We report the case of a 36-year-old lorry driver who sustained left dorsal radiocarpal fracture dislocation and left median nerve injury in a traffic accident in 2010. Emergency operation of closed reduction, cross-wrist-bridging external fixation, percutaneous transradial styloid Kirschner wire fixation, decompression of left median nerve, and repair of the partially torn palmar radiocarpal ligament were performed under general anaesthesia. Because of the persistent depressed dorsal articular rim fracture of left distal radius, another operation of open reduction, corticocancellous bone grafting, and dorsal buttress plating was performed 5 days after the initial operation. Six months after the operation, the patient enjoyed good range of wrist motion but weak twisting power, especially in supination. There was no radiological feature of radiocarpal subluxation.
Background/Purpose: Curettage followed by the application of iliac crest autograft was the traditional treatment of hand enchondroma in Princess Margaret Hospital, Hong Kong. Methods: We reviewed the results of 13 patients with hand enchondroma who were operated on in the past 15 years (1999e2013). Eight patients (1999e2009) received iliac crest autograft after curettage, whereas the other five patients (2009e2013) received artificial bone substitutes. Results: Both groups of patients had good functional outcome and bone graft incorporation. There was no recurrence. One patient in the autograft group had mild residual finger stiffness. One patient receiving artificial bone substitutes had a gouty attack, early wound infection, and finger stiffness. The use of artificial bone substitutes eliminated donor site morbidities, decreased operation time and, hospital stay. They took a longer time for radiological incorporation than autograft, but it did not translate into adverse clinical effects. Conclusion: Artificial bone substitute is a good alternative to iliac crest autograft in the treatment of hand enchondroma.
a b s t r a c tObjective: The aim of this retrospective study was to analyse the clinical outcome of the application of stainless steel 2.0-mm locking compression plate (LCP) system for the treatment of comminuted hand fractures in Asian adults. Methods: Six patients who had comminuted hand fractures were treated by open reduction and internal fixation with the application of stainless steel 2.0-mm LCP (AO Compact Hand System; Synthes, Oberdorf, Switzerland) from December 2009 to October 2010. The total arc of motion of fingers, grip power, complications, and additional surgery were recorded. Results: Three out of six patients eventually restored good hand functions in terms of the total arc of finger motion (>220 ) and grip power. The commonest complication was skin impingement in finger region by the implant (4 cases). Another common complication was restricted range of motion (3 cases). One patient had minimal degree of malrotation of his left little finger. Additional surgery was required in all the patients for implant removal (6 cases), tenolysis (3 cases), and capsulotomy (2 cases). Conclusions: The stainless steel 2.0-mm LCP is useful for the fixation of unstable comminuted hand fractures, especially in metacarpal bones, because of its advantage of better stability, which allows more aggressive rehabilitation. However, its design is not very versatile and, therefore, limits its use in the finger region. Its bulkiness frequently causes implant impingement. The patients must be informed about the chance of implant removal later.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.