J Trauma
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The risk of bacterial sepsis in the surgically or functionally asplenic host is reviewed. The lowest morbidity occurs in patients splenectomized because of trauma to the spleen; the highest morbidity occurs in patients splenectomized for thalassemia. ⋯ Finally, alternatives to and indications for splenectomy as well as prophylactic measures are considered. It is concluded that, at the present time, antibiotic coverage for an indefinite period of time may be indicated for surgically or functionally asplenic patients.
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Volar fracture dislocation of the second and third metacarpal bases associated with acute carpal tunnel syndrome in a 17-year-old football player were treated with open reduction, via volar incision to decompress the carpal tunnel, and via a second dorsal incision for internal fixation of the fracture dislocations with Kirschner wire fixation and reinsertion of the avulsed extensor carpi radialis:longus tendon. Anatomic reduction by closed or open reduction is recommended to avoid leaving patients with a weak grip and pain over the site of the fracture.