RESUMEN
Porokeratosis of Mibelli is an uncommon dermatosis, which may be associated with immunosuppression and which may undergo malignant transformation. We report a patient with a chronic history of a skin lesion of his right 5th finger that was histologically confirmed to be Porokeratosis of Mibelli. Although it commonly affects the extremities, the isolated involvement of an individual digit of the hand has not been previously reported.
Asunto(s)
Dedos , Dermatosis de la Mano/patología , Poroqueratosis/patología , Dermatosis de la Mano/cirugía , Humanos , Masculino , Persona de Mediana Edad , Poroqueratosis/cirugía , Trasplante de PielAsunto(s)
Traumatismos del Brazo/fisiopatología , Nervio Mediano/lesiones , Examen Neurológico/métodos , Traumatismos de los Nervios Periféricos/fisiopatología , Heridas Penetrantes/fisiopatología , Epidermis/inervación , Humanos , Hipoestesia/etiología , Masculino , Examen Neurológico/instrumentación , Umbral Sensorial/fisiología , Adulto JovenRESUMEN
Scaphotrapezoidal osteoarthrosis can cause persistent pain after trapeziectomy. It has previously been recommended that the scaphotrapezoidal joint should be resected at the time of trapeziectomy to avoid this complication if radiographs show evidence of joint degeneration. We have reviewed the records of 77 patients who had 87 trapeziectomies and assessed their radiographs for the presence and degree of osteoarthrosis. There was evidence of scaphotrapezoidal osteoarthrosis in almost half of the hands. Its presence, however, had no influence on subjective or objective measures of pain, function or power before or after operation, or on outcome. Only one patient required resection of the scaphotrapezoidal joint because of persistent pain. Resection of the joint cannot be recommended as a routine adjunct to trapeziectomy on radiological evidence alone.
Asunto(s)
Huesos del Carpo/cirugía , Procedimientos Ortopédicos/métodos , Osteoartritis/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/fisiopatología , Resultado del Tratamiento , Articulación de la Muñeca/fisiopatologíaRESUMEN
This study reports on 565 consecutive endoscopic carpal tunnel releases using the Agee one-portal technique of which 25 (4.4%) were converted to the open technique. The follow-up period was from 4 to 52 months. Immediate symptomatic relief was reported in 562 wrists (99.5%). There were 25 complications (4.4%) including pillar pain (8 wrists), digital neuropraxia (n = 6), median nerve contusion (n = 3), incomplete division of the flexor retinaculum (n = 3), superficial infection (n = 3), reflex sympathetic dystrophy (n = 1), and tenderness of the scar (n = 1). We describe the evolution of our selection of patients and surgical technique. We recommend caution in performing ECTR in short patients who are liable to have small wrists because of the risk of contusion of the median nerve. We present some technical modifications that may make the technique safer.