Acute carpal tunnel syndrome.

Carpal tunnel syndrome is considered the most common of the chronic compressive neuropathies. Its cause is generally unknown. Acute carpal tunnel syndrome, which is much less common, is more often directly related to fractures and fracture-dislocations about the wrist, hemorrhagic conditions, and vascular disorders involving the wrist. Many rare and unusual causes have been described, including chronic conditions that may be associated with acute carpal tunnel syndrome, such as rheumatologic disorders and anomalous anatomy. In contrast to the more common chronic idiopathic form, the acute form of carpal tunnel syndrome requires urgent surgical intervention to avoid or diminish serious sequelae.

The pediatric triplane ankle fracture.

The pediatric triplane ankle fracture represents a unique spectrum of injury that does not fit neatly into the Salter-Harris classification of physeal injury. This fracture is particular to the pediatric population and often is termed a transitional injury. It is the result of the characteristic asymmetric closure of the distal tibial physis over a period of approximately 18 months. The triplane ankle fracture is a multiplanar injury with three classically described fracture fragments. It has several variations and represents 5% to 10% of pediatric intra-articular ankle injuries. The fracture typically presents in children aged 12 to 15 years; incidence is slightly higher in boys than in girls. Nondisplaced triplane fractures and extra-articular fractures can be managed with immobilization in a long leg cast. Displaced fractures are treated with open reduction and internal fixation performed through an anterolateral approach or an anteromedial approach. Intra-articular reduction to within 2 mm is required for optimal treatment of these unique pediatric ankle fractures.