Concurrent musculoskeletal complaints in elbows, shoulders, and necks after common hand and forearm injuries or conditions: A cross-sectional study among 600 patients.

STUDY DESIGN: This is a cross-sectional study among 600 patients. INTRODUCTION: Isolated hand and forearm injuries or conditions are common in the emergency and orthopedic departments. So far, little is known about whether these patients suffer from concurrent musculoskeletal complaints (MSCs) besides their hand and forearm complaints. Neglecting concurrent MSCs in the upper limbs and necks could hamper rehabilitation and prolong the time taken to return to daily and work-related activities. PURPOSE OF THE STUDY: The purpose of this study was to investigate the prevalence of concurrent MSCs in the elbow, shoulder, and neck after common hand and/or forearm injuries or conditions. METHODS: This study included 600 patients with any type of diagnosis referred to rehabilitation after hand and/or forearm injuries or conditions. Basic characteristics, diagnoses, and location of patients' symptoms were collected and analyzed. RESULTS: The overall prevalence of concurrent MSCs was 40%. Twenty-eight percent of the whole sample developed concurrent MSCs after the hand and forearm injury or condition. The gender distribution was 68% women and 32% men. The most common location for complaints was the shoulder (62%), followed by the elbow (49%), and the neck (32%). DISCUSSION: The present results suggest that MSCs from the elbows, shoulders, or necks are very common in patients with hand and/or forearm injuries or conditions. CONCLUSION: Clinicians treating patients with isolated hand and forearm injuries or conditions should be aware of the high prevalence of concurrent MSCs. Future research should investigate if specific rehabilitation, focusing on concurrent MSCs, may influence the outcome in this population.

[Open surgical removal of a lost stent after percutan coronary intervention].

Coronary stent loss is a rare but potentially life-threatening complication during percutaneous coronary intervention (PCI) if displacement and embolisation occur in a coronary artery or a cerebral vessel. In this case report a distally dislodged stent and the surgical removal of it is described. Removal of the stent was attempted after failed PCI, but the stent was lost at the puncture site of the left radial artery. The lost stent displaced itself more distally and gave rise to pain in the left hand. The patient was referred to an orthopaedic surgeon, who removed the lost stent successfully by an arterial cutdown.

[Glomus tumour of the distal phalanx].

A glomus tumour is a benign, small, rare tumour, primarily localised to the fingers. Literature describes a delayed diagnosis, and patients will describe a classic triad of symptoms: paroxysmal pain, hypersensitivity, and pinpoint pain at the location of the tumour. MRI can confirm the presence and the localisation of a glomus tumour, and an osseous defect can often be found by X-ray. If the patient show classic symptoms, exploratory surgery should be performed, despite negative radiology. Excision of the tumour will provide immediate pain relief and has a very low rate of recurrence.

[Long delay until correct diagnosis of glomus tumours in the distal phalanx].

Glomus tumours tend to be diagnosed with long delay due to lack of knowledge about the condition. This is a case report of two patients with longstanding symptoms, which remained undiagnosed for several years despite X-ray and MRI. One was operated on without finding the tumour at the initial surgical procedure, and the other had the diagnosis confirmed by ultrasound. Both were cured of the pain, when the subungual tumour was excised.