Volar dislocation of the fourth and fifth carpometacarpal joints: a case report and review of the literature.
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ABSTRACT:
SUBMITTER: Prokopis PM
PROVIDER: S-EPMC2553172 | biostudies-other | 2008 Sep
REPOSITORIES: biostudies-other
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Project description:Isolated pure dislocation of the fifth carpometacarpal (CMC) joint is a very rare injury and classified depending on displacement of the metacarpal base. This rare injury is often difficult to recognize and is liable to be overlooked. The purpose of this case report is to present a patient with an isolated dislocation of the fifth CMC joint that was satisfactorily treated with closed reduction and ulnar gutter pop slab.A 21-year-old male presented with severe pain on the right carpus following a fall with injury to right hand. There was a mild swelling at fifth CMC joint region and a bony prominence was felt dorsally, little finger presented an abduction deformity, and there was apparent shortening of the fifth ray. A diagnosis of isolated dislocation of fifth CMC dislocation was made based on radiographs. Immediate closed reduction was done in emergency room by applying longitudinal traction and direct pressure on metacarpal base dorsally, reduction was stable and confirmed by postreduction radiographs.Isolated pure dislocation of the fifth CMC joint is very rare injury and is prone to be missed in emergency room and particular attention should be made to diagnose it in polytrauma patients.
| S-EPMC5553826 | biostudies-other
Project description:We developed a new fixation method that involves the insertion of two wires and external wire fixation using a metal clamp. The aim of this technique was to increase the stability and rigidity of conventional percutaneous Kirchner wire fixation. Here, we present a patient with dislocation of the fourth and fifth carpometacarpal joints who was satisfactorily treated with closed reduction and percutaneous fixation with a linking external wire fixator (Ichi-Fixator). Operative treatment using the Ichi-Fixator system facilitates anatomical reduction and immediate full mobilization, resulting in good outcomes. The patient could perform all routine activities with normal grip strength and a full range of hand motion without pain. Such a treatment that improves comfort after the operation and may allow an immediate return to work will clearly boost patient satisfaction. Linked external wire-type fixation enables enhanced security of fixation, facilitates postoperative mobilization, and may allow an immediate return to work.
| S-EPMC6311754 | biostudies-literature
Project description:IntroductionWe report the case of volar dislocation of the ulnar head occurred after osteosynthesis for the treatment of distal radius fracture.Presentation of caseThe patient, 68-year-old female, had the dorsal displaced left distal radius fracture and volar dislocation of the ulnar head. Osteosynthesis was performed using a volar locking plate without postoperative immobilization. Two weeks after surgery, volar dislocation of the ulnar head in distal radioulnar joint (DRUJ) was noted on CT. Re-operation, triangular fibrocartilage complex (TFCC) was sutured to the ulnar fovea using a suture anchor, was performed in order to stabilize DRUJ. At 24 months after surgery, left wrist joint pain and the range of motion have improved, and the Mayo wrist score was excellent.DiscussionBased on the fact that the radius was fractured and the ulna was dislocated in DRUJ at the time of injury, the present case may have been a Galeazzi fracture.ConclusionWhen distal radius fracture is complicated by ulnar instability of DRUJ, active repair of the TFCC function may be necessary to prevent residual postoperative instability.
| S-EPMC6197738 | biostudies-literature
Project description:High-energy trauma can cause transsyndesmotic ankle fracture dislocation. These fractures are quite rare. Here we present a clinical case of a male patient with this type of injury. A systematic review of PubMed, Ovid MEDLINE, and Embase electronic databases revealed only two prior publications on a similar topic. We discuss the typical clinical features of these injuries, the treatment of high-energy trauma which can cause transsyndesmotic ankle fracture dislocation, and its prognosis.
| S-EPMC6230424 | biostudies-literature
Project description:We report a case of a 55 years old women who present a ALK associated renal cell carcinoma, with 3p deletion and measling of TFE3 expression. With CGH analysis and FISH we identify the rearrangment of ALK with TPM3
2017-03-24 | GSE96980 | GEO
Project description:Traumatic hip dislocation is a rare injury in children, and an open dislocation is exceptional. We report the case of a 7 year old patient who presented an open anterior dislocation of the left hip following trauma by accident of the public highway. The patient received treatment under general anesthesia: articular toilet, debridement and reduction. Then, He was put under traction for 6 weeks and antibiotic. The short term evolution is marked by the occurrence of post-traumatic septic arthritis and osteonecrosis of the femoral head after two months.
