Isolated traumatic dislocation of the carpometacarpal joint of the thumb is an uncommon injury. Left untreated, resulting mechanical instability of this joint interferes with normal function of the hand and can lead to articular degeneration of the joint. Most are amenable to closed reduction with or without supplementary pinning. We present a case of a 21 year old female patient with continual instability of the carpometacarpal joint of her right thumb, following closed reduction and pinning. Surgical stabilization was achieved by anterior oblique ligament reconstruction using a Modified Eaton- Littler's technique. At 1 year follow-up evaluation the patient was pain free with no clinico-radiological evidence of instability.
Isolated fractures of the clavicle have been rarely reported to be complicated by a pneumothorax. However, a delayed pneumothorax following this injury has not yet been reported in the literature. This case report describes a 19-year-old man who developed a left-sided apical pneumothorax from an ipsilateral fractured clavicle 5 days after his initial motorbike accident. Initial chest examination and radiographs showed no evidence of a pneumothorax in the accident and emergency department but a repeat radiograph in fracture clinic to assess the clavicle diagnosed an ipsilateral apical pneumothorax. He was then promptly treated with a chest drain which resolved the pneumothorax within 2 days. The clavicle fracture was treated non-operatively and after 6 weeks the patient had full function in his upper limb. Clinicians should therefore be aware of this rare complication from displaced clavicle fractures both immediately after the initial trauma and also on follow-up.
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