PRIMARY SHORTENING OF THE FOREARM AND SAUVÉ-KAPANDJI FOR SEVERELY COMMINUTED FRACTURES OF THE DISTAL FOREARM IN ELDERLY PATIENTS: A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 399-402 ◽  
Author(s):  
Chul Ki Goorens ◽  
Ghislain Geurts ◽  
Jean F. Goubau
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Distal Radius ◽  
Distal Forearm ◽  
Volar Plating ◽  
Elderly Female ◽  
Ulnar Fracture ◽  
Comminuted Fractures

We report a case of an elderly female who sustained a severely comminuted distal radial and ulnar fracture, treated by shortening of the forearm, combined with a primary Sauvé-Kapandji procedure and volar plating of the distal radius.

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

2017 ◽  
Vol 43 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Daniel Martinez-Mendez ◽  
Alejandro Lizaur-Utrilla ◽  
Joaquin de-Juan-Herrero
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Surface ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Loss Of Reduction

We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures. Level of evidence: I

scholarly journals Erosive pustular dermatosis of the scalp successfully treated with oral prednisone and topical tacrolimus

2013 ◽  
Vol 88 (5) ◽  
pp. 796-798 ◽  
Author(s):  
Mariana Ribas Zahdi ◽  
Gabriela Bestani Seidel ◽  
Vanessa Cristina Soares ◽  
Camila Fernanda Novak Pinheiro de Freitas ◽  
Fabiane Andrade Mulinari-Brenner
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Female Patient ◽  
Oral Prednisone ◽  
Inflammatory Disorder ◽  
Parietal Region ◽  
Topical Tacrolimus ◽  
Elderly Female ◽  
Local Trauma ◽  
Progressive Enlargement

Erosive pustular dermatosis of the scalp is a rare inflammatory disorder of the scalp, affecting elderly patients after local trauma and leading to scarring or cicatricial alopecia. Case Report: An elderly female patient complained of painful pustules on the parietal region bilaterally with progressive enlargement and ulceration. A biopsy suggested erosive pustular dermatosis of the scalp and the patient was treated with prednisone 40 mg/day and 0.1% topical tacrolimus. After 10 weeks complete closure of the eroded areas was observed and a stable scarring alopecia developed.

scholarly journals Flexor Carpi Radialis Brevis Resection for Treatment of a Distal Radius Fracture: A Case Report

2021 ◽  
Author(s):  
Ryan L. Werntz ◽  
Andrew J. Hadeed ◽  
Giacomo L. Cappelleti ◽  
Jorge L. Orbay
Keyword(s):  
Case Report ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Daily Living ◽  
Fracture Site ◽  
Radius Fracture ◽  
Volar Plating ◽  
Muscle Belly ◽  
Flexor Carpi Radialis ◽  
Anomalous Muscle

AbstractThe flexor carpi radialis brevis (FCRB) is an anomalous muscle of the forearm that is only present in 3.5 to 8.6% of the population. In the case of volar plating of distal radius fractures, the FCRB inhibits proper fracture exposure and thus hinders proper reduction. A 78-year-old female presented with right distal radius fracture which necessitated internal fixation. Following mobilization and retraction of the flexor carpi radialis tendon, an anomalous muscle belly was identified as the FCRB. With continued difficulty in exposure and fracture site reduction, resection of the FCRB was performed. The patient was able to return to her activities of daily living without pain and demonstrated no appreciable functional deficit. This case report demonstrates a distal radius fracture where FCRB resection was used, resulting in no detrimental clinical outcomes.

scholarly journals Chorea Associated with Diabetic Striatopathy in an Elderly Female: A Case Report

2022 ◽  
Vol 40 (1) ◽  
pp. 65-67
Author(s):  
Md Rashedul Islam ◽  
Tanbin Rahman ◽  
Mohammad Sakhawat Hossen Khan
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Elderly Patients ◽  
The Elderly ◽  
Elderly Female ◽  
Rare Manifestation ◽  
Asian Descent ◽  
Hyperosmolar Hyperglycemic State

Diabetic striatopathy is a rare manifestation of diabetes mellitus. The disease commonly affects individuals of Asian descent, female, and the elderly. Patients usually present with hemiballism-hemichorea caused by hyperosmolar hyperglycemic state. Prompt recognition of a hyperglycemiainduced hemiballism-hemichorea is essential because the symptoms are reversible with correction of hyperglycemia. Diagnosis is possible based on blood reports and neuroimaging findings. J Bangladesh Coll Phys Surg 2022; 40: 65-67

scholarly journals Management of Unstable Distal Radius Fractures: A Survey of Hand Surgeons