| S-EPMC7026524 | biostudies-literature
Project description:Introduction and importanceCombined proximal humerus fracture and glenohumeral dislocation in the pediatric population is extremely rare, with only few reports of such cases been reported. We review all cases of combined proximal humerus fracture and glenohumeral dislocation in the pediatric population and present a case of left proximal humerus fracture dislocation in a healthy 5-year-old girl.Case presentationA 5-year-old girl fell from 2 m height and landed on her left shoulder where she started to complain from severe left shoulder pain, inability to move her left shoulder and bruising. She was diagnosed at our facility to have left proximal humerus fracture combined with glenohumeral dislocation and was treated with open reduction, K-wires fixation and immobilization in a shoulder cast.Clinical discussionTraumatic proximal humeral fracture associated with glenohumeral dislocation is a rare presentation in pediatric age group. This type of fracture is usually managed by closed reduction and casting, with a minority being managed with open reduction. Indications for surgical intervention are open fractures, severely displaced fractures, fractures that are associated with neurovascular compromise, or irreducible fracture due to soft tissue obstacles.ConclusionsA high index of suspicion is required to diagnose such injuries along with appropriate radiographic evaluation. We recommend open reduction with K-wires fixation for irreducible combined proximal humeral fracture and glenohumeral dislocation.
| S-EPMC8253919 | biostudies-literature
Project description:Background Fifth-carpometacarpal (CMC)-joint fractures and dislocations can produce carpometacarpal joint arthritis. The purpose of this study was to evaluate the radiographic and clinical outcomes of arthroplasty for fifth carpometacarpal joint arthritis. Material and Methods A series of six patients who had symptomatic advanced fifth-CMC arthritis and had failed to respond to conservative treatment. All patients underwent Dupert's technique of fifth-CMC arthroplasty with a mean follow-up of 17.6 months. Results were reviewed clinically and radiographically. Results Union between the fourth and fifth metacarpals was observed at an average of 6.2 weeks after surgery. Grip strength improved. Range of motion (ROM) of the fifth metacarpophalangeal (MCP) joint and the fifth metacarpal height remained unchanged. Visual analog scale (VAS) results improved significantly. Conclusion Despite the medium-term follow-up and small number of patients, our results suggest fifth-CMC arthroplasty with arthrodesis of the fourth and fifth metacarpal bases may be a reliable procedure for fifth-CMC arthritis.
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Project description:Objective: The aim of the present study is to explore the clinical and genetic characteristics of 3p deletion syndrome to improve clinicians' understanding of the disease. Methods: The clinical manifestations, process of diagnosis and treatment, and genetic characteristics of an individual case of 3p deletion syndrome were analyzed. CNKI, Wanfang Data, and the Biomedical Literature Database (PubMed) were searched. The search time limit, using "3p deletion syndrome" and "BRPF1" as keywords, was from the creation of the database up to June 2020. Related data were reviewed. Results: The proband was a male child with general developmental and intellectual disabilities, special facial features and congenital heart disease. The child was the parents' first pregnancy and first born. Gene microarray analysis showed a 10.095 Mb deletion in the 3p26.3-p25.3 region, resulting in a heterozygous mutation of the BRPF1 gene; thus, the patient was diagnosed with 3p deletion syndrome. At the time of diagnosis, the child was 1 year of age and was responding to comprehensive rehabilitation training. A total of 29 well-documented cases were found in the literature, of which 19 cases had an onset within 1 year of birth, and mainly manifested with mental and motor development disabilities and abnormal facial features, with different gene deletions, depending on the size and location of the 3p deletion. Conclusion: The genetic test results of the child in this study indicated a heterozygous deletion of the BRPF1 gene on the short arm of chromosome 3, which was a unique feature of this study, since it was rarely mentioned in other reports of 3p deletion syndrome. The clinical phenotype of this syndrome is complex as it can include intellectual and motor development backwardness, low muscle tone, certain abnormal facial features (low hairline, bilateral ptosis, widely spaced eyes, a forward nose, left ear auricle deformity, a high-arched palate, a small jaw), and the deformation of systems such as the gastrointestinal tract and the urinary tract malformation or symptoms of epilepsy. As clinical manifestations can be relatively mild, the syndrome is easy to miss or misdiagnose. Clinical workers need to be aware of this disease when they find that children have special features, such as stunted growth, low muscle tone or ptosis, and it needs to be diagnosed through genetic testing. Most children are able to develop certain social skills after rehabilitation treatment.
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Project description:Uterine carcinosarcomas are rare and extremely aggressive undifferentiated carcinomas which include both carcinomatous and sarcomatous elements. A 52-year-old female presented with heavy irregular menstrual bleeding for several years and new right elbow pain and swelling. Ultrasound and computed tomography showed a large uterine mass with regional and distant metastatic lymphadenopathy and suspicious findings of osseous metastasis to the right elbow. A biopsy confirmed uterine carcinosarcoma, and the patient underwent chemotherapy and then surgical resection of the uterine mass with palliative radiotherapy of the right elbow. The postoperative imaging showed new metastasis, and the patient was scheduled to start on immunotherapy. Considering the highly invasive nature of uterine carcinosarcomas, timely detection of this cancer using characteristic imaging and pathology findings is of extreme importance to improve the patient's survival.
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