RESUMO
Introduction: Avulsion fractures of the extensor carpi ulnaris (ECU) from its insertion are rare injuries that are rarely reported in the literature. Most of the case reports detailed closed ruptures. We present avulsion fractures of the bilateral ECU from the base of the 5th metacarpal. Not much of the literature has been published in this regard. Case Report: A 33 year old male presented with pain around both wrists and hands following a fall from a bike. Following evaluation and radiological investigation, he was found to have a volar Barton fracture with an undisplaced avulsed 5th metacarpal base fracture on the right side and a displaced avulsed fracture of the left 5th metacarpal base. Internal fixation of the volar Barton fracture and mini open fixation of the left 5th metacarpal were done with a wire. The wires were removed at 6 weeks and rehabilitation started. At 3 months, the patient returned to activity with full wrist and hand function. Conclusion: Bilateral avulsion fractures of the ECU from its insertion are a rare injury. Displaced fractures might benefit from surgical intervention. Early diagnosis and treatment are essential for a good functional outcome.
RESUMO
Introduction: Talus fractures are relatively rare injuries. These injuries are very serious because they can compromise the motion of foot and ankle and result in severe disability. Fractures of talar neck and body constitutes about 40% of all talus fractures. These occur secondary to high energy trauma most commonly motor vehicle collisions or fall from height. Fractures involving the lateral process results due to ankle inversion and dorsiflexion. Majority of talar surface is covered by articular cartilage and its role in force transmission between leg and foot makes successful treatment of such injuries a mandatory prerequisite to regain function. We present an atypical case of talus fracture in which fracture plane extends from posterior aspect of lateral talar process involving the body in coronal plane. Not much of literature has been published in this regard. Case Report: A 28 year old male presented with pain in the left ankle following fall from a tree. Following the radiological investigations, in coronal plane fracture line extends from posterior aspect of lateral talar process into the body medially and anteriorly. Internal fixation of the fracture was done by an open approach and a strict rehabilitation protocol was followed. At three months the patient had satisfactory healing of fracture without any irregularity of the articular surface and ambulant pain free with full range of ankle movements. Conclusion: There are several choices to treat talar fractures. The ideal treatment should be customized as per the fracture morphology. Open reduction and internal fixation is one of the best options to restore the tibiotalar and subtalar joint congruency and to prevent post traumatic arthritis. Appropriate diagnosis and perioperative treatment is the key to success in talar fracture management.
