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INTRODUCTION: Swan neck deformity (SND) is characterized by hyperextension of proximal interphalangeal (PIP) joint and extension lag of distal interphalangeal (DIP) joint with functional loss of finger and impairs of tight grip of the finger. SND often results from chronic mallet injury and requires surgical treatment. One of the procedure is spiral oblique retinaculum ligament (SORL) reconstruction. We reported good outcome of swan neck deformity due to chronic mallet finger cases treated with SORL reconstruction using lateral band technique. CASE PRESENTATION: We presented 2 case of swan neck deformity due to chronic mallet finger. A 21-year-old male with deformity of the left index finger for 2 years with with extension lag 50° and -20° PIP joint hyperextension and A 18-year-female with deformity of right ring finger for 4 years with extension lag 40° and -20° PIP joint hyperextension. We performed SORL reconstruction using lateral band technique. Ten weeks after surgery, patient achieved good range of motion and stability of PIP and DIP joint was obtained. DISCUSSION: SORL reconstruction in a finger with a chronic mallet deformity coordinates extension of PIP and DIP joints by a dynamic tenodesis effect. This concept improves stability of both DIP and PIP joints by linking the volar flexor sheath to the lateral aspect of the terminal tendon using lateral band, thereby providing a mechanism of for automatic DIP joint extension upon active PIP extension. CONCLUSION: SORL reconstruction using lateral band technique may be a good choice for treating swan neck deformity.
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INTRODUCTION: Lipomas are common benign mesenchymal tumor that arise from the adipose tissue. Differential diagnosis between the benign and malignant form (liposarcoma) must be made to prevent complication and recurrence. PRESENTATION OF CASE: We reported a 63-year-old man who presented with recurrent large-sized mass on the right forearm with the first presentation approximately 28 years before being treated in our center. Main complaints were discomfort, social embracement, and difficulty in dressing. There were no compression symptoms observed. We performed marginal excision and sent the sample for histopathological examination. The work has been reported in line with the Surgical Case Report (SCARE) criteria. DISCUSSION: During one year of post-operative period, no recurrence was detected and a complete relief of symptoms was as expected. CONCLUSION: Diagnostic challenge in such a large-sized (giant) lipoma is in differentiating it with the malignant form. Surgical excision is the choice of treatment. However, long-term follow up is needed due to the risk of recurrence.
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INTRODUCTION: Every emergency surgery performed is aimed at saving lives; however, during COVID-19 pandemic, surgeries are often postponed. Many existing recommendations take into account postponing surgery during a pandemic. How these surgeries can lead to increasing infection rates has not been widely published. This study aims to investigate the relationship of emergency orthopaedic surgery and the incidence rate of COVID-19. PRESENTATION OF CASE: This was a case series of 14 patients. The study was performed at the emergency department unit at a national tertiary hospital in Jakarta, Indonesia. A total of 14 patients underwent orthopaedic surgery in the emergency room of our institution. The mean age of the subjects was 40.07 ± 20.5 years. Twelve (85.7%) were male patients and 2 (14.3%) were female patients. The average duration of surgery was 125 minutes. The most used type of anaesthesia was general anaesthesia for 6 operations (50%). Patients were hospitalized for an average length of 4 days. Three patients had infiltrates found on plain x-ray examination, which required further examination to determine whether the cause was COVID-19 infection or not. There was no ground glass appearance (GGO) in the three patients in further follow-up examination. CONCLUSIONS: We found that emergency orthopaedic surgery was not associated with increasing number of COVID-19 cases. Factors including duration of surgery, length of stay, types of anaesthesia and comorbidities were also not associated with COVID-19 cases in this study.
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INTRODUCTION: Mycobacterium tuberculosis causes infection in approximately one-third of the world's population. Arthritis due to Mycobacteriurn tuberculosis usually presents as a chronic, slowly progressive, monoarticular infection that predominantly involves the weight-bearing joints and the spine. The hand and wrist are rare sites for tuberculosis (TB) and comprises of < 1% of all skeletal TB. Even though it is rare, TB of the wrist is a cause of great morbidity. We presented a case of wrist TB treated with debridement and synovectomy. PRESENTATION OF CASE: A 35 years old woman came with the chief complaint of pain and swelling on the right wrist since 1â¯year ago and was diagnosed with rheumatoid arthritis of the wrist. Patient then was given methylprednisolone 4â¯mg twice a day and methotrexate 175â¯mg once a week. However, the pain and swelling of her right wrist became worse. Subsequently patient was admitted to hospital and laboratory findings suggested a tuberculous arthritis of the wrist. Debridement, synovectomy, and biopsy, in addition to antituberculosis therapy, were then performed. DISCUSSION: Tuberculous arthritis is generally a monoarticular disease that typically involves the spine or large and medium-sized joints. Rheumatoid arthritis (RA) and tuberculous arthritis may have similar clinical characteristics, which consists of a chronic course with periarticular soft-tissue swelling. CONCLUSION: Tuberculous arthritis and RA can have similar characteristic but laboratory examination can help in establishing diagnosis.