Blast injury of the finger caused by mobile battery explosion: A case report.

Lithium-ion batteries can cause several types of injuries upon explosion due to misfire. We report a case in which a mobile battery explosion resulted in high-pressure injection of metal debris into a small entry point on the skin creating puncture wounds on a patient's index finger, necessitating surgical intervention for massive debridement. A healthy 45-year-old, right-hand-dominant woman presented to the emergency department 4 h after a mobile battery had exploded in her left hand, causing burns to the left index finger. The battery had exploded due to misfire because the patient had accidentally hit it with a hammer. Radiographs of the index finger demonstrated foreign material extending from the fingertip to the ulnar proximal phalanx along the flexor tendon sheath, which was consistent with a high-pressure injection injury. She underwent semiurgent incision, irrigation, and debridement of the left index finger the day after the injury. The wound healed uneventfully within a month. At the 6-month follow-up, the palm-to-tip distance was 1 cm, and sensation at the tip was recovered. Compositional analysis of the debris revealed that the two major elements were aluminum and nickel (both less than 10%); lithium constituted less than 1% of the debris, a level deemed safe in humans. The protocol of semiurgent incision, irrigation, and debridement was safe and effective in the treatment of the injection injury caused by the mobile battery explosion.

Triple Fracture of the Intra-Articular Second Metacarpal Head, Intra-Articular Fourth Metacarpal Base, and Ulnar Styloid of An Ice Hockey Player: A Case Report.

We present a case of simultaneous ipsilateral fractures at the intra-articular second metacarpal head, intra-articular fourth metacarpal base, and ulnar styloid. These fractures were caused by the peculiar condition of a blow to the fist during an ice hockey game; the hand was struck while it was gripping a stick. The specific combination of these fractures has not been previously reported in the literature. In this incident, axial compression force was transmitted from the second and fourth metacarpal heads while skipping the third metacarpal head to the ulnar side of the wrist via the carpometacarpal joints and carpal bones. Because each fracture exhibited only slight displacement, we used conservative treatment with good outcomes.

Ultrastructural change of ligamentum flavum in galactosialidosis.

PURPOSE: Galactosialidosis is an autosomal recessive lysosomal storage disease caused by deficiency of both α-neuraminidase and ß-galactosidase due to a defect of the protective protein/cathepsin A. Three clinical subtypes have been described, depending on the age of onset and severity of the symptoms: the early infantile, late infantile and juvenile/adult form. We report an adult-type patient who underwent surgery for galactosialidosis-related spinal deformity, and showed a favorable course thereafter. METHODS: The patient was a 50-year-old male, and he consulted our hospital with pain of the bilateral anterior thigh. Lumbar radiograph showed applanation and horn-like deformity of the L2 vertebral body, which is characteristic of this disease, narrowing of the L1/2 intervertebral space, and topical kyphosis. Fenestration between the L1/2, decompression of the L2 nerve root, and posterolateral fusion involving the T12 to L3 were performed. RESULTS: Immediately after surgery, pain of the lower limbs disappeared. During the 2-year postoperative follow-up, bone assimilation was achieved, showing a favorable course. Histological examination of the ligamentum flavum (LF) collected during surgery showed that the elastic fibers were thin, whereas the collagen fibers were abundant and dense. The ligament cells were swollen, and there were a large number of vacuoles in the cytoplasm. CONCLUSION: This is the first report on spinal surgery for adult-type galactosialidosis and histological examination of spinal LF.

Phalanges deformity associated with neurofibromatosis-1: a case report.

We present a case of phalangeal deformity in a 17-year-old boy. The deformity was caused by a neurofibroma associated with neurofibromatosis type 1, affecting the left ring finger. The mass was surgically resected. Recurrence had not occurred at three-year follow-up.