Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand
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Case Reports
Irreducible open dorsal dislocation of the proximal interphalangeal joint: a case report.
We report a rare case of open dorsal dislocation of the proximal interphalangeal joint which needed operative reduction. A 39-year-old man injured his right middle finger while playing baseball. There was a laceration on the proximal interphalangeal crease, and the condyles of the proximal phalanx protruded through the wound. ⋯ After the flexor tendons and volar plate were replaced back into their normal position, the reduction was successful. Finally, the patient had full and painless motion of the digit. We review the reported cases of this injury in the relevant literature.
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Review Case Reports
Irreducible simultaneous dislocation of both interphalangeal joints in the little finger: a case report.
We present a case with irreducible simultaneous dislocation of both the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints in the little finger. A combination of the delay from injury to closed reduction and the entrapped flexor digitorum profundus (FDP) tendon at the PIP joint prevented closed reduction from being performed. To our knowledge, this is the first report of such a condition.
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Our purposes were to report the radiographic outcomes and complications of patients with Colles' fracture treated with the Nakashima locking volar plate system (variable angled distal screw locking mechanism) prospectively and to report the results of objective clinical variables such as grip strength and range of motion of the wrist prospectively at up to one year. This study consisted of eight men and 32 women for analysis of radiographic parameters (volar tilt, radial inclination and radial length) and complications. Radiographic parameters were measured pre-operatively, immediately post-operatively and at final follow-up visit. ⋯ Satisfactory clinical and radiographic results were obtained by using this system. The variable angled distal fragment plating system appears to be a reliable construct for rigid fixation of Colles' fractures; however, technical errors can occur, as with other fixation systems. We demonstrated that the follow-up of Colles' fracture treated by our volar locking plate less than one year post-operative may be insufficient.
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The diagnosis of chronic wrist pain is challenging and wrist arthroscopy has been recognised as the "gold standard". The present study investigated the efficacy of adding distal radioulnar joint (DRUJ) arthroscopy to routine wrist arthroscopy. The records of 67 patients who underwent DRUJ arthroscopy were reviewed, and the success rates for visualisation of intra-articular structures were determined. ⋯ The ulnar head and proximal surface of the triangular fibrocartilage complex (TFCC) were visualised in 100% and 99% of patients, respectively, while the foveal insertion of TFCC and sigmoid notch were visualised in 57% and 69%, respectively. Pathological findings of the proximal surface of TFCC tended to relate to ulnar wrist pain (p = 0.06). DRUJ arthroscopy should be included in routine wrist arthroscopy to enhance the accuracy of diagnosis.
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Healed distal radial fractures are frequently complicated by chronic wrist pain which is multifactorial and can be debilitating. An accurate delineation of the pathoanatomy is the key for successful treatment. ⋯ Surgical treatment directed towards identified abnormalities gave satisfactory outcome. At six months after surgery the mean functional score improved 36%, mean pain score decreased 50%, mean grip strength improved 25%, and 64% of patients returned to work.