve-Kapandji (SK) procedure can be indicated to address multiple etiologies of DRUJ dysfunction. CASE PRESENTATION: A 54-year-old woman presented with pain and difficulty moving the left wrist. X-ray imaging revealed the union of the distal radius with the plate still in there with subluxation of the distal radioulnar joint after surgery in 2005. Afterwards, she underwent the Sauve-Kapandji procedure. Follow-ups were done at periodic intervals, and wrist physiotherapy was instituted. We evaluated the range of motion and the VAS score as well. The patient had acceptable motion after four weeks of evaluation. DISCUSSION: The SK method has been advocated as a treatment for DRUJ derangement because, un-like the Darrach surgery, it preserves the ulnar head at the wrist. As with the Darrach opera-tion, postoperative instability of the proximal ulnar stump or radioulnar convergence may occur despite the favourable clinical prognosis. CONCLUSION: The Sauve-Kapandji procedure could treat wrist pain and deformity in DRUJ arthritis. It gives a good result in two weeks, four weeks, twelve weeks, and twenty after the procedure. The peak time of recovery is four weeks after the procedure.
ABSTRACT
BACKGROUND: Tourniquet use is prevalent in the orthopaedic field to achieve a bloodless operating field, but it poses risks of local and systemic complications, including lung injury. This study aims to examine the effect of tourniquet application on the hindlimb of a rat to its lung. MATERIALS AND METHODS: This is an experimental study with 48 male Wistar strain rats as samples. The rats were divided into group A (n = 24), killed directly after fracturization and tourniquet application, and group B (n = 24), killed 14 days post-procedure. Each group was divided into four: group A1/B1 (control group, three hours tourniquet application without reperfusion interval), A2/B2 (5-min reperfusion between 2-h and 1-h tourniquet application), A3/B3 (10-min reperfusion), and A4/B4 (15-min reperfusion). The lung tissue was examined histologically within ten high-power fields (400 × magnification). The severity of lung injury was measured using the Lung Injury Score (LIS). The oxidative damage was measured by determining the malondialdehyde (MDA) level, using the TBARS (thiobarbituric acid reactive substance assay) method. RESULTS: There was a dose-dependent decrease of LIS and MDA in groups A and B with increasing reperfusion interval. Fifteen-minute reperfusion interval caused a 54.55% and 45.33% LIS reduction in groups A and B, respectively. All pair-wise group comparisons (p < 0.05) showed significant differences. Five-minute interval reduced the MDA level by 16.56% and 30.13% in groups A and B, respectively. All possible pair-wise comparisons in both groups A and B also showed a significant difference (p < 0.05). CONCLUSIONS: Reperfusion interval is a possible clinical approach to mitigate the remote organ damage induced by limb ischemia-reperfusion injury.
ABSTRACT
Unicameral bone cyst (UBC) or simple bone cyst (SBC) is a benign cystic lesion commonly found in the humerus and femur that is mainly encountered during childhood. The currently available treatments for UBC of the hand commonly involve curettage, bone grafting, partial resection with or without grafting, multiple drilling, fracture immobilization and observation alone, and steroid injection. We herein report a case treated with total resection of the cyst and non-vascularized fibular graft in a 9-year-old right-handed female patient. The patient presented with a chief complaint of a large, fast growing lump over the first metacarpal of the left hand. Flexion of the first metacarpophalangeal joint was limited. After the diagnosis was established with plain radiographs followed by biopsy, the cyst was completely removed by resecting the shaft of the metacarpal bone with preservation of the epiphyseal plate. A bone graft was obtained from the fibula and inserted in the gap, distally attached to the epiphyseal plate of the metacarpal and fixed with a Kirshner wire proximally. Radiographs revealed solid union of the bone graft to the epiphyseal plate at the head after 7 weeks, with improving function of the thumb. SBC or UBC of the metacarpal bone is very rare. A more aggressive method, such as in the case presented herein, may be necessary to treat this condition.
