scholarly journals The role of two-sided splinting for recalcitrant paediatric post-burn hand flexion contracture: a case report

2017 ◽  
Vol 99 (6) ◽  
pp. e185-e187
Author(s):  
TOH Prasetyono ◽  
I Caroline

A 2-year-old boy presented to the plastic and reconstructive surgery outpatient clinic with bilateral post-burn hand flexion contracture. The contracture had been released twice elsewhere. The third surgical repair on one hand at a time was conducted by the author (TOHP). However, inadeq.uate compliance to the postoperative splinting and exercise led to the recurrence of the contracture in the following year. A customised two-sided splint was therefore created to ensure proper placement and compliance. Reinforcement to the parents to encourage the boy to practise active exercise on demand was also an integral part of the management. Good functional and cosmetic outcome were presented at 1-year follow-up. This case highlights the value of a two-sided splint for the management of post-burn hand flexion contracture in children whose compliance is inevitably cannot be guaranteed.

1970 ◽  
Vol 5 (4) ◽  
pp. 61-66
Author(s):  
Patrícia Resende Penido ◽  
Rhanna Junqueira Westin de Carvalho ◽  
Roger Willian Moraes Mendes

RESUMOIntrodução: A Arterite de Takayasu (AT) consiste em uma vasculopatia de origem indefinida, sendo de caráter crônico, que afeta a aorta e seus ramos principais. Em gestantes é uma condição complexa, em que o tratamento clínico é realizado com restrições. A utilização de corticoides tem sido favorável no controle inflamatório, principalmente naqueles casos em que antes da gravidez se fazia uso de imunossupressores. Casuística: Foi relatado um caso de uma gestante portadora de AT, através da análise de prontuário e de exames complementares, sendo realizado o pré-natal pelas equipes de Obstetrícia e Reumatologia, onde foi realizado tratamento clínico com corticoides, mostrando uma evolução satisfatória, ocorrendo apenas uma hospitalização que foi seguida de uma cesárea na trigésima sexta semana de gravidez, com recém nato saudável de 3.810g. Discussão: A AT pode estar associada a várias etiologias, sendo a gênese pouco conhecida. O diagnóstico na maioria das vezes é demorado, pela dificuldade da suspeita clínica, além de demandar o uso de técnicas de imagem mais sofisticadas. A gestação associada é fenômeno raro, já que as portadoras são orientadas a evitarem a gravidez. O controle clínico permitiu uma gestação sem grandes complicações e serviu como meio para levar a gestação até praticamente o fim do terceiro trimestre. Conclusão: Deve-se ressaltar o papel do acompanhamento clínico, especialmente com esta pan-arterite, mostrando os medicamentos que podem ser utilizados nesse grupo, especialmente quando se usava imunossupressores antes da gravidez. Palavras chave: Arterite de Takayasu, Gravidez, Vasculite. ABSTRACT:Introduction: Takayasu's arteritis (TA) consists of a vascular disease of unknown origin and chronic nature, which affects the aorta and its main branches. In pregnant women it is a complex condition, in which the clinical treatment is performed with restrictions. The use of corticosteroids has been favorable to control inflammation, especially in those cases when immunosuppressant had been used before pregnancy. Case Report: A case of a pregnant patient with TA has been reported through the analysis of medical records and laboratory tests. The Obstetrics and Rheumatology staff performed the prenatal care, and clinical treatment with corticosteroids was done showing a satisfactory outcome. There was only one hospitalization of the patient, which was followed by a cesarean in the thirty sixth week of pregnancy.  The newborn was a healthy one, weighing 3.810g. Discussion: TA may be associated with several etiologies, and the genesis is little known. The diagnosis most often takes time due to the difficulty of clinical suspicion, and requires the use of more sophisticated imaging techniques. The pregnancy is rare phenomenon, since the carriers are advised to avoid pregnancy. The clinical management allowed a pregnancy without major complications and served as a means to carry the pregnancy to almost the end of the third quarter. Conclusion: The role of the clinical follow-up should be noticed especially with this pan-arteritis, showing the drugs that can be used in this group, especially when there is use of immunosuppressive drugs before pregnancy. Keywords: Takayasu Arteritis, Pregnancy, Vasculitis.


Author(s):  
Jonathan Gaughran ◽  
Argha Datta ◽  
Judith Hamilton ◽  
Tom Holland ◽  
Ahmad Sayasneh

This case report describes the rare finding of a granulosa cell tumour in the third trimester of pregnancy. The presentation, investigation, management, histopathological findings and subsequent follow up are detailed. The difficulties associated with such diagnoses in pregnancy are explored.


