The American journal of orthopedics
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Case Reports
Isolated laceration to the deep motor branch of the ulnar nerve by a retained foreign body.
This report describes an isolated laceration to the deep motor branch of the ulnar nerve by a retained foreign body. The patient sustained a laceration on the ulnar, volar aspect of his palm after a fall on gravel. ⋯ Confusion over the patient's intact sensory examination and lack of awareness of the complex distal anatomy of the ulnar nerve contributed to the misdiagnosed nerve lesion. Isolated injuries of the deep motor branch are very rare, but increased awareness and understanding of the complex ulnar nerve distal anatomy will help avoid future delays in diagnosis and treatment.
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Surgical fires are a serious threat to the patient and surgical team in the operating room. Burns have been reported at, and distant to, the operating site, as well as within the body. The essential point to remember is that at least 1 arm of the fire triangle-an oxidizer, fuel, and an ignition source-must be completely controlled to prevent an intraoperative fire. Here we give the example of a pulse lavage system as a possible ignition source.
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Case Reports
Traumatic C4-C5 unilateral facet dislocation with posterior disc herniation above a prior anterior fusion.
We report the case of a unilateral cervical facet dislocation above the level of a prior non-instrumented cervical discectomy and fusion, resulting in incomplete neurologic injury. Pre-reduction imaging demonstrated a large posterior disk extrusion. This finding altered our management approach from closed reduction to urgent anterior cervical discectomy, open anterior reduction, and fusion. The patient had excellent neurologic recovery and outcome at 12 months postoperative follow-up.
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Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence. Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evaluate the functional outcome and the complication rate after using this plate. ⋯ The average ASES score between patients 60 years and older and those 60 years and younger was not different significantly. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients developed a nonunion. Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, especially in the older population with osteoporotic bone.
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Obesity, one of the most common health problems in the United States, is becoming more prevalent. At the same time, because of technological advances, the rate of spine surgeries is on the rise. Given these trends in obesity and spine surgeries, it can be inferred that the number of obese patients who undergo spine surgeries will increase as well. ⋯ Nevertheless, appropriate clinical outcomes can be achieved in obese patients who undergo spine surgery. Obesity is not a contraindication for spine surgery. Patient selection is key in achieving favorable clinical outcomes.