Carpometacarpal fracture dislocations of the hand are a relatively uncommon injury. The injury is difficult to diagnose because of the gross swelling of the hand. The diagnosis of this unusual form of injury requires a high index of suspicion, vigilant examination and high-quality radiography. This article reports a case of young male grieved with dislocation of all carpometacarpal (CMC) joints due to motor vehicle collision. Standard radiographs and CT scan revealed dorsal dislocations of second to fourth CMC joints, volar fracture dislocation of fifth carpometacarpal joint, fracture dislocation of CMC joint of thumb and dorsal dislocation of the trapezoid. Patient was treated with closed manipulation and percutaneous pinning with multiple K - wires. Follow up radiographs showed adequate reduction and fracture union. Intensive postoperative physiotherapy is vital for achieving a good outcome.
Background: Proximal femoral fractures are common in elderly and with high velocity trauma in younger age groups too. Nailing of proximal femoral fractures is technically demanding procedure which needs experience to tackle the difficulties. Detailed literature regarding the difficulties faced during the procedure is lacking. Methods: Analysis of the intra operative complications faced during closed and open proximal femoral intra-medullary nailing. Conclusions: Technical difficulties arise due to many reasons starting from improper positioning of the patient. With good instrumentation and with experience these problems can be minimized with attention to each surgical step.
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