ABSTRACT
This case report discusses a cervical psammomatous melanotic schwannoma - a rare form of peripheral nerve sheath tumour - which may be highly vascular and is often associated with the Carney complex. Significant intraneural bleeding, which was encountered intraoperatively, was controlled successfully with a gelatine-based thrombin haemostatic agent (Floseal®, Baxter International, Deerfield, IL, USA) without complication.
Subject(s)
Head and Neck Neoplasms/diagnosis , Neurilemmoma/diagnosis , Blood Loss, Surgical/prevention & control , Female , Gelatin Sponge, Absorbable/therapeutic use , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Hemostasis, Surgical/methods , Humans , Middle Aged , Neurilemmoma/pathology , Neurilemmoma/surgerySubject(s)
Bone Screws , Device Removal/instrumentation , Device Removal/methods , Bone Plates , Humans , Surgical InstrumentsABSTRACT
We present an unusual case of a closed perilunate dorsal-dislocation of the carpus, with an associated scaphoid fracture. In this extreme case, the proximal scaphoid pole was extruded volarly and proximally. After closed manipulation, the proximal pole of the scaphoid was further dislocated dorsally, a phenomenon not previously described in the literature. At open reduction this fragment was noted to have no soft tissue attachment but after reduction, distal radius bone graft and compression screw fixation the scaphoid went on to unite with a good functional result. This case highlights a rare but serious injury to the wrist with an unusual dislocation pattern not previously described. It demonstrates that early surgical intervention to fix such fractures with an avascular fragment can still achieve fracture union, despite the severity.
