scholarly journals Treatment of a Subacute Locked Thumb Metacarpophalangeal Joint with Sesamoid Entrapment

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
John J. Carroll ◽  
William D. McClain ◽  
Julia A. V. Nuelle
Keyword(s):  
Occupational Therapy ◽  
Conservative Management ◽  
Closed Reduction ◽  
Open Reduction ◽  
Metacarpophalangeal Joint ◽  
Persistent Pain ◽  
Volar Plate ◽  
Case Presentation ◽  
Thumb Metacarpophalangeal Joint

Introduction. Locked thumb metacarpophalangeal (MCP) joints due to entrapped radial sesamoids are rare injuries that commonly require open reduction, especially when the injury is delayed in presentation. Case Presentation. We present a case of a 24-year-old female with a subacute thumb MCP joint subluxation due to an incarcerated radial sesamoid. She underwent successful closed reduction but had persistent pain and difficulty gripping large objects necessitating eventual open volar plate repair despite therapy. She was able to achieve full motion, with little pain and disability, after undergoing delayed volar plate repair. Discussion. Delayed volar plate repair may be considered for those patients who fail to improve with conservative management and occupational therapy after a successful closed reduction for thumb MCP joint subluxation due to an incarcerated radial sesamoid.

Locked Metacarpophalangeal Joint of the Little Finger in Extension Position due to the Incarceration of a Chronic Fracture Fragment: A Case Report

2018 ◽  
Vol 23 (04) ◽  
pp. 601-604 ◽  
Author(s):  
Shunsuke Asakawa ◽  
Takeshi Ogawa
Keyword(s):  
Case Report ◽  
Open Reduction ◽  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Volar Plate ◽  
Collateral Ligament ◽  
Fracture Fragment ◽  
Osteochondral Fracture ◽  
Unique Condition ◽  
Little Finger

We managed a case of locked metacarpophalangeal joint of the little finger in the extension position. Incarceration of a chronic osteochondral fracture fragment led to this unique condition. The fracture fragment partially adhered to the volar plate and ulnar collateral ligament on the joint side, which is supposed to have resulted in manually irreducible locking of the joint. We performed open reduction and achieved release of the locked joint by excising the fracture fragment.

scholarly journals Treatment of Locking of the Metacarpophalangeal Joint of the Thumb

2019 ◽  
Vol 12 (01) ◽  
pp. 62-66
Author(s):  
Yoshifumi Harada ◽  
Atsuyuki Inui ◽  
Yutaka Mifune ◽  
Hanako Nishimoto ◽  
Takeshi Kokubu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Successful Treatment ◽  
Open Reduction ◽  
Case Series ◽  
Rare Condition ◽  
Metacarpophalangeal Joint ◽  
The Other ◽  
Chronic Case ◽  
Metacarpal Head ◽  
Thumb Metacarpophalangeal Joint

AbstractLocking of the thumb metacarpophalangeal joint is a relatively rare condition. We report successful treatment in 11 cases of locking of the thumb. Ten patients were diagnosed at an average of 3.2 days (range: 0–21 days) from the injury onset, whereas one patient was diagnosed at 4 months from the injury. Seven of 11 cases underwent successful manual reduction, whereas the other four cases required surgical treatment. Among the surgically treated cases, all cases had a sharp prominent of the radial condyle of the metacarpal head. Therefore, this case series showed 1 chronic case and 4 of 10 cases with a nonround shape of metacarpal heads requiring open reduction.

scholarly journals Calcaneocuboid and Naviculocuneiform Dislocation: An Unusual Injury of the Midfoot

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Anne Kummer ◽  
Xavier Crevoisier ◽  
Antoine Eudier ◽  
Paul E. Di Cesare
Keyword(s):  
Clinical Outcome ◽  
Closed Reduction ◽  
Open Reduction ◽  
Crush Injury ◽  
Percutaneous Pinning ◽  
Anatomical Reduction ◽  
Case Presentation ◽  
Traumatic Injuries ◽  
Unusual Pattern ◽  
Unusual Injury

Introduction. Midfoot dislocations are rare traumatic injuries. The best known patterns involve the Lisfranc and Chopart joints, although some other types have been described. Dislocations that occur at the level of the naviculocuneiform and calcaneocuboid joints simultaneously represent a very rare configuration of dislocation. Case Presentation. A 34-year-old man sustained a crush injury to his left foot causing a complete dislocation through the naviculocuneiform and calcaneocuboid joints. Immediate closed reduction and percutaneous pinning were performed, followed by open reduction and stabilization of both joints two weeks later. Anatomical reduction was obtained, and the clinical outcome remained satisfactory 10 months after surgery. Discussion. Anatomical reduction is essential to obtain favorable outcomes in traumatic midfoot injuries. An unusual pattern of midfoot dislocation can be treated according to the same principles as those for classical Lisfranc or Chopart injuries.

scholarly journals In Dogs With Traumatic Elbow Luxation, Does Treatment Using Closed Reduction and Conservative Management Have a Better Prognosis Than Those Treated With Open Reduction and Surgery?

