Introduction: Volkmann’s contracture condition is of high prevalence in our population and is linked to therapeutic faults. The treatment and its results are determined according to the severity of the lesions. Methods: This retrospective study was performed in three centers and was conducted over 30 years (1987–2018); it included 32 patients. The disabilities of the arm, shoulder and hand (DASH) score and the Weber test were used to evaluate the functional outcome looking at mid and long-term results. Results: Thirty-two patients were treated for Volkmann’s Ischemic Contracture (VIC). The age ranged from 4 to 58 years, with 19 patients aged under 15. Wrist fracture was the predominant cause in 16 cases. Fourteen patients obtained a completely functional hand, seven good functional results, four fair functional results, and seven poor results. Discussion: In comparison with other studies, we noticed significant differences: apart from the dominant male sex and right side, this is one large case series conducted over 30 years (1987–2018) looking at mid-and long-term results. All the patients presented with severe or moderate lesions on the first visit. In our study, the wrist fracture is predominant compared to elbow fractures and soft trauma. X-rays are especially helpful and are a first-line investigation for identifying displaced fractures and other associated lesions. Our study population is not large, and the treatment methods are varied, so it is impossible to provide statistically relevant correlations between the treatment method and outcome. But this work is based on the experience of more than 30 years, which makes it possible to help adequate decision making according to the state of the lesions. This study is a level IV case series.
Introduction: Mallet finger is a frequent lesion. It represents 2% of sports emergencies and is the most common closed tendon injury seen in contact sports or in work environment. It occurs always after a traumatic etiology. Our case is atypical and exceptional, because it is caused by a villonodular synovitis, condition which has been never reported in the literature. Case Report: A 35-year-old woman presented for a mallet finger deformity of the second right finger. When questioned, the patient did not recall any trauma; she reported that the deformation had developed gradually over a period of more than 20 days preceding the definitive deformation of the finger into a classic mallet finger. She reported experiencing mild pain before the deformation, with burning sensations at the third finger phalanx. On palpation, we noted the presence of nodules at the level of the distal interphalangeal joint and on the dorsal face of the second phalanx of the concerned finger. The X-ray examination showed the classic mallet finger deformity, with no bone associated lesion. The diagnosis of pigmented villonodular synovitis (PVNS) was suspected intraoperatively by the presence of hemosiderin into the tendon sheath and distal articulation. The excision of the mass with tenosynovectomy and reinsertion of the tendon was the essential elements of the treatment. Conclusion:A mallet finger caused by a villonodular tumor is an exceptional condition with local aggressivity and uncertain prognosis. A meticulous surgical procedure could achieve an excellent result. Complete tenosynovectomy, tumor surgical resection, and tendon reinsertion were the mainstay of treatment for a long-lasting excellent result. Keywords: Non-traumatic mallet finger, villonodular tumor of extensor tendon sheat, pigmented villonodular tenosynovitis, extensor tendon injury, finger deformity.
Background: Utilized since 1951, the Boytchev procedure is an open anterior repair, performed for the treatment of anterior gleno-humeral instability, which involves rerouting the muscles that attach the coracoid process deep to the subscapularis muscle between this and the capsule. The tip of the coracoid with its muscles is reattached to its base in the anatomical position. Method: We conducted a prospective study of twenty patients with recurrent shoulder dislocations who were treated by the Boytchev procedure. All are men, with an average age of 29.2 years (age range from 17 to 42 years). 14 patients were affected on the right shoulder, 6 on the left. All had a clinical history of recurrent dislocation . We also performed a search of all published articles in the literature (16),17 studies including our series, with the aim of estimating, via a statistical analysis, to shed light on the post-operative results of recurrent anterior dislocations of the shoulder, for determining the reliability of this technique and possible specific risk factors that might lead to recurrence. Results: Evaluated using the Rowe score in our series, 19 patients had excellent and good results; one patient, who suffered a recurrence, had a poor result in terms of stability. Another patient developed osteoarthrosis. For the 17 studies, the number of patients is 477 with 485 dislocated shoulders. The rate of recurrence is 7.33% .In 12 studies, the rate is 2%, versus 21.08% in 5 studies with a significant difference (1-p=99.89%). Concerning the gradation of results, we have 441 excellent and good results and 44 fair and poor (91% versus 9% with p=>99.9% which is also very significant). Conclusion: The Boytchev procedure exhibits low recurrence rates in compiled studies and so can be considered a reliable surgical technique. Keywords: Shoulder recurrent dislocation, Boytchev treatment
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