scholarly journals Carpometacarpal Dislocation of the Third to Fifth Fingers and an Associated Fracture of the Hamate in a Military Paratrooper

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Georgios Kalinterakis ◽  
Emmanouil Antonogiannakis ◽  
Arezoo Abdi ◽  
Georgios Demetriades ◽  
Alexandros Koulouktsis ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Functional Results ◽  
Concomitant Injuries ◽  
Military Hospitals ◽  
The Third ◽  
Carpometacarpal Joints ◽  
Orthopedic Surgeons ◽  
Term Basis ◽  
Great Force ◽  
High Index Of Suspicion

Multiple carpometacarpal dislocations with a simultaneous fracture of the hamate represent less than 1% of all injuries to the hand and wrist regions, with a scarcity of published cases. These injuries usually require a great force, and diagnosis can be missed or delayed because of the high likelihood of other severe concomitant injuries. We report a case of acute closed dislocation of the third through fifth carpometacarpal joints and an associated fracture of the hamate in a military paratrooper. The injury was caused by a wrong landing technique during parachuting. The patient was managed with primary surgical repair, and after a six-month follow-up, he has excellent functional results. The fact that both this clinical entity and the mechanism of injury are very unusual a high index of suspicion is needed, especially for orthopedic surgeons working in military hospitals. Additionally, given that there is a paucity of published cases and optional treatment is controversial, this study corroborates the superiority of surgical repair in a long-term basis.

Possibility of simultaneous transposition of segments of the pectoralis major muscle to restore flexion in the shoulder and elbow joints (clinical observation)

MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 61-68
Keyword(s):  
Anterior Part ◽  
Pectoralis Major Muscle ◽  
Elbow Flexion ◽  
Functional Results ◽  
Proximal Part ◽  
Deltoid Muscle ◽  
Pectoralis Major ◽  
Orthopedic Surgeons ◽  
Active Function ◽  
Head Neck

The pectoralis major is a widely used muscle in reconstruction surgery for replacement soft tissue defects of a head, neck, thorax, upper limbs and restoration of muscle active function. The peculiarities of anatomy of the pectoralis major makes it possible to divide the muscle into several segments with their own innervations and supply and use them independently from each other. This article describes the anatomy of the pectoralis major and the opportunity for clinical applications of different segments of this muscle. The authors demonstrate the result of the restoration of shoulder and elbow flexion in a patient with arthrogryposis due to simultaneous transfer of the proximal part of pectoralis major to the anterior part of the deltoid muscle and the distal part of pectoralis major to the biceps with good functional results. The article will be useful for plastic surgeons, orthopedic surgeons and physiotherapists.

Tracheoinnominate fistula: surgical management of an iatrogenic disaster

2006 ◽  
Vol 120 (8) ◽  
pp. 676-680 ◽  
Author(s):  
R W Ridley ◽  
J B Zwischenberger
Keyword(s):  
Operating Room ◽  
Surgical Management ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Rare Condition ◽  
Innominate Artery ◽  
Significant Potential ◽  
High Index Of Suspicion

Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF.

scholarly journals Prurigo Pigmentosa: A Clinicopathological Report of Three Middle Eastern Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
N. Almaani ◽  
A. H. Al-Tarawneh ◽  
H. Msallam
Keyword(s):  
Middle Eastern ◽  
Sudden Onset ◽  
Clinicopathological Features ◽  
Inflammatory Disorder ◽  
Histological Features ◽  
The Third ◽  
Strict Diet ◽  
Postinflammatory Hyperpigmentation ◽  
High Index Of Suspicion ◽  
Distinct Features

