RESUMO
PURPOSE: The purpose of this retrospective study was to investigate the frequency and appearance of median nerve neuropathy following perilunate dislocation injuries with respect to the preceding surgical decompression and the clinical outcome. PATIENTS AND METHODS: 32 patients were followed for a mean of 65 months after surgery for perilunate dislocation, including carpal tunnel release in 13 patients. 10 of 11 patients with clinical symptoms of median nerve affection at follow-up had additionally an electrophysiological examination. Median neuropathy was assumed if 2 or more parameters were pathologic. Patients with and without median neuropathy were compared. The DASH score, pain, wrist motion, grip strength and the Mayo wrist score were used to rate the outcome. RESULTS: In 6 patients, neuropathy of the median nerve persisted since injury in spite of carpal tunnel release in 5 of them. 3 patients showed secondary, delayed median nerve affection. Patients with median neuropathy had a worse result with regard to pain at rest, grip force, the DASH score, and the Mayo wrist score. The difference was statistically significant for pain with activities. CONCLUSION: Median neuropathy following perilunar dislocation injuries is frequent. It appears rather like a chronic neural lesion than a typical compression syndrome. A primary carpal tunnel release cannot always prevent persistent neural disorders.
Assuntos
Luxações Articulares/complicações , Luxações Articulares/cirurgia , Osso Semilunar/lesões , Osso Semilunar/cirurgia , Neuropatia Mediana/diagnóstico , Neuropatia Mediana/etiologia , Complicações Pós-Operatórias/etiologia , Adolescente , Adulto , Idoso , Criança , Descompressão Cirúrgica , Feminino , Seguimentos , Humanos , Luxações Articulares/diagnóstico , Masculino , Neuropatia Mediana/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Reoperação , Adulto JovemRESUMO
Allergic reactions occurring after tattooing, especially after the use of red tattoo ink ingredients are relatively rare. We report a painful skin reaction occurring 6 months after the tattoing of the right lower extremity in a 30-year-old female patient. Pathohistological and immunchemical results confirmed a pseudolymphoma. Only the tangential excision of the affected areas led to a sufficient healing process. Split thickness skin grafts were used for defect coverage. 2 years later, the patient was still pain free and the wounds had healed completely without any irritation.