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Barnaby Luke Dean
Keyword(s):  
Conservative Management ◽  
Closed Reduction ◽  
Open Reduction ◽  
Surgical Intervention ◽  
Treatment Method ◽  
Bottom Line ◽  
Elbow Luxation ◽  
Long Term Prognosis

<p><strong>Clinical bottom line:</strong></p><p>In the available literature, cases of traumatic elbow luxation managed by closed reduction appear to have a better long-term prognosis  than cases managed by open reduction and surgical stabilisation. That being said, it is important to consider that the poorer outcome in surgically-managed cases could reflect the severity or chronicity of the injury rather than the treatment method itself, or indeed could reflect a combination of the two.</p><p>Closed reduction of traumatic canine elbow luxation should be attempted in all cases as soon as possible as this is associated with a better prognosis. Should closed reduction not be possible, or should the elbow remain unstable or reluxate following closed reduction, surgical intervention is indicated. Joint immobilisation is recommended with either a Robert Jones bandage or splinted bandage for two-to-four weeks following treatment.</p>

Osteoarthritis of the hand

2018 ◽  
Author(s):  
Philippa Rust ◽  
Meg Birks ◽  
David Warwick
Keyword(s):  
Surgical Treatment ◽  
Natural History ◽  
Occupational Therapy ◽  
Joint Replacement ◽  
Surgical Intervention ◽  
Metacarpophalangeal Joint ◽  
Excision Arthroplasty ◽  
And Function ◽  
Thumb Metacarpophalangeal Joint

The small joints of the hand are vulnerable to osteoarthritis, usually spontaneous but sometimes following trauma or infection. Nodular arthritis and arthritis in the thumb CMC has a benign natural history and most might get a little stiff but pain usually settles and function is good. Precipitous surgical intervention is inappropriate; time, reassurance, occupational therapy, splints, analgesics, and occasionally steroids should always be tried. The choice of surgical treatment depends on the functional needs of the joint—the little and ring fingers need flexibility for grip whereas the index and thumb require stability for pinch. Options include fusion (e.g. thumb metacarpophalangeal joint), excision arthroplasty (e.g. thumb base) and joint replacement (e.g. finger metacarpophalangeal joint)

Volar Dislocation of the Metacarpophalangeal Joint of the Thumb—A Case Report

1986 ◽  
Vol 11 (1) ◽  
pp. 51-54
Author(s):  
M. MIYAMOTO ◽  
T. HIRAYAMA ◽  
M. UCHIDA
Keyword(s):  
Case Report ◽  
Closed Reduction ◽  
Open Reduction ◽  
Metacarpophalangeal Joint ◽  
Collateral Ligament ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Extensor Pollicis Brevis ◽  
Extensor Pollicis Longus Tendon

A patient with a volar dislocation of the metacarpophalangeal joint of the thumb is reported in which closed reduction proved impossible because of the interposition of the dorsal capsule, extensor pollicis longus tendon and extensor pollicis brevis tendon in the metacarpophalangeal joint. The collateral ligament was also ruptured. Therefore open reduction is recommended for similar cases.

scholarly journals Dislocation of the metacarpophalangeal joint of the index finger requiring open reduction due to the presence of an intra-articular sesamoid bone

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110211
Author(s):  
Elizabeth S O’Neill ◽  
Mia M Qin ◽  
Kevin J Chen ◽  
Marek A Hansdorfer ◽  
Matthew E Doscher
Keyword(s):  
Open Reduction ◽  
Surgical Intervention ◽  
Index Finger ◽  
Metacarpophalangeal Joint ◽  
Volar Plate ◽  
Digital Nerve ◽  
Sesamoid Bone ◽  
Joint Dislocation ◽  
Patient Reported ◽  
Definitive Management

Complex dislocation of the metacarpophalangeal joint of the index finger is rare and often requires surgical intervention. Here, we present a case of an index finger metacarpophalangeal joint dislocation requiring open reduction due to obstruction by a displaced volar plate and the intra-articular entrapment of a sesamoid bone. Surgical approach was performed dorsally, allowing easy visualization of the volar plate and sesamoid bone as well as minimizing risk to the radial digital nerve to the index finger. Postoperatively, the patient reported good functional return despite the delay in definitive management.

Open Reduction for Dorsal Dislocation of Second to Fifth Carpometacarpal Joints: A Case Report

2020 ◽  
Author(s):  
Hiroo Kimura ◽  
Akira Toga ◽  
Taku Suzuki ◽  
Takuji Iwamoto
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Delayed Diagnosis ◽  
Preoperative Assessment ◽  
Radiographic Examination ◽  
Clinical Images ◽  
Left Hand ◽  
Carpometacarpal Joints ◽  
Joint Deformity ◽  
Poor Outcomes

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

Survival of both twins in a pregnancy complicated by pre-viable cord prolapse at 21 weeks of gestation

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Abdullah Alnoman ◽  
Ghazi Alsarraj ◽  
Richard Brown
Keyword(s):  
Conservative Management ◽  
Perinatal Outcome ◽  
Positive Outcomes ◽  
Premature Rupture ◽  
Case Presentation ◽  
Vitro Fertilization ◽  
Obstetric Emergency ◽  
Cord Prolapse ◽  
Umbilical Cord Prolapse

AbstractBackgroundUmbilical cord prolapse is rare but a very serious obstetric emergency. Its incidence has declined over time and significant advances in its management have improved perinatal outcome.Case presentationA 38-year-old woman (gravida 3, para 0) conceived a dichorionic twin pregnancy through in vitro fertilization presented at 21 weeks of gestation with premature rupture of membrane of the presenting twin. At 21+4 weeks’ gestation, cord prolapse of the presenting twin into the vagina was identified by ultrasound. Parents chose conservative management, and planned cesarean section was done at 27+4 weeks.ConclusionOur case demonstrates that conservative management with measures to reduce the risks of infection and a planned delivery can result in positive outcomes even in cases where the cord prolapse occurs prior to viability.

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