RESUMO
Encounters with venomous snakes can lead to substantial morbidity or mortality if managed inappropriately. Medical management is the mainstay of treatment, but surgery may be necessary in rare cases. The hand surgeon should be well versed in the types of venomous snakes, the mechanism of action of venom, and the management of these injuries, given the frequency of hand envenomation. The indications for surgery are not well established and rely on clinical judgment and practitioner's experience. An understanding of previously reported outcomes and an algorithmic approach to treatment will help improve patient care and avoid complications.
Assuntos
Antivenenos/uso terapêutico , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Mordeduras de Serpentes/terapia , Extremidade Superior/lesões , Analgésicos Opioides/uso terapêutico , Animais , Criança , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/cirurgia , Desbridamento , Fasciotomia , Humanos , Masculino , Necrose/cirurgia , Venenos de Serpentes/imunologia , Toxoide Tetânico , Extremidade Superior/cirurgiaRESUMO
BACKGROUND: Triangular fibrocartilage complex (TFCC) injuries are a known cause of ulnar-sided wrist pain. Wrist arthroscopy is the gold standard for diagnosis of these lesions and is becoming a more frequent method of treatment. Isolated radial-sided tears are uncommon and treatment of these lesions is controversial. There are few reports on repair techniques. Here we report on a novel arthroscopic, all-inside technique for traumatic radial-sided TFCC tears that resulted in full range of motion, significant improvement in pain, and ultimately return to sport. METHODS: This is a single case report describing an all-inside, arthroscopic repair of a radial-sided TFCC tear. The techniques and postoperative protocol are discussed. Clinical outcomes were reported at final follow-up of 3.5 months. RESULTS: At final follow-up, our patient had full wrist range of motion, 95% strength, occasional 1/10 pain, and returned to sport at her previous level of play. There were no complications. CONCLUSION: Although just a single case report, our patient had an excellent result based on modified Mayo wrist score. When comparing our result and the previous literature, this technique seems to be a valid method for addressing radial-sided TFCC tears.