The potential presence of an intradural disc herniation must always be considered when performing an open discectomy on a patient whose CT scan study shows the presence of epidural gas. This association is particularly striking given the relative rarity of intradural herniations and intraspinal gas. In the event that no clear disc herniation was found, an intradural examination may be indicated to justify clinical signs and symptoms or previous radiologic studies.
The use of FRIDs among patients with a fall-related fracture is very high. This use rises 1 month after the fracture, significantly in the case of hypnotics and antidepressants.
This report describes 2 new cases of toe tourniquet syndrome without accompanying signs of irritability. They were an 18-month-old girl and a 5-month-old boy suffering from strangulation of the third toe. The period of evolution was 20 days and 5 weeks. The toe worsened, with more extensive reddening and swelling, and deepening of the circular groove. Since a hair tourniquet was suspected, attempts were made to grasp the fiber with small-sized, blunt, and hook-shaped instruments, and mosquito clamp, with no success. The strand of hair compressing the toe lay deeper than expected. As improvement was barely noticeable, 2 dorsal paratendinous incisions were made and the hairs were extracted. Our aim is to raise awareness in the pediatric orthopaedic community of the existence of this syndrome, with a view to promoting the earliest possible diagnosis and appropriate management. In case of impossibility of removing the hairs we propose performing 2 dorsal paratendinous incisions, deep to the bone, to release completely the strangulation.
Although both SF and HP are effective for reduction of PE, a higher first-attempt success rate was achieved by HP, and this should therefore be the first maneuver used. In recurring cases, it would seem appropriate to teach the child's parents the HP maneuver as the most effective and easiest to do.
The possibility of an intradural herniated disc must always be considered when performing an open discectomy on a patient whose computed tomography scan reveals the presence of epidural gas. In the event that no clear disc herniation is found to justify the clinical symptoms or the previous radiologic findings, an intradural exploration may be indicated.
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