2018 ◽  
Vol 08 (04) ◽  
pp. 335-343 ◽  
Author(s):  
Ara A. Salibian ◽  
Karl C. Bruckman ◽  
Jonathan M. Bekisz ◽  
Joshua Mirrer ◽  
Vishal D. Thanik ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Current Evidence ◽  
Evidence Based ◽  
Years Of Experience ◽  
Volar Plating ◽  
Radius Fractures ◽  
Fixed Angle ◽  
Operative Fixation

Background Length of immobilization after operative fixation of unstable distal radius fractures and management in elderly patients is an area of debate. Purpose The purpose of this study is to delineate common practices of fellowship-trained hand surgeons and how they compare with current evidence-based protocols. Methods Surveys were distributed to American Society for Surgery of the Hand members on preferred methods of fixation, postoperative immobilization, and variations in treatment of elderly patients with unstable distal radius fractures. Responses were analyzed in comparison to a literature review. Subgroups were compared with regard to training, practice type, and years in practice. Results Four-hundred eighty-five surveys were analyzed. Volar fixed-angle plating was the most common choice of fixation (84.7%). Patients are most often immobilized for 1 to 2 weeks (40.0%) with range of motion (ROM) therapy begun most commonly between 1 and 4 weeks (47.2%). The majority of surgeons do not treat fractures differently in patients more than 65 years old. Physicians with more than 20 years of experience were significantly more likely to begin wrist ROM sooner with volar plating versus other fixation techniques compared with physicians with less than 20 years of experience (40.7% vs. 34.2%, respectively). Also, physicians in academic-only practices were more likely to immobilize patients for a shorter time after volar plating compared with those in privademics. Conclusion Volar fixed-angle plating is the dominant fixation method for unstable distal radius fractures among fellowship-trained hand surgeons. Elderly patients are not treated more conservatively and rigid immobilization after operative fixation remains the treatment of choice despite current evidence-based protocols.

Entrapment of Extensor Pollicis Longus Tendon after Volar Plating of a Smith Type Pediatric Distal Forearm Fracture

2016 ◽  
Vol 21 (02) ◽  
pp. 253-256 ◽  
Author(s):  
Torsten Franz
Keyword(s):  
Distal Radius ◽  
Open Reduction ◽  
Forearm Fracture ◽  
Distal Forearm ◽  
Volar Plating ◽  
Distal Forearm Fracture ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Tendon Entrapment ◽  
Extensor Pollicis Longus Tendon

Extensor pollicis longus tendon entrapment is a rare complication of volarly displaced pediatric distal radius fractures. The few pediatric case reports have described tendon entrapment associated with conservative fracture treatment, or have been recognized at subsequent revision surgery after failure to achieve closed fracture reduction. A case of extensor pollicis longus tendon entrapment after open reduction and volar plate fixation of a pediatric distal forearm fracture is reported. This complication may also occur secondarily after open reduction and volar plating of the distal radius.

scholarly journals Absence of Flexor Carpi Radialis Identified During Volar Approach for Fixation of Distal Radius Fracture: A Case Report

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Dharmesh Patel ◽  
Rajeev Vohra ◽  
Avtar Singh
Keyword(s):  
Case Report ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Radius Fracture ◽  
Distal Forearm ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Volar Approach ◽  
Flexor Carpi Radialis

Introduction: Volar locking plate fixation of distal radius fractures is commonly performed because of its good clinical outcomes. The flexor carpi radialis (FCR) approach is one of the most popular approaches to dissecting the volar side of the distal radius because of its simplicity and safety. We describe an extremely rare case of an absent FCR identified during a volar approach for fixation of a distal radius fracture. Case Report: A 40-year-old male with comminuted distal radius fracture underwent surgery using the usual FCR approach and volar locking plate. We could not identify the absence of the FCR tendon preoperatively because of severe swelling of the distal forearm. At first, we wrongly identified the palmaris longus (PL) tendon as the FCR because it was the tendinous structure at the most radial location of the volar distal forearm. When we found the median nerve just radial to the PL tendon, we were then able to identify the anatomical abnormality in this case. To avoid iatrogenic neurovascular injuries, we changed the approach to the classic Henry’s approach. Conclusion: Although the FCR approach is commonly used for fixation of distal radius fractures because of its simplicity and safety, this is the first report of complete absence of the FCR during the commonly performed volar approach for fixation of a distal radius fracture, to our knowledge. Because the FCR is designated as a favorable landmark because of its superficially palpable location, strong and thick structure, and rare anatomical variations, there is the possibility of iatrogenic complications in cases of the absence of the FCR. We suggest that surgeons should have a detailed knowledge of the range of possible anomalies to complete the fixation of a distal radius fracture safely. Keywords: Flexor carpi radialis, Anomaly, Distal radius fracture, Volar approach, Flexor carpi radialis approach.

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