RESUMEN
The authors report the case of a knee joint wound caused by a needlefish of the Belonid type, or "Orphie." This observation is one of a series of 10 traumas reported over the past few years with this dangerous fish that resides in the New Caledonian lagoon. The authors show the importance of a thorough clinical examination of the patient and, more especially, the importance of the radiological opacity of the foreign body, which is essential for diagnosis. Our experience with this type of wound in articular disorders leads us to recommend arthroscopic treatment combined with intraoperative radiological control. This method is to assure the total exeresis of the foreign body whose sepsis would irremediably cause serious acute arthritis.
Asunto(s)
Peces , Cuerpos Extraños/cirugía , Traumatismos de la Rodilla/etiología , Traumatismos de la Rodilla/cirugía , Heridas Penetrantes/etiología , Heridas Penetrantes/cirugía , Adulto , Animales , Artritis Infecciosa/etiología , Urgencias Médicas , Cuerpos Extraños/diagnóstico , Humanos , Traumatismos de la Rodilla/diagnóstico , Masculino , Heridas Penetrantes/diagnósticoRESUMEN
Seventeen cases of late ulnar paralysis treated by neurolysis-transposition are reported. The clinical characteristics of these paralyses are emphasized: very prolonged symptom free interval, rapid onset and severe involvement. Ulnar transposition was most often done subcutaneously. Cubitus valgus and definite nerve compression proximal to the arcade of the flexor carpi ulnaris muscle are almost always present. The results as regards the neuropathy are undependable: no patient is completely cured and only half are improved. An anatomical study of the nerve path shows the essential role, in the compression of the nerve, of the muscular arcade of the flexor carpi ulnaris muscle which acts in a way similar to the bridge of a violin. Hence, opening it longitudinally is the principal step of neurolysis. This should be routine before the first signs of neuropathy occur in an elbow whose axis is out of alignment as a sequela of a childhood injury.
Asunto(s)
Lesiones de Codo , Síndromes de Compresión Nerviosa/etiología , Parálisis/etiología , Nervio Cubital , Adulto , Femenino , Fracturas Óseas/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Parálisis/diagnóstico , Parálisis/cirugía , Seudoartrosis/complicaciones , Factores de Tiempo , Nervio Cubital/patología , Nervio Cubital/cirugíaRESUMEN
Seventeen cases of late ulnar paralysis treated by neurolysis-transposition are reported. The clinical characteristics of these paralysis are emphasized. A very prolonged symptom free interval, a rapid onset and a severe involvement. The ulnar transposition was most often done subcutaneously. Cubitus valgus and definite nerve compression proximal to the arcade of the flexor carpi ulnaris muscle are almost always present. The results as regards the neuropathy are notable: no patient is completely cured and only half are improved. An anatomical study of the nerve path shows the essential role, in the compression of the nerve, of the muscular arcade of the flexor carpi ulnaris muscle which acts in a way similar to the bridge of a violin. Hence, opening it longitudinally is the principal procedure of the neurolysis. This should be routine before the first signs of neuropathy occur in an elbow whose axis is out of alignment as a sequela of a childhood injury.