Open axillary arterial injury is life-threatening, and upper-extremity reperfusion must be performed within approximately 6 h. We present the case of a patient who underwent reperfusion of the upper limb and nerve reconstruction of the post-ganglionic brachial plexus injury in one stage while maintaining stable vital signs. The injury was an avulsion with no fracture.
View Article and Find Full Text PDFThe patient was a 48-year-old female recreational triathlete who had been experiencing mild low back pain since high school. She had recently developed right leg pain and had gradually worsening difficulty in running. She preferred to undergo spinal surgery without fusion so that she could return to triathlons as soon as possible, and she was referred to our hospital.
View Article and Find Full Text PDFWe report a case of double-level lumbar spondylolysis at L4 and L5 that was successfully treated with the double "smiley face" rod method. A healthy 29-year-old man who presented with a 6-year history of chronic low back pain was referred to us for surgical treatment. Plain radiographs and computed tomography of the lumbar spine revealed bilateral pars defects at L4 and L5 without slip or scoliosis.
View Article and Find Full Text PDFReconstruction is challenging in a patient with loss of a segment of Achilles tendon and infection in the overlying soft tissue. Here the authors describe one-stage tendon reconstruction, using an anterolateral thigh free flap incorporating a vascularized muscle flap and a strip of iliotibial tract in a patient with re-rupture of an Achilles tendon and soft tissue infection. Postoperative immobilization of the affected ankle using an external fixator enabled us to observe the flap directly and reduce pressure on the flap.
View Article and Find Full Text PDFIn this report we present a case of re-stabilization of the proximal radius using vascularized free fibular graft combined with anconeus arthroplasty to stabilize the transplanted fibula in a patient with large loss of the proximal radius due to Ewing's sarcoma. A 20-year-old woman had Ewing's sarcoma in the proximal three-fourths of the radius. The resection of large part of the radius containing radial head were necessary for removal of the sarcoma.
View Article and Find Full Text PDFUnlabelled: We present seven cases of a relatively rare swan neck deformity resulting from chronic radial collateral ligament (RCL) injury of the proximal interphalangeal (PIP) joint in the little finger. All patients were middle-aged women (mean 51 years old, range 42-55), and the duration between the initial injury and surgery was 20 years (range 5-40). The chief complaint was painful snapping of the PIP joint.
View Article and Find Full Text PDFCase Reports Plast Surg Hand Surg
April 2017
We describe the use of a pedicled unipolar latissimus dorsi flap to restore finger extension. The patient had large defects in the radial nerve and extensor musculature. A long-tailed, 50-cm-long flap was prepared, which enabled the end of the flap to be sutured to the extensor digitorum.
View Article and Find Full Text PDFTraumatic lunate fractures are very rare and those treatments require an understanding of anatomical features. We present a case of an ulnolunate ligament avulsion fracture of the lunate that was successfully repaired by surgical fixation with open reduction and internal fixation. We believe that restoration of ulnolunate ligament function is important to prevent further deterioration of wrist function after this injury.
View Article and Find Full Text PDFCase: We report a case of recurrent dislocation of the extensor pollicis longus and extensor pollicis brevis tendons due to chronic rupture of the radial sagittal band of the metacarpophalangeal joint of the thumb.
Conclusion: Successful restabilization of these tendons was achieved by transferring a half-slip of the abductor pollicis brevis tendon.
Percutaneous endoscopic discectomy (PED) is a minimally invasive disc surgery that can be performed under local anesthesia and requires only an 8-mm skin incision. For transligamentous extruded nucleus pulposus with foraminal stenosis, it is very hard to remove the migrated mass with a simple transforaminal approach. For such difficult cases, foraminoplasty and an epiduroscopic technique is useful.
View Article and Find Full Text PDFOpen dislocation of the proximal interphalangeal (PIP) joint is relatively rare. We report a case of a 32-year-old man who had open dislocation of the PIP joint of the little finger while playing American football. He had a history of chronic radial collateral ligament injury.
View Article and Find Full Text PDFWe report a rare case of entrapment of the median nerve following a closed fracture of the proximal one-fourth of the radius in an adolescent in failure of back hand spring. We proposed that the forearm pronation and the wrist extension in, "the Back Handspring position" made the median nerve close to the radius at one-fourth proximal radius, played an important role in this complication.
View Article and Find Full Text PDFA hyperextension deformity in the advanced stages of carpometacarpal (CMC) arthritis of the thumb could affect the outcomes of thumb CMC joint arthroplasty. We introduce the interesting approach for treating severely collapsed thumb deformities with gradual distraction and coordinated correction of the MCP and CMC joints by means of external fixators. We divided 8 cases into 3 groups according to the angle of passive flexion of the hyperextended MCP joint: group 1, 10-20°, group 2a, 20-40°, and group 2b, >40°, retrospectively.
View Article and Find Full Text PDFSince irreducible dislocation of the distal interphalangeal joint (DIP joint) is dorsal dislocation, irreducible palmar dislocation of the DIP Joint is very rare. This case was associated with a closed degloving injury of the distal phalanx of the little finger and required operative treatment.
View Article and Find Full Text PDFDevelopmental anterior dislocation of the radial head resulting from a congenital solitary osteochondroma of the proximal ulna is an extremely rare condition. We present a case of a 4-year-old girl with this condition affecting her right elbow, which was treated by a trapezoidal shortening osteotomy at the radial neck following an oblique ulnar osteotomy with angulation and elongation after a complete resection of the tumor mass. The child remained asymptomatic with symmetric carrying angles during 2.
View Article and Find Full Text PDFSalmonella osteomyelitis of the radius in a healthy individual is very rare. We present such a case involving the distal radius of a healthy 23-year-old man without underlying disease or possible episode. He had right wrist pain for approximately 3 years, and osteolytic lesion was seen in the right distal radius.
View Article and Find Full Text PDFBackground: Although precise ulna-shortening osteotomy is popular, the procedure sometimes results in delayed union or nonunion. The periosteum including the inner cambium layer plays an important role in fracture healing. We tested the hypothesis that preservation of the corticoperiosteal attachment may accelerate healing at osteotomy sites after ulna-shortening osteotomy.
View Article and Find Full Text PDFWe aimed to introduce a surgical option for crushing-penetrating injuries around the metacarpophalangeal (MP) joint of the middle finger with extensor reconstruction of the interphalangeal (IP) joints. We also assessed the outcomes of patients using this surgical protocol. First, MP joint reconstruction was performed early (mean, 1.
View Article and Find Full Text PDFBackground: Vascularized medial femoral condyle (MFC) corticoperiosteal bone-flap is a well-accepted technique when dealing with tissue defects or infection. Its role in refractory conditions and in the possible use for options concerning modifications of this bone-flap compared to a conventional iliac bone graft (conventional-graft) are rarely discussed.
Methods: We reviewed 21 consecutive cases concerning alternatives with some modifications of original MFC bone-flap surgery used to treat refractory conditions with bone defects, necrosis, or infection in the extremities.