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:Introductionand importance: Herein we present a rare case of multiple second to fifth carpometacarpal joint fracture-dislocations. It is important in such cases to be aware of a high-velocity impact etiology of the fractures, which will ensure proper imaging, diagnosis and treatment.Case presentationA 34-year-old male presented with severe pain in his left hand following a motorcycle accident. He was diagnosed as multiple second to fifth carpometacarpal joint fracture-dislocations. He was successfully treated with closed reduction with multiple Kirshner wires fixation under general anesthesia. A one-year follow up confirmed excellent clinical results.Clinical discussionThere are various surgical options including casting, closed reduction and percutaneous pinning (CRPP), and open reduction internal fixation, however, the optimal treatment is still controversial. The closed reduction is recommended in all CMC joint dislocations. Adding a K-wire fixation can create a secure fixation and achieve an excellent outcome.ConclusionMultiple carpometacarpal joint fracture-dislocations is a very rare injury. Careful clinical examination is important for an accurate diagnosis and plain radiographic studies are necessary. Standard fracture dislocation treatment can be used. Simple closed reduction with the K-wires fixation technique is easy to perform and in our case achieved successful treatment in terms of clinical and radiographic outcomes.
| S-EPMC9052289 | biostudies-literature
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:Isolated volar metacarpophalangeal dislocations of fingers are extremely rare. There are few cases published in English and French literature. In this article, we aim to review the literature and present a case of isolated open volar dislocation of a finger. We treated this dislocation first by a dorsal approach alone and later, after recurrence, using a combined dorsal and volar approach. This report emphasizes the pathology of such injuries, clarifies the mechanisms, and outlines the treatment options of the dislocations. Close reduction can be achieved and maintained if done early. It must be attempted first for all cases. In irreducible or reducible but unstable dislocations, we recommend surgical restoration. During an open reduction, the major torn or avulsed soft tissue joint stabilizers must be repaired. A combined dorsal and volar approach, starting dorsally, is useful.
| S-EPMC8991436 | biostudies-literature
Project description:Bullous pemphigoid (BP) is a rare, life-threatening autoimmune blistering disease with pruritus and tension blisters/bullous as the main clinical manifestations. Glucocorticosteroids are the main therapeutic agents for it, but their efficacy is poor in some patients. Tofacitinib, a small molecule agent that inhibits JAK1/3, has shown incredible efficacy in a wide range of autoimmune diseases and maybe a new valuable treatment option for refractory BP. To report a case of refractory BP successfully treated with tofacitinib, then explore the underlying mechanism behind the treatment, and finally review similarities to other cases reported in the literature. Case report and literature review of published cases of successful BP treatment with JAK inhibitors. The case report describes a 73-year-old male with refractory BP that was successfully managed with the combination therapy of tofacitinib and low-dose glucocorticoids for 28 weeks. Immunohistochemistry and RNA sequencing were performed to analyze the underlying mechanism of tofacitinib therapy. A systematic literature search was conducted to identify other cases of treatment with JAK inhibitors. Throughout the 28-week treatment period, the patient experienced clinical, autoantibody and histologic resolution. Immunohistochemical analysis showed tofacitinib significantly decreased the pSTAT3 and pSTAT6 levels in the skin lesions of this patient. RNA sequencing and immunohistochemical testing of lesion samples from other BP patients identified activation of the JAK-STAT signaling pathway. Literature review revealed 17 previously reported cases of BP treated with four kinds of JAK inhibitors successfully, including tofacitinib (10), baricitinib (1), upadacitinib (3) and abrocitinib (3). Our findings support the potential of tofacitinib as a safe and effective treatment option for BP. Larger studies are underway to better understand this efficacy and safety.
2024-11-13 | GSE278926 | GEO
Project description:Hemoptysis caused by Parvimonas micra: case report and literature review
| PRJEB72347 | ENA
Project description:Introduction and importanceA distal radioulnar joint (DRUJ) dislocation is an uncommon occurrence. If not managed properly could result in severe functional impairment.Case presentationWe report a case of a 45-year-old lady who was injured 6 months ago. She suffered a volar dislocation of the DRUJ and an ulnar head fracture. The DRUJ was stable after open reduction and reconstruction using suture-button technique.DiscussionApplication of the first suture-button still result in positive ballottement with subluxation of ulnar head. Additional of second suture-button improved the stability and restored DRUJ motion.ConclusionThe double suture-button technique restored the DRUJ's stability and produced a good functional outcome.
| S-EPMC9577852 | biostudies-literature
Project description:BackgroundBecause of the severity and fatal outcome of traumatic vertical atlantoaxial dislocation (AAD), most patients may die in the early post-traumatic period. The post-injury management of patients with vertical AAD has been rarely reported. Improper treatment may lead to disastrous outcome and further aggravate the neurologic symptoms.Case presentationThis report describes the perioperative management and outcome of a rare improperly treated patient with traumatic vertical AAD. The severe pulmonary infection of this patient prevented further surgery for vertical AAD. After placement of a halo vest, combined with effective antibiotic drug treatment, the patient's pulmonary infection was brought under control. The patient underwent atlantoaxial fusion using C1 lateral mass screws and C2 pedicle screws with the assistance of the halo vest. A computed tomography scan at 1 year follow-up indicated that the bone graft was fused and the patient was able to walk independently.ConclusionSkull traction is contraindicated in patients with traumatic vertical AAD. Application of a halo vest can be used for temporary fixation of the cervical spine and atlantoaxial fixation should be performed to maintain the stability of atlantoaxial articulation.
| S-EPMC9891968 | 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