Isolated Avulsion Fracture of the Extensor Carpi Ulnaris: A Case Report and Review of Literature.

Avulsion fractures of the extensor carpi ulnaris (ECU) insertion are rare injuries that are poorly described in the literature. Several case reports detail closed ECU ruptures, however, only one previous case report describes an ECU avulsion fracture from the insertion on the fifth metacarpal base in the setting of multiple wrist and hand injuries. To our knowledge, we present the only case report of an isolated ECU avulsion fracture. In our case, a 35-year-old female presented with ulnar-sided wrist pain after forcefully impacting a steering wheel while radially deviating her wrist. She was diagnosed with an ECU avulsion fracture and elected to undergo open repair with a suture button technique. The patient recovered to nearly full strength and range of motion compared to her contralateral side by her eight-week visit. She returned back to work without restrictions after completing hand therapy.

Chronic locked anterior shoulder dislocation with impaction of the humeral head onto the coracoid: a case report.

The glenohumeral joint is one of the most commonly dislocated joints. When dislocated, the humeral head typically moves anteriorly and medially within the soft tissues adjacent to the glenoid. We present a case of a 64-year-old female who presented with a locked anterior shoulder dislocation with impaction of the humeral head onto the coracoid. To our knowledge, this is the first reported instance of humeral head impaction onto the coracoid causing the shoulder dislocation to be irreducible by closed means. Complications of this dislocation can include humeral head deformity, pseudoparalysis, brachial plexus injury, and significant pain.

A Case of Metastatic Prostate Cancer to the Distal Phalanx.

Metastatic bone tumors to the hand are extremely rare. We present a case of metastatic prostate cancer to the right middle finger distal phalanx. To our knowledge, there is one other case of metastatic prostate cancer to the hand in the literature. In our case, a 59-year-old man with a history of widely metastatic prostate cancer presented to urgent care and was diagnosed with a nail plate avulsion injury. He was referred to hand surgery and treated with amputation of the right middle finger distal phalanx. The pathology reported high-grade poorly differentiated adenocarcinoma with primary lesion from the prostate.

Spondylolisthesis with spondylolysis in a 17-month-old: a case report.

Spondylolysis is frequently seen in adolescents, typically at the L5 vertebral level. While there may be a congenital predisposition for spondylolysis, it has long been suggested that the defect results from a fatigue or stress fracture of the pars interarticularis. Spondylolisthesis may result from a bilateral spondylolytic defect and is frequently asymptomatic. There is a paucity of literature on infant and toddler spondylolysis, as the focus is primarily on school-aged children, typically those over ten years of age. This case report presents an incidentally discovered L5 spondylolysis with spondylolisthesis in a 17-month-old female. The patient presented to the emergency department with multiple facial abrasions and bruises from reportedly being struck by her 4-year-old sister. Her past medical history included a hospitalization four months prior for a distal radius buckle fracture from a thirty foot fall from a window. A routine non-accidental trauma work-up was performed, including a skeletal survey which demonstrated L5 bilateral pars defect with Myerding grade 2 spondylolisthesis. An MRI of the lumbar spine was performed, again demonstrating the L5 bilateral pars defect with position dependent reduction of the spondylolisthesis. The patient was seen back in the orthopedic office three months later which is her latest follow-up. Dynamic plain films of the lumbar spine were unchanged from previous imaging, without evidence of instability or slip progression. Further progression of her slip should warrant consideration for further treatment, whether it be cast immobilization or surgery.