RESUMEN
A closed spontaneous rupture of the extensor hallucis longus (EHL) tendon is an infrequent yet challenging clinical occurrence, typically associated with systemic conditions (diabetes mellitus or rheumatoid arthritis). A closed EHL rupture, however, exists but is only reported as scattered cases in the literature. This article presents a unique case of a traumatic EHL tendon rupture in a patient without underlying predisposing factors. A 66-year-old woman, previously healthy, presented with an inability to dorsiflex her big toe following trauma, showcasing the clinical triad of pain, edema, and deficit in big toe extension. Magnetic resonance imaging confirmed a 5.9 cm EHL tendon gap that was treated by primary end-to-end repair of the ruptured tendon. The aim of this case report is to provide an overview of the literature available concerning the classification and treatment of EHL rupture and to assist in the early diagnosis and treatment of this rare condition.
RESUMEN
Dorsal dislocation of the toes is an infrequent injury that can result in severe pain and deformity. Timely diagnosis and appropriate management are paramount for optimizing patient outcomes. This case report illustrates a 53-year-old male patient who suffered dorsal dislocation of the first and second metatarsophalangeal (MTP) joints due to a crush injury. We present the clinical manifestation, radiographic findings, and management approach for this unique isolated first and second ray MTP joint dorsal dislocation, without any associated fractures. This case report underscores several critical observations: firstly, hallux dorsal dislocation can potentially coincide with other injuries; secondly, it can stem from crushing trauma to the big toe; and thirdly, successful closed reduction, when followed by effective immobilization and early rehabilitation, can yield outstanding outcomes. Additionally, the report emphasizes the importance of pursuing another closed reduction attempt under general anesthesia, if the initial attempt in the emergency room proves unsuccessful, before contemplating open reduction.
RESUMEN
Fractures of the upper end of the humerus raise a therapeutic problem in particular for three-fragment and 3 and 4-fragment complex fractures. The purpose of our study is to determine the epidemio-clinic features of complex fractures of the upper end of the humerus in adults and to assess the functional and radiological results in our case series. The study involved 25 patients whose data were collected in the Department of Orthopaedics at the Habib Bourguiba University Hospital between 2012 and 2017. We listed the epidemiological data of patients and the circumstances of the occurrence of the traumatism. Treatment was based on surgery: plate or nail osteosynthesis or prosthetics replacement. Post-operative radiographs were used to asses´ reduction. Constant-Murley score was used to assess functional outcomes at the follow-up visit. Twelve men and thirteen women were enrolled, the average age of patients was 55 years, public road accidents were reported in 48% of cases, and 4-fragment fractures were found in 76% of cases. Screwed plate osteosynthesis was used in 40% of cases and anterograde nailing was performed in 40% of cases. A prosthesis was put in place in 5 patients. Mean Constant-Murley score was 65.24, ranging between 35 years and 88 years. Consolidation of the fractures without malunions was reported in 68% of patients. In complex fractures of the upper end of the humerus, osteosynthesis performed according to patients´ needs and fracture types as well as early post-operative rehabilitation allow for acceptable functional outcomes.Domain: Orthopedic surgery.
