A unique scaphocapitate fracture syndrome in an adolescent: a case report and a review of literature from the last decade.

Scaphocaptiate fracture syndrome is a unique condition and is challenging to manage. This rare fracture develops after high-energy wrist trauma. We reported a patient with a history of falling on an outstretched hand. A 15-year-old boy had scaphocapitate fracture syndrome, which included a displaced fracture of the capitate, an avulsion fracture at the distal tubercle of the scaphoid bone with an extension to the articular surface, and a perilunate fracture. A few months after open reduction and internal fixation were performed, the patient had a satisfying outcome. In addition, we have conducted a review of the literature regarding the mechanism of injury, diagnosis and outcome of published cases in correlation to our discussed case.

Patient Satisfaction After Conservative Treatment for Burn Scars in Saudi Arabia.

Background Burn injury is a typical physical injury that occurs as a result of a thermal, electrical, or chemical stimulus. Burn injuries to the skin cause complicated issues, including scar marks, psychological impacts, and affect quality of life (QOL). The preferred treatment technique for burn scars is controversial, as attempts to control the contraction rate remain a challenge, often leading to a poor outcome. Thus, treating burn scar patients is one of the biggest challenges in reconstructive surgery. In this study, we aimed to assess the patients' perception of pain and QOL after conservative treatment for burn scars in Saudi Arabia. Methodology This was a cross-sectional study conducted on Saudi Arabian patients who underwent conservative treatment for their burn scars. Information was obtained using a self-reported questionnaire which was distributed online using Google Forms on several social media platforms. MS Excel was used for data entry, while SPSS version 23 was used for data analysis. Results We collected 523 responses to our questionnaire. Among respondents, 70.2% were aged between 18-29 years and 62.1% were single. Most burns were on the upper limbs (74.2%), and 78% of burns were caused by a thermal stimulus (exposure to heat). In terms of emotional status, most respondents did not report significant emotional issues related to their burn scars with a mean emotional score of 12.5 out of 24. Overall, burn scars did not affect the respondents' ability to work or independence in performing daily work. Regarding the impact of the burns on the patients' appearance, 29.4% of respondents reported that their scars bothered them significantly, 64.2% reported that their appearance never bothered them, and 11.5% reported that they sometimes tried to forget how their appearance had been changed. Conclusions We found that conservative treatment of burn scars is effective in controlling the pain associated with the burns and can improve the patient's ability to perform work and other daily activities. However, it did not completely improve the psychological distress associated with scars. Further investigations are required to understand the impact of adherence to conservative treatment for burn scars on the psychological status of patients.

Persistent median artery in carpal tunnel syndrome for a patient with end stage renal disease after thrombosis of the left radiocephalic AV forearm loop graft: A case report.

INTRODUCTION & IMPORTANCE: Carpal tunnel syndrome (CTS) is the most common neuropathy in the world and is caused by compression of the median nerve. It has many known risk factors, including hemodialysis and a persistent median artery (PMA), which can be an incidental finding during carpal tunnel release (CTR). CASE PRESENTATION: A 65-year-old woman with end-stage renal disease (ESRD) on dialysis for seven months presented with typical signs and symptoms of carpal tunnel syndrome. Nerve conduction studies (NCS) displayed severe neuropathy. Upon carpal tunnel release (CTR) a rare superficial non-calcified persistent median artery critical to the circulation of the hand was found. The patient's symptoms resolved completely within four weeks of the operation. CLINICAL DISCUSSION: The PMA is a relatively common anomaly and could cause carpal tunnel syndrome by: directly pressing the median nerve, thrombosing, or in the setting of an aneurysm. Although usually found deep to the flexor retinaculum, the PMA could also be found superficially. It can be critical to the blood supply of the hand and should therefore be dealt with carefully. CONCLUSION: Surgeons should be aware of the possibility of finding a PMA when performing CTR. The PMA could be deep or superficial to the transverse carpal ligament. Where possible, the PMA should be preserved. Especially if its contributions to the blood supply of the hand are undetermined.