RESUMEN
The authors describe a symptomatic intraosseous ganglion of the lunate communicating directly with the scapholunate joint. The communication was demonstrated by arthrography and computed tomography. This case is believed to be the first reported in which the communication was shown by arthrography. Demonstration of such a communication can obviate the need for further imaging to diagnose the lesion. A review of intraosseous ganglia of the hand and their treatment is presented.
Asunto(s)
Quistes Óseos/diagnóstico por imagen , Hueso Semilunar/diagnóstico por imagen , Quiste Sinovial/diagnóstico por imagen , Articulación de la Muñeca/diagnóstico por imagen , Adulto , Artrografía , Femenino , Estudios de Seguimiento , Humanos , Artropatías/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
A retrospective review of our experience with fractures after 27 Wagner limb lengthenings (23 patients) was undertaken. Ten fractures occurred after lengthening in eight patients (six spontaneous, four traumatic). Seven patients fractured despite a "staged" removal of the fixation plate. Seven of 10 fracture patients required open reduction/internal fixation (ORIF) to obtain union and/or satisfactory alignment. Our results indicate that patients with a congenital limb length inequality are prone to spontaneous fracture after Wagner limb lengthening. These results raise serious questions regarding the quality of bone healing after a Wagner-type lengthening for congenital limb length inequality.
Asunto(s)
Alargamiento Óseo/métodos , Fracturas Óseas/etiología , Adolescente , Placas Óseas , Niño , Femenino , Humanos , Diferencia de Longitud de las Piernas/etiología , Diferencia de Longitud de las Piernas/cirugía , Masculino , Complicaciones Posoperatorias/etiología , Falla de Prótesis , Estudios RetrospectivosRESUMEN
Although the initial trauma was minimal in this unusual case of bilateral congenital radioulnar synostosis and anterior radial head dislocation associated with myositis ossificans, a progressive decrease in elbow ROM ensued. Manipulation under general anesthesia was performed to improve flexion and extension of the involved elbow. This manipulation most likely initiated or enhanced the process of myositis ossificans in the elbow. Final treatment consisted of reassurance and active ROM exercises, with resolution of symptoms.
Asunto(s)
Miositis Osificante/diagnóstico por imagen , Radio (Anatomía)/diagnóstico por imagen , Sinostosis/diagnóstico por imagen , Cúbito/diagnóstico por imagen , Adulto , Humanos , Luxaciones Articulares/congénito , Luxaciones Articulares/diagnóstico por imagen , Masculino , Miositis Osificante/complicaciones , RadiografíaRESUMEN
A 45-year-old man with transverse myelitis developed an unstable neuropathic spinal arthropathy manifesting as a "silent" L1-L2 dislocation after laminectomy and rhizotomies performed for increased spasticity. Treatment consisted of reduction, posterolateral spinal fusion with Cotrel-Dubousset instrumentation utilizing hooks and pedicular screws, and a posterior lumbar interbody fusion. The authors conclude that laminectomy on a chronic paralytic through the insensate area should be coupled with fusion and instrumentation even if the facet joints and capsules are preserved during the laminectomy.