Every year thousands of people are victims of hand trauma, with serious injuries for half of them. Hand injuries occur twice as often in accidents in everyday life than in accidents at work. They are the cause of several amputations (hand or fingers). The nature of the trauma does not only affect the survival rate, but also the functional outcome. Sometimes it is better to have an amputated finger than a non-functional and sometimes even embarrassing, painful and insensitive leftover finger. Traumatic digit amputation generates functional, aesthetic and psychological disabilities. Such post-traumatic consequences call for a rigorous therapeutic approach, aiming at an early secondary surgical procedure which is ideally to be performed before the patients psychologically recover from their initial trauma. Through this technical point, we describe a technique for additional amputation of the index finger by transforming the middle finger into an index finger while maintaining a free and functional first commissure.
The Luxatio erecta humeri is the inferior dislocation of the glenohumeral joint and the poterior hip dislocation are rare cases in the emergency department. The association of the two presentations is a rare entity and similar cases are very little found in the literature, hence the purpose of this work. We report the case of a 35-year-old taxi passenger victim of a public road accident who presented with both luxatio erecta humeri and pure posterior hip dislocation. An orthopaedic surgeon reduced the luxatio erecta humeri and the posterior hip dislocation under procedural anesthesia as soon as the patient’s vital signs were stable. Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, pure posterior dislocation of the hip as a concomitant distant region injury for luxatio erecta humeri is being described for the first time in this case report. Some authors suggested that a two-step manoeuver can be easier to practice than a one-step manœuvre, in our specific case, luxatio erecta was easily reduced by a single operator in a single attempt. Luxatio erecta humeri and posterior hip dislocation are lesions that occur at high energy and complex injuries can accompany them in patients with multiple traumas. A two-step closed reduction can be easily applied by a single operator under procedural anesthesia. hip and shoulder dislocations are extreme emergencies.
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