RESUMO
Ten children with supination deformity of the forearm due to obstetric paralysis were treated by pronation osteotomy of the radius and ulna. In two patients release of the interosseous membrane was added. The main achievement of the operation was an improved position of rest, which rendered a mechanical advantage for the basic function of the hand in grasping medium-sized objects. Preliminary results of three other patients who recently underwent rerouting of the biceps tendon concurrently or following the osteotomy are encouraging. One patient who had both procedures underwent rerouting of the biceps, which resulted in a gain of 135 degrees of active pronation.
Assuntos
Antebraço/anormalidades , Osteotomia/métodos , Rádio (Anatomia)/cirurgia , Supinação , Ulna/cirurgia , Criança , Pré-Escolar , Anormalidades Congênitas/diagnóstico por imagem , Anormalidades Congênitas/etiologia , Anormalidades Congênitas/cirurgia , Feminino , Antebraço/diagnóstico por imagem , Humanos , Masculino , Paralisia Obstétrica/complicações , Radiografia , Rádio (Anatomia)/diagnóstico por imagem , Ulna/diagnóstico por imagemRESUMO
On an average 5 years after arthrolysis for posttraumatic stiffness of 13 elbows, motion was good in eight, fair in three, and poor in two. The poor cases were reoperated on with unsatisfactory results.
Assuntos
Articulação do Cotovelo/cirurgia , Adolescente , Adulto , Criança , Articulação do Cotovelo/fisiopatologia , Feminino , Fraturas Ósseas/fisiopatologia , Humanos , Luxações Articulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento , Rotação , Lesões no CotoveloRESUMO
We report a series of 12 patients (19 hands) with clasped thumb who underwent surgical treatment. The series is divided into three groups. In the first group, the prominent pathological feature was hypoplasia of the extensor tendons which was treated by tendon transfer. The second group, the arthrogryphotic type, had contracture of the intrinsic muscles of the thumb and shortening of the skin; these needed mainly release operations. In only three hands out of nine was tendon transfer performed. The third group was defined by a combination of skeletal, muscular and tendon hypoplasia. Instability of the M.P. joint and adduction contracture of the first ray were found in all hands of this group. The adduction deformity was corrected by skin-plasty of the first web and the extension was improved by tendon transfers. Only one case needed stabilisation of the M.P. joint. The final results were related to the extent of the contractures and to the age of the patient when treatment started.
Assuntos
Contratura/cirurgia , Transferência Tendinosa , Polegar/anormalidades , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Métodos , Polegar/cirurgiaRESUMO
Five patients with calcinosis circumscripta were treated, four of them surgically. The indications for surgery included painful lumps, recurrent infection of the calcified masses, secreting ulcers, functional disorders, severe esthetic problems, and pressure on nerves. One patient showed permanent improvement; four gained temporary relief.
Assuntos
Calcinose/terapia , Dermatopatias/terapia , Adulto , Calcinose/diagnóstico por imagem , Calcinose/patologia , Calcinose/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Radiografia , Dermatopatias/diagnóstico por imagem , Dermatopatias/patologia , Dermatopatias/cirurgiaRESUMO
We present an uncommon case of large nonarticular chondromatosis of the hand. Some of the foci were found to cause compression of the median nerve, the ulnar artery, and also triggering of the third finger. The fourth lumbrical muscle was involved as well. A thorough, but not complete, excision with preservation of the median nerve and ulnar artery was performed. No recurrence was found during 5 years of follow-up.