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Introduction: Anterior elbow dislocation is a rare occurrence, mostly produced by direct trauma to elbow in flexion attitude following fall from height. Posterior dislocation is the commoner entity at the elbow joint, thus rarity of this case incites reporting. Case Report: A 53-year-old male presented to our outpatient department with complaints of pain, swelling, and inability to move his right upper limb, following fall from height. On examination, no associated neurovascular deficit was found. Radiological investigations confirmed anterior dislocation of elbow joint with medial epicondyle fracture of the right humerus. Dislocation was reduced under general anesthesia with ulnohumeral K-wire and fracture of the medial epicondyle was stabilized by open reduction and internal fixation with K-wire. Conclusion: Anterior dislocation of elbow is a rare occurrence with frequent association with periarticular fractures and neurovascular injury. Therefore, a careful assessment followed by the early proper reduction and management leads to better functional outcome.
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Neer's type II lateral end clavicle fracture is inherently unstable due to coraco-clavicular ligament disruption. Timely surgery can avoid complications of conservative management. Our study is based on open reduction and fixation with double endobutton and fibre tape in 12 patients. Radiological and functional outcome were assessed using Quick DASH score and SPADI score at regular interval. All the fractures achieved both clinical and radiological union. No intra-operative or post-operative complication was noted. Functional out come and range of motion at 1-year follow-up was quite satisfactory. Open reduction and fixation with double endobutton and fibre tape for lateral end clavicle fracture is a quite rewarding surgery with less steep learning curve, economical and enough stable fixations leading to union and good functional outcome without need of re-surgery for implant removal.
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INTRODUCTION: The optimal method for fixation of extra-articular distal humerus fractures poses a management dilemma. Although various plate configurations have been proposed, anatomic shaped extra-articular distal humerus locking plates (EADHPs) have emerged as a viable solution for these complex injuries. We assessed functional and radiologic outcomes in our retrospective case series of extra-articular distal humerus fractures managed with these plates at different centers in Cuttack, Odisha. MATERIALS AND METHODS: One hundred and ten patients of extra-articular distal humerus fractures, who were operated at various trauma centers between January 2012 and December 2020, were identified. After exclusion, 100 patients were available for the final assessment. All patients were operated with the triceps-reflecting modified posterior approach. Regular functional-radiologic follow-up was done evaluating elbow functionality, fracture union, secondary displacement, nonunion, implant failure, and any complications; Mayo Elbow Performance Score (MEPS) was used for the final functional assessment. RESULTS: Sixty-seven percent of male and 33% of female patients constituted the study group, who had an average follow-up of 18 months. Preoperatively three patients and postoperatively one patient had radial nerve palsy; all had neurapraxia and recovered completely. Overall, 95% of patients were adjudged to have complete radiological union within 3 months; 6% of patients developed nonunion. The mean flexion achieved was 123 + 22, and the mean extension was 4.031 + 6.50; five patients with head injury developed flexion deformity of 45. The average MEPS at the final follow-up was 91 + 9.8. CONCLUSION: Stable reconstruction and early initiation of physiotherapy are utilitarian to envision optimal outcome; the use of precontoured EADHPs has yielded satisfactory results with minimal complications in our hands.
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Hemangioma of the tendon sheath is an uncommon tumor-often slow-growing and misdiagnosed until final biopsy. We hereby report a 30-year-old woman who presented with pain and swelling of the wrist for 2 years, which was proven to be cavernous hemangioma of extensor tendon sheath.
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BACKGROUND: The relationship of Common peroneal nerve (CPN) to the posterolateral corner of the knee joint is important for surgeons who perform total knee arthroplasty to avoid injury to the nerve during surgery. This relationship varies among different races on account of anthropometry. This study aims to evaluate the anatomical location of this nerve in Indian patients using an MRI based reference system. METHODS: 213 knee magnetic resonance images (MRIs) were evaluated in axial plane 8â¯mm below the joint line for distance of the CPN from the closest posterolateral capsule. The angle of the CPN from the center of the tibial anteroposterior axis and relation of CPN with respect to the popliteus were evaluated. A comparative analysis of these measurements among Caucasian, Chinese and Indian patients was made to evaluate for any differences. RESULTS: The mean distance between the CPN and the knee capsule was 15.55â¯mm (range, 7.8-26.2â¯mm). The mean angle of the CPN from the center of the AP axis was 50.1° (range, 38-63). CPN was found to be in line with the popliteus from center of the knee in 62% cases. There was no significant difference among the different races among the measured parameters (pâ¯>â¯0.005). CONCLUSION: This study establishes a "danger zone" and a "safe zone" to avoid CPN injury in total knee arthroplasty in Indian patients and identifies anatomic landmarks to localize the nerve before the soft-tissues release in order to avoid direct injury.