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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Case Reports
Osteochondral autograft and hemiarthroplasty for bilateral locked posterior dislocation of the shoulder.
Posterior shoulder dislocations are rare and account for less than 4% of all shoulder dislocations, with only 6.6% of these proving to be bilateral. More importantly, the majority of posterior shoulder dislocations continue to represent a diagnostic trap for the unwary physician who first sees patients with this condition. ⋯ Posterior bilateral dislocation of the shoulder is still a diagnostic challenge. In the chronic setting, bilateral hemiarthroplasty should be postponed as long as possible since posterior bilateral dislocation is usually experienced by middle-aged active males.
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The purpose of this study was to evaluate neurologic recovery following an acute, traumatic central cord syndrome (TCCS) injury. We retrospectively reviewed 69 patients who were treated surgically following an acute TCCS injury. The American Spinal Injury Association (ASIA) motor scores (AMS) were obtained from the time of presentation, from the time of hospital discharge, and from the most recent follow-up visit. ⋯ Adverse events were encountered in 24.6% of the patients. There were no deaths. A history of a loss of consciousness, decreased rectal tone at presentation, the presence of a fracture, the timing of surgery, and surgical approach did not have a significant impact on motor recovery.
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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.