Prurigo pigmentosa is a unique cutaneous inflammatory disorder characterized by a sudden onset of pruritic and erythematous macules, urticarial papules, and plaques that may coalesce to form a reticulated pattern. Lesions typically heal within weeks leaving a reticulated and mottled postinflammatory hyperpigmentation. The majority of reported cases originate from Japan with much fewer cases described worldwide without predominant ethnicity. The histopathological features of prurigo pigmentosa can be nonspecific; however, distinct features exist for each stage of the disease. The aetiology of prurigo pigmentosa is not fully understood. However, ketoacidosis has been implicated in the pathogenesis and indeed prurigo pigmentosa has been associated with ketoacidotic states such as diabetes mellitus, fasting, dieting, and anorexia nervosa. In this report, we present 3 Jordanian patients with prurigo pigmentosa and describe their clinicopathological features. One patient developed prurigo pigmentosa while fasting during the month of Ramadan and another was undertaking a strict diet. No associations were identified in the third patient. In view of the largely nonspecific clinical and histological features, a high index of suspicion is required as many cases of prurigo pigmentosa are probably undiagnosed.

scholarly journals Hypomelanosis of Ito: Case report of a rare neurocutaneous syndrome in a neonate and review of the literature.

1970 ◽  
Vol 42 (3) ◽  
pp. 231-233
Author(s):  
M Mukhtar-yola ◽  
LI Audu ◽  
AT Otuneye ◽  
AB Mairami ◽  
EC Otubelu ◽  
...  
Keyword(s):  
Case Report ◽  
High Index ◽  
Review Of The Literature ◽  
Cutaneous Lesions ◽  
Hypomelanosis Of Ito ◽  
The Third ◽  
Neurocutaneous Syndrome ◽  
Paediatric Practice ◽  
High Index Of Suspicion

Hypomelanosis of Ito (HI) though said to be the third most common neurocutaneus disorder, is rarely reported in paediatric practice in Africa. A high index of suspicion must be maintained in children with cutaneous lesions as a seizure may be the first symptom that may bring the child to attention. A case of HI in a neonate is hereby reported to sensitize clinicians about this relatively uncommon disorder

Functional Results Following Surgical Repair of Simultaneous Bilateral Quadriceps Tendon Ruptures

2014 ◽  
Vol 42 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Edward S. Chang ◽  
Christopher C. Dodson ◽  
Fotios Tjoumakaris ◽  
Steven B. Cohen
Keyword(s):  
Surgical Repair ◽  
Quadriceps Tendon ◽  
Functional Results ◽  
Tendon Ruptures

Acute Cardiac Events in Patients With Severe Limb Infection

2018 ◽  
Vol 17 (4) ◽  
pp. 261-267
Author(s):  
Mohita Singh ◽  
Khurrum Khan ◽  
Evan Fisch ◽  
Christopher Frey ◽  
Kristen Mathias ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Primary Care Physicians ◽  
Myocardial Infarctions ◽  
Cardiac Complications ◽  
Cardiac Events ◽  
Orthopedic Surgeons ◽  
Tertiary Center ◽  
High Index Of Suspicion ◽  
Acute Cardiac Event

Recent studies have shown an association between infections, such as influenza, pneumonia, or bacteremia, and acute cardiac events. We studied the association between foot infection and myocardial infarction, arrhythmia, and/or congestive heart failure. We analyzed the records of 318 consecutive episodes of deep soft tissue infection, gangrene, and/or osteomyelitis in 274 patients referred to a vascular surgery service at a tertiary center. We identified 24 acute cardiac events in 21 of 318 (6.6%) episodes of foot infection or foot gangrene. These 24 events included 11 new myocardial infarctions (3.5%), 8 episodes of new onset or worsening congestive heart failure (2.5%), and 5 new arrhythmias (1.6%). Tachycardia and systemic inflammatory response syndrome were associated with acute cardiac events ( P < .05 for each). The 1-year survival of patients with acute cardiac events was 50.4%, significantly lower than the 91.7% 1-year survival of patients without acute cardiac events ( P < .0015). Acute cardiac complications are not uncommon among patients presenting with severe foot infection and are associated with a high 1-year mortality. Primary care physicians, cardiologists, and vascular and orthopedic surgeons must keep a high index of suspicion for the occurrence of an acute cardiac event.

