Background: Trapeziometacarpal joint (TM joint) dislocation is an uncommon lesion, mentioned primarily in isolated case reports. Various treatment modalities are used, including conservative and surgical options; however no gold standard approach exists for this rare injury. We present such a case, and review the current literature concepts about the anatomy of the TM joint and its stabilizing ligament. Case Report: We report a case of a patient presenting an acute TM joint dislocation, handled with closed reduction maneuvers under regional block anesthesia and a splint for 6 weeks. With complete full recovery of thumb function. Discussion: Isolated dislocation of the TM joint is a rare lesion in the hand, caused by an injury to the ligament stabilizers. An complete understanding of the anatomy is necessary to make a correct diagnosis and treatment. Despite this, there are differences between different authors about which ligaments have a greater function in the stability of the joint. Since Bettinger's description, it was maintained that the main stabilizer of this joint whas the palmar oblique ligament, known by the name of beak ligament. Conclusion: We believe that according to the current evidence the DRL, or a dorsal root ligament complex, is the main stabilizer of the TM joint, although findings are not conclusive. Understanding the anatomy of the region is important for comprehending the physiopathology of this rare dislocation, and avoids misconceptions of widely established anatomical concepts in the different literature. What will be essential for surgical treatment?
Miscelanea 83S with restricted cubic splines. Results: Overall, mean residual contracture (total active extension deficit) at follow-up was 24°, which corresponded to a postprocedure improvement of 65%. Forty-seven percent of patients experienced at least 1 adverse event, with neuropraxia (12%), scar sequelae (12%), and wound healing problems (8%) being the three most common events. Surgeon volume was inversely related to the degree of residual contracture: Every 58 additional procedures performed annually were associated with 5° less residual contracture at follow-up (P, .03). Moreover, surgeon volume had an inverse effect on overall events (odds ratio per 50 additional procedures, 0.86, P, .01). Conclusions: Even among experienced hand surgeons, patients treated by surgeons performing high volumes of Dupuytren surgery had better outcomes in terms of residual contracture and adverse events. The findings of this study suggest that surgeons may improve outcomes by increasing their annual procedural volume for these specific interventions.
Massive ovarian oedema is a rare entity, non-neoplastic tumor of the ovary. We report a case of massive ovarianoedema (MOO) in a 18-year-old female who presented with abdominal pain along with large solid pelvis mass. It iswidely accepted that MOO results from the incomplete torsion of the ovary causing accumulation of fluid within the stroma and enlargement of the ovary. Awareness of this rare lesion due to its lack of pathognomonic features may allow surgeons to a conservative management preventing unnecessary oophorectomy in young patients.
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