Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 1994
Case ReportsCoracoid process fracture combined with acromioclavicular dislocation and coracoclavicular ligament rupture. A case report and review of the literature.
A coracoid process fracture associated with acromioclavicular joint dislocation and with rupturing of the coracoclavicular ligaments of an adult has been reported only once in the literature. This report adds another unusual case to the literature to reemphasize the importance of recognizing this unusual lesion. Two separate mechanisms--direct trauma to the shoulder girdle and sudden pull on the coracoid process by the conjoined tendons of short head biceps and coracobrachialis muscles--appear to be responsible for this unusual triple lesion. Open reduction with coracoid screw and acromioclavicular fixation, combined with an All-dredge repair to replace the ruptured coracoclavicular ligaments, resulted in an excellent outcome.
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Clin. Orthop. Relat. Res. · Mar 1994
Acute median neuropathy after wrist trauma. The role of emergent carpal tunnel release.
Ten cases of acute carpal tunnel syndrome (ACTS) and six cases of nerve contusion were identified in patients with acute median neuropathy associated with blunt wrist trauma. The patients with ACTS initially had normal sensation and subsequently developed objective sensory loss (2-point discrimination greater than 15 mm) in the median nerve distribution associated with severe wrist pain. Patients with nerve contusion injuries had immediate sensory loss and symptoms were nonprogressive. ⋯ The results of this study and review of the literature reflect the urgency of carpal tunnel release in ACTS. Neuropathy, secondary to nerve contusion without coexisting ACTS, may be treated initially by observation. Acute carpal tunnel syndrome must be distinguished from nerve contusion as a cause of acute posttraumatic median neuropathy.