The American journal of orthopedics
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High-pressure injection injuries often have a misleadingly benign presentation. However, it is important to recognize the potential surgical urgency and long-term sequelae associated with these injuries. We present a case of paint gun injection to the palm and review the literature on high-pressure paint injection injuries. ⋯ The immediate use of antibiotics and tetanus prophylaxis, with or without steroids, is indicated. Urgent debridement in the operating room is imperative and can decompress the neurovascular structures and flexor tendon sheath by removing the irritating agents. Reported overall amputation rates have been as high as 30%.
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Latissimus dorsi avulsion injuries are rarely reported in the literature and are managed with a variety of strategies. Primary anatomical repair of tendon to bone may offer athletes the best chance for successful return to sports. ⋯ Using 1 low anterior axillary incision and 1 posterior axillary incision for tendon retrieval when retraction is more than 5 cm, this technique allows for direct anatomical repair of a retracted tendon to bone using 3 points of bony fixation supplemented by soft-tissue repair. The technique also minimizes the risks for neurovascular compromise and cosmetic deformity, while decreasing the risk for postinjury strength deficits.
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Both-bone forearm fractures, also known as concomitant diaphyseal radius and ulna fractures, and distal radioulnar joint (DRUJ) dislocations are each uncommon injuries in adult upper extremity trauma. DRUJ dislocations are more often associated with radial shaft (Galeazzi) fractures. In this article, we report the case of a patient who sustained a both-bone forearm fracture and DRUJ dislocation, and we review the literature on this unique injury pattern.
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Unstable fractures of the distal clavicle are often encountered in high-demand, young athletes. We evaluated biomechanical performance and mode of failure in 4 treatment methods. ⋯ Four fixation techniques were utilized, 5 times each on 5 different cadavers: suture fixation with a cerclage suture and coracoclavicular suture, distal clavicle locking plate, distal clavicle locking plates with suture augmentation, and distal clavicle hook plate. No significant difference in ultimate load to failure was found among groups in the treatment of the unstable distal clavicle fractures.