The journal of hand surgery Asian-Pacific volume
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J Hand Surg Asian Pac Vol · Mar 2018
Case ReportsIsolated Salter-Harris Type III Physeal Fracture of the Distal Ulna.
We describe a case of isolated physeal fracture of ulna distal end in a 13-year-old boy. This fracture type is uncommon, especially Salter-Harris type III of this injury has not been reported. Plain radiographs showed a small vertical fracture line at the ulnar distal end and an enlargement of epiphyseal plate at the base of ulnar styloid process. The present case was successfully managed with conservative treatment because of its minimal displacement.
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J Hand Surg Asian Pac Vol · Mar 2018
Complications of Intramedullary Fixation for Distal Radius Fractures in Elderly Patients: A Retrospective Analysis Using McKay's Complication Checklist.
Intramedullary fixation for distal radius fractures is reported to be free of hardware irritation and less invasive than other fixation methods. Some specific complications associated with intramedullary fixation, such as radial nerve sensory neuritis, have been reported, but no study has focused on the complication rates of intramedullary fixation for distal radius fractures in the elderly population. Furthermore, no studies have analyzed common complications, such as carpal tunnel syndrome and flexor tenosynovitis including trigger finger, among patients with distal radius fractures treated by intramedullary fixation based on a comprehensive complication checklist. ⋯ Intramedullary fixation for distal radius fractures was free from tendinous complications such as tenosynovitis and tendon ruptures around the implant, which are frequently caused by volar locking plate fixation. However, this less invasive technique could not avoid common complications such as trigger finger and carpal tunnel syndrome associated with distal radius fractures.
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J Hand Surg Asian Pac Vol · Mar 2018
A Prospective Study of Acute Undisplaced and Minimally Displaced Scaphoid Fractures Managed by Aggressive Conservative Approach.
To identify acute un-displaced and minimally displaced scaphoid fractures which are unlikely to unite with non-operative treatment at six weeks with CT scan and stabilize them with percutaneous screw fixation with the aim of preventing non-union. ⋯ An objective measurement of fracture gap by CT scan at six weeks is useful in predicting cases with tendency for delayed union. Early percutaneous fixation of fractures would not further jeopardize the blood supply of fracture site. This aggressive conservative management also avoids unnecessary surgery in all acute scaphoid fractures.
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J Hand Surg Asian Pac Vol · Mar 2018
Use of Computed Tomography in Determining the Occurrence of Dorsal and Intra-articular Screw Penetration in Volar Locking Plate Osteosynthesis of Distal Radius Fracture.
The use of volar locking plate in distal radius fracture can lead to extensor tendon rupture due to dorsal screw penetration. The aim of our study was to investigate the occurrence of dorsal and intra-articular screw penetration using CT scan after volar distal radius osteosynthesis for distal radius fractures. ⋯ This study demonstrated a high incidence of dorsal and intra-articular screw penetration detected by CT scan which was not apparent in plain radiograph. We recommend that surgeons adhere to the principle of only near cortex fixation and downsizing the locking screw length by 2 mm.
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J Hand Surg Asian Pac Vol · Mar 2018
Case ReportsAttrition of the Extensor Tendon of the Index Finger Following an Avulsion Fracture of the Third Metacarpal.
We report an avulsion fracture at the base of the third metacarpal involving the extensor carpi radialis brevis insertion and a resulting complication of attritional rupture of the extensor indicis proprius tendon and the extensor digitorum communis to the index finger, in a 67-year-old man.