RESUMO
Two women presented with similar symptoms of acute pain in the hand that was diagnosed as acute carpal tunnel syndrome caused by peritendinitis calcarea. Radiological examinations in both cases showed calcifications in the carpal tunnel. Both patients were operated on immediately and the median nerve was decompressed. Both were completely relieved of pain after operation and hand function returned to normal.
Assuntos
Calcinose/complicações , Síndrome do Túnel Carpal/etiologia , Tendinopatia/complicações , Doença Aguda , Adulto , Calcinose/diagnóstico por imagem , Calcinose/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia , Tendinopatia/diagnóstico por imagem , Tendinopatia/cirurgiaRESUMO
Sixteen patients were reexamined 2 to 5 years after surgical treatment of acute compartment syndrome in forearm fractures. High-energy trauma was the casual factor in 11 cases, in 5 of which there was an open fracture with skin defect. Fracture stabilization and fasciotomy of forearm and carpal compartments were performed as emergency procedures. The time for fracture healing averaged 8 weeks. Median nerve function was impaired in all the patients, and the ulnar nerve function in 8. The median nerve recovered completely in 15 patients, but ulnar nerve function was still impaired in 2 patients, 1 of whom had a nerve tissue defect. Eight patients could resume their occupation within a year.
Assuntos
Síndromes Compartimentais/cirurgia , Traumatismos do Antebraço/complicações , Fraturas Ósseas/complicações , Doença Aguda , Adulto , Idoso , Síndromes Compartimentais/etiologia , Fasciotomia , Feminino , Seguimentos , Traumatismos do Antebraço/fisiopatologia , Traumatismos do Antebraço/cirurgia , Humanos , Masculino , Nervo Mediano/lesões , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Nervo Ulnar/lesões , Nervo Ulnar/fisiopatologiaRESUMO
Flexor tendon synovitis caused by Mycobacterium terrae resulted in considerable permanent functional impairment of the hand in six patients. Initial symptoms were subtle and uncharacteristic. Cortisone injections aggravated the condition. Surgical treatment including synovectomy was combined with antimycobacterial chemotherapy. Early diagnosis obtained by culture of synovial biopsy material to detect mycobacteria may result in an improved outcome in chronic synovitis.
Assuntos
Mãos/microbiologia , Infecções por Mycobacterium/etiologia , Tenossinovite/microbiologia , Adulto , Idoso , Biópsia , Feminino , Mãos/patologia , Humanos , Pessoa de Meia-Idade , Mycobacterium/isolamento & purificação , Infecções por Mycobacterium/patologia , Infecções por Mycobacterium/terapia , Gravidez , Tenossinovite/patologia , Tenossinovite/terapiaRESUMO
The management of scaphoid pseudarthrosis is still controversial. The numerous methods that have been proposed can be roughly classified according to their aim - relief of pain or healing of bone. Following a review of the literature, and guided by personal experience with the Matti-Russe technique and McLaughlin internal fixation, the authors present recommendations for treatment according to clinical presentation of the condition.
Assuntos
Ossos do Carpo/cirurgia , Pseudoartrose/cirurgia , Ossos do Carpo/lesões , Fraturas não Consolidadas/fisiopatologia , Fraturas não Consolidadas/cirurgia , Humanos , Métodos , CicatrizaçãoRESUMO
Forty-three patients with scaphoid pseudarthrosis were surgically treated using the Matti-Russe technique. Twenty-seven patients were examined seven to 17 years after surgery (mean, 12 years). The interval between trauma and operation of the pseudarthrosis was 40 months. Before operation, all patients were unable to do any work because of pain. Fracture healing was observed in 22 cases (81%). Radiocarpal osteoarthrosis was present in 18 cases, compared with eight before operation. Radial deviation and extension was impaired, and pronation and supination was unaffected, compared with the healthy side. Twenty-four patients were satisfied with the operative result and none felt worse. All patients but one could return to work. The Matti-Russe method proved satisfactory in 24 of 43 patients available for long-term follow-up evaluation.
Assuntos
Ossos do Carpo/lesões , Pseudoartrose/cirurgia , Adulto , Transplante Ósseo , Moldes Cirúrgicos , Feminino , Seguimentos , Fraturas não Consolidadas/cirurgia , Humanos , Masculino , Fatores de Tempo , CicatrizaçãoRESUMO
17 patients were re-examined 13 to 19 years (mean 16 years) after operation for non-union of the scaphoid. A standardized method including styloidectomy and compression screw fixation according to McLaughlin was used. The mean interval between trauma and operation was 34 months. All patients were male and the mean age at surgery was 31 years. Bone union was obtained in 65% (11/17) and radio-carpal arthrosis was found in 83% (14/17) compared with 41% (7/17) at the time of operation. Impaired motion as well as marked decrease in strength was noted in comparison with the healthy side. 88% of the patients were satisfied with the result. All returned to and continued in their previous occupation. The McLaughlin method proved to be clinically beneficial in spite of a relatively high percentage of persistent non-unions.
Assuntos
Parafusos Ósseos , Ossos do Carpo/lesões , Fixação Interna de Fraturas/instrumentação , Fraturas não Consolidadas/cirurgia , Rádio (Anatomia)/cirurgia , Adulto , Fraturas não Consolidadas/reabilitação , Humanos , Masculino , CicatrizaçãoRESUMO
Locomotor output to the gastrocnemius muscle was studied after a transposition giving the muscle a dorsi-flexing action around the ankle. Except for a slight prolongation of the activity, the old extensor pattern was retained in all cats throughout the study. A peak of activity before termination was seen in one cat at higher walking speed. It is concluded that neither the spinal locomotor network controlling the gastrocnemius muscle nor the supraspinal circuits influencing the network exhibit a high degree of plasticity in response to locating the muscle in a position antagonistic to the original.
