The Ellis Jones Method of Treating Chronic Peroneal Subluxation: Revisited and Colorized After 87 Years.

Chronic cases of peroneal subluxation typically call for surgical treatment; however, research on current surgical procedures suggests nonuniformity. The purpose of this study is to remind surgeons of the efficacy of an older surgical method by using the case of a selected patient. In this study, the Ellis Jones procedure was performed on a patient who had been suffering from a chronic peroneal subluxation for 22 years, since, in this particular case, other approaches were deemed likely to be unsuccessful. The patient had hypertrophied, frayed, and swollen tendons, which were unsuitable to be rerouted, whereas the superior peroneal retinaculum was diminished and deepening procedures would not be able to establish sufficient volume for retaining the hypertrophied tendons. After the debridement and repair of the peroneal tendons, » of the lateral Achilles tendon was split, passed through a hole in the fibula, and sutured onto itself, and the subluxation path of the peroneal tendons was closed with an effective tendon barrier. The patient returned to work after 8 weeks of the surgery and was followed up for 4 years postoperatively. On selected patients, the Ellis Jones surgical method might therefore still be applied.Levels of Evidence: Level V.

Ulnar Nerve and Ulnar Artery Injury Caused by Comminuted Distal Radius Fracture.

INTRODUCTION: Distal radius fractures are one of the most frequent traumas encountered in daily orthopedic practice. With this case report, we would like to emphasize the significance of an unexpected associated ulnar nerve and artery injury with distal radius fracture to physicians. CASE REPORT: A 56-year-old male patient was evaluated in the emergency room after a motorcycle accident. The left wrist had a deformity and swelling, and about 3 × 1.5 cm of superficial skin abrasion was found in the volar surface of the wrist. It was noted that distal pulses were palpable, no neurological damage was found except hypoesthesia in the 5th finger. Radiologic examination revealed that the right shoulder was dislocated, and there was a displaced comminuted distal radius fracture in the left wrist with a non-displaced fracture of the ulnar styloid. The fracture was treated with open reduction and internal fixation using volar anatomic plate through the volar approach. After the surgery, pre-operative numbness did not resolve and opposing that expected; it increases with associated pain on the ulnar nerve innervated area within 30 days. The electromyographic analysis revealed severe partial ulnar nerve injury. The surgical exploration of the nerve was decided. The ulnar nerve was found to be trapped in scar tissue, and intimal injury and consequent thrombosis were observed at the ulnar artery. CONCLUSION: Distal radius fractures are well-known fractures among the orthopedic surgeons; median nerve compression with a fracture is also within the expectation of the physician. However, the injury of the ulnar nerve and artery is unexpected. With this case report, we would like to emphasize the awareness of the diagnosis and treatment of this kind of associated unexpected ulnar nerve and artery injuries.