Racing performance after surgical repair of medial condylar fracture of the third metacarpal/metatarsal bone in thoroughbred racehorses

2020 ◽  
Vol 49 (4) ◽  
pp. 648-658 ◽  
Author(s):  
Sophie Boorman ◽  
Dean W. Richardson ◽  
Patricia M. Hogan ◽  
Darko Stefanovski ◽  
David G. Levine
Keyword(s):  
Surgical Repair ◽  
Metatarsal Bone ◽  
Condylar Fracture ◽  
The Third ◽  
Racing Performance ◽  
Thoroughbred Racehorses

Children’s hand trauma

2011 ◽  
Author(s):  
Henk Giele
Keyword(s):  
Nerve Injury ◽  
Upper Limb ◽  
Growth And Development ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
General Anaesthetic ◽  
Hand Trauma ◽  
Nail Bed ◽  
The Common ◽  
High Index Of Suspicion

♦ This chapter reinforces that children are not small adults and the management of these injuries must consider the effect on growth and development♦ Nail bed injuries require microsurgical repair if permanent deformity is to be avoided♦ Every attempt should be made to replace amputated digits, whatever the level of amputation♦ Good results are the common outcome in children’s fractures unless complicated by surgical intervention or infection. However, angulation, rotation, and intra-articular deformities should be corrected where possible♦ All children with deep lacerations of the upper limb should have a general anaesthetic for adequate exploration and repair of the wound♦ A high index of suspicion of nerve injury should exist when assessing hand lacerations, and the outcome of early surgical repair is good.

scholarly journals Behavioural disorders in children with pectus excavatum in China: a retrospective cohort study with propensity score matching and risk prediction model

2019 ◽  
Vol 56 (3) ◽  
pp. 596-603
Author(s):  
Hongbo Li ◽  
Xianqing Jin ◽  
Shulei Fan ◽  
Daoxin Wang ◽  
Chun Wu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Prediction Model ◽  
Propensity Score Matching ◽  
Risk Prediction ◽  
Pectus Excavatum ◽  
Surgical Repair ◽  
Risk Prediction Model ◽  
Nuss Procedure ◽  
Behavioural Disorders ◽  
The Third

Abstract OBJECTIVES Surgical repair of pectus excavatum is typically carried out immediately prior to puberty. However, at the time of surgery, some psychosocial issues, such as behavioural disorders may already have developed and the likelihood of these psychosocial disorders resolving after surgery is unclear. For this reason, some surgeons choose to perform surgical repair at an earlier age in some children. The study retrospectively compares the rate of behavioural disorders in children undergoing the Nuss procedure at 4 vs. 10 years of age. We also attempted to develop a model to predict the risk of behavioural disorders in 10 year-old patients. METHODS The current study included children receiving Nuss procedure for pectus excavatum at either 4 or 10 years of age. The presence/absence of behavioural disorder was assessed preoperatively, and in the third year, after removal of the bar. A propensity score matching (PSM) analysis was conducted to reduce the potential for confounding by baseline factors. Multivariable logistic regression was conducted to establish a model to predict the risk of behavioural disorders in the third year after the removal of the bar. The model was accessed by discrimination and calibration. A formula and a nomogram were developed based on the results. RESULTS The number of patients in each group was 45 after PSM. The rate of behavioural disorders at the baseline was significantly higher in the children undergoing Nuss procedure at 10 years of age [36% vs 20%, odds ratio (OR) 2.21, 95% confidence interval (CI) 0.85–5.72; P = 0.157]. The rate of behavioural disorders in the third year after the removal of the bar was 36% and 18% in children undergoing surgery at 10 and 4 years of age, respectively (OR 2.55, 95% CI 0.96–6.79; P = 0.094). The rate of persistent behavioural disorders, defined as continuing to have behavioural disorders in the third year after the removal of the bar in those with behavioural disorders at the baseline, was 88% vs 56% (OR 3.47, 95% CI 0.56–21.36; P = 0.204). Two patients (4%) relapsed in each group. A risk prediction model by variables of gender, Haller index, pulmonary function and score of Child Behaviour Checklist at the baseline was provided. CONCLUSIONS The rate of behavioural disorders was considerably lower in children who underwent the Nuss procedure at 4 years of age than at 10 years of age. Behavioural disorders may not readily resolve after surgery. Performing surgery at an early age rather than just before puberty may be better for psychosocial development. Psychosocial aid is necessary in addition to surgery to address behavioural disorders.

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