The American journal of orthopedics
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Avulsion of the flexor digitorum profundus (rugger jersey finger) commonly occurs in athletes as a result of forced extension of a flexed distal interphalangeal joint. Ultrasound can be a useful tool in defining the anatomy of a tendon avulsion when no fracture is present. ⋯ Use of ultrasound for closed flexor tendon injuries has not been covered enough in the hand surgery literature. We report on the use of ultrasound as a diagnostic tool in evaluating and treating subacute avulsion injuries to the flexor digitorum profundus.
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Antegrade intramedullary nailing using the piriformis fossa as an entry point for insertion has become the treatment of choice for most diaphyseal fractures of the femur. In obese or well-muscled patients, however, creating an entry point can be difficult. ⋯ Unfortunately, retrograde nailing is associated with higher nonunion rates and increased incidence of knee pain and stiffness. We describe an antegrade nailing technique that is useful and easy to perform even in obese patients.
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Review Case Reports
Chronic coccidioidomycosis infection of the knee: a case report.
Coccidioidomycosis is a rare fungal infection caused by C immitis in endemic areas of the southwestern United States. Extrapulmonary hematogenous dissemination is a feared complication of the primary pulmonary disease. The musculoskeletal system can be involved, and disseminated musculoskeletal infections can be extremely difficult to eradicate. Surgical treatment of chronic bone and joint infections includes débridement and eventual arthrodesis for end-stage secondary osteoarthritis.
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Functional outcome after V-Y musculofascial lengthening of the flexor-pronator musculotendinous origin was assessed in conjunction with submuscular transposition of the ulnar nerve for cubital tunnel syndrome. We retrospectively evaluated 38 submuscular transpositions with V-Y lengthening in 35 patients. ⋯ Mean functional score improved from 33.5 preoperatively to 62.7 at latest follow-up (P<.001), pain improved from 7.4 to 3.5 (P<.001), and numbness improved from 7.0 to 4.1 (P<.001). V-Y lengthening of the flexor-pronator origin is an effective alternative to musculofascial lengthening in combination with submuscular transposition for treatment of cubital tunnel syndrome.