RESUMEN
CASE: A fifty-three-year-old man presented with an intrathoracic glenohumeral dislocation (ITGHD) and associated hemothorax, rib fracture, massive rotator cuff tear, and axillary nerve palsy following an ice hockey injury. Treatment consisted of closed reduction and staged open rotator cuff repair. Despite a substantial injury, the patient recovered nearly normal use of the arm two years postoperatively. CONCLUSION: ITGHD is an extremely rare entity. This injury should be managed by a multidisciplinary team with anticipation of associated thoracic and vascular injuries. In cases with repairable pathology (e.g., an acute rotator cuff tear), good functional outcomes can be obtained.
RESUMEN
This article describes the basic bony, ligamentous, and neurologic anatomy of the structures about the elbow. The surgical exposures of the elbow joint are described, providing details of the various posterior, lateral, and medial approaches to the articular segments. Clinical applications describing the potential benefits of each surgical exposure are provided as examples.
Asunto(s)
Articulación del Codo/cirugía , Ligamentos Colaterales/anatomía & histología , Ligamentos Colaterales/lesiones , Ligamentos Colaterales/cirugía , Articulación del Codo/anatomía & histología , Humanos , Fracturas del Húmero/cirugía , Músculo Esquelético/anatomía & histología , Osteotomía/métodos , Nervio Radial/anatomía & histología , Tendones/anatomía & histología , Nervio Cubital/anatomía & histologíaAsunto(s)
Accidentes de Trabajo , Luxaciones Articulares/cirugía , Traumatismos de la Muñeca/cirugía , Curación de Fractura , Humanos , Luxaciones Articulares/complicaciones , Luxaciones Articulares/diagnóstico , Masculino , Persona de Mediana Edad , Fracturas del Cúbito/complicaciones , Fracturas del Cúbito/diagnóstico , Fracturas del Cúbito/cirugía , Traumatismos de la Muñeca/diagnósticoRESUMEN
Traumatic injuries of the distal radioulnar joint (DRUJ) may give rise to complex wrist pathologies. Substantial ongoing disability can arise should these injuries go unrecognized resulting in sub-optimal treatment and lack of appropriate rehabilitation. Injuries of the DRUJ may occur in isolation but more commonly are found with a fracture of the radius. These challenging DRUJ injuries may be simple or complex (irreducible or severe instability), acute or chronic. An adequate knowledge of the stabilizers of the DRUJ is essential in understanding treatment options. Traumatic instability of the DRUJ is reviewed and the anatomy and stabilizing factors are discussed. An algorithm to guide selection of treatment options in complex cases is presented.
RESUMEN
We present a case of infection caused by an uncommon pathogen, Mycobacterium chelonae, in a patient that underwent Swanson silicone arthroplasty of the metacarpophalangeal joints for rheumatoid arthritis. This is the first report of an infection caused by nontuberculous Mycobacteria in flexible silicone implants in the hand. The patient was successfully treated with implant removal, debridement, and antimicrobials tailored to the results of in vitro susceptibility testing.
RESUMEN
Traumatic injuries of the distal radioulnar joint (DRUJ) may give rise to complex wrist pathologies. Substantial ongoing disability can arise should these injuries go unrecognized resulting in sub-optimal treatment and lack of appropriate rehabilitation. Injuries of the DRUJ may occur in isolation but more commonly are found with a fracture of the radius. These challenging DRUJ injuries may be simple or complex (irreducible or severe instability), acute or chronic. An adequate knowledge of the stabilizers of the DRUJ is essential in understanding treatment options. Traumatic instability of the DRUJ is reviewed and the anatomy and stabilizing factors are discussed. An algorithm to guide selection of treatment options in complex cases is presented.
Asunto(s)
Fracturas del Radio/terapia , Fracturas del Cúbito/terapia , Traumatismos de la Muñeca/terapia , Algoritmos , Humanos , Inestabilidad de la Articulación/terapiaRESUMEN
New techniques of internal fixation, postoperative rehabilitation, and emphasis on functional as well as radiographic outcome have refined the surgical treatment of complex fractures of the glenoid, humeral head, supracondylar and intracondylar humerus, olecranon, radial head, distal radius, and distal radioulnar joint over the past decade. Early stabilization and rehabilitation of these injuries leads to soft-tissue stabilization and facilitates the patient's ability to place the hand in three-dimensional space.