2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS51-ONS56 ◽  
Author(s):  
Jeremy D.W. Greenlee ◽  
Charles Teo ◽  
Ali Ghahreman ◽  
Bernard Kwok

Abstract Objective: To further assess the safety and long-term efficacy of endoscopic resection of colloid cysts of the third ventricle. Methods: A retrospective review of a series of 35 consecutive patients (18 male, 17 female) with colloid cysts treated by endoscopic surgery was undertaken. Results: The mean patient age was 32.4 years (range, 11–54 yr). Headache was the most common presenting symptom (22 patients). The average tumor size was 18 mm (range, 3–50 mm). The endoscopic technique could not be completed in six patients, necessitating conversion to an open craniotomy and a transcortical approach to the colloid cyst. All patients had histologically confirmed colloid cysts of the third ventricle, and complete resection of the lesion was confirmed macroscopically and radiologically in all patients. There were no deaths. Two patients developed aseptic meningitis without any permanent sequelae. One patient developed unilateral hydrocephalus attributable to obstruction of the foramen of Monro, which was treated with endoscopic septum pellucidotomy. The median follow-up period was 88 months (range, 10–132 mo). There was one asymptomatic radiological recurrence. No seizures occurred after surgery. Conclusion: The results of this study support the role of endoscopic resection in the treatment of patients with colloid cysts as a safe and effective modality. In some cases, conversion to an open procedure may be required. Additional follow-up will be required to continue to address the duration of lesion-free survival.


Author(s):  
Masaya Akashi ◽  
Satoshi Wanifuchi ◽  
Junya Kusumoto ◽  
Megumi Kishimoto ◽  
Yasumasa Kakei ◽  
...  

2012 ◽  
Vol 69 (12) ◽  
pp. 1101-1105 ◽  
Author(s):  
Stevo Matijevic ◽  
Zoran Damjanovic ◽  
Zoran Lazic ◽  
Milka Gardasevic ◽  
Dobrila Radenovic-Djuric

Introduction. Odontogenic keratocyst (OKC) is a rare developmental, epithelial and benign cyst of the jaws of odontogenic origin with high recurrence rates. The third molar region, especially the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. Different surgical treatment options like marsupialization, decompression, enucleation, enucleation with Carnoy?s solution, peripheral ostectomy with or without Carnoy?s solution, and jaw resection have been discussed in the literature with variable rates of recurrence. Case report. We presented a 52-yearold male with orthokeratinized odontogenic keratocyst. Elliptical unilocular radiolucency located in the third molar region and the ascending ramus of the mandible, 40 ? 25 mm in diameter with radiographic evidence of cortical perforation at the anterior ramus border of the mandible 20 mm in diameter, was registrated on orthopantomographic radiography. Surgical treatment included enucleation of the cyst and peripheral ostectomy with the use of Carnoy?s solution and excision of the overlying attached mucosa. Postoperatively, no paresthesia in the inervation area of the inferior alveolaris nerve was registrated. Recurrences were not registrated within 5 years post-intervention. Coclusion. Treatment of odontogenic keratocyst with enucleation and peripheral ostectomy with the use of Carnoy?s solution and excision of the overlying attached mucosa had a very low rate of recurrence. Radical and more aggressive surgical treatments as jaw resection should be reserved for multiple recurrent cysts and when OKC is associated with nevoid basal cell carcinoma syndrome (NBCCS). Following the treatment protocol in the management of OKC and systematic and long-term postsurgical follow-up are considered key elements for successful results.


2020 ◽  
pp. 1-4

Abstract This case report demonstrated that electro-acupuncture treatment has improved the outcome of an adolescent with severe traumatic brain injury due to a traffic accident. The patient had a bilateral frontal hematoma, subdural hematoma, subarachnoid hemorrhage, stem hematoma and diffuse parenchymal swelling with the initial Glasgow Coma Scale score of E1V1M1. Daily electro-acupuncture therapy was prescribed with strong stimulation at GV 26 (Shuigou), PC6 (Neiguan) and EX-UE11(Shixuan) when the vital signs of the patient became stable. The patient had a full recovery of the consciousness in 30 days. The follow-up observation found that he has also restored the motor and speech functions. This result suggested a potential role of electro-acupuncture in the treatment of consciousness disturbance for patient with traumatic brain injury.


2019 ◽  
Vol 23 (2) ◽  
pp. 98-101
Author(s):  
Orçun Toptaş ◽  
Sinan Bulut ◽  
Murat Canbolat

Summary Background/Aim: Hard palate fistulas are due to pathologies such as noma, syphilitic gom, leprosy, leishmaniasis, radiotherapy, removal of cysts or tumors of the sinus or palate, trauma or tooth attraction. Symptoms of palatal fistulas include hypernasality in the phonation due to nasal air escape during a speech, nasal cavity fluid flow, and infection due to food accumulation. Surgical repair of palatal perforations is technically difficult and complicated. Different surgical methods can be used depending on the size and location of the defect. Among these techniques, the locoregional flap types used are palatal flap, nasolabial flap, a buccal fat pad and tongue flap. Case Report: In this case report, we presented a patient with oronasal fistula due to a previous surgical operation, which was surgically closed by a palatal rotational flap. Conclusions: As a result, the oronasal communucation was relieved by successful closure of the defect and the donor area healed uneventfully.


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