Volar perilunate fracture dislocation is an extremely rare carpal injury, but associated with metacarpophalangeal joint dislocation of both the ipsilateral index and middle finger has never been reported. We report one case of a 28-year-old man following a high-energy trauma. After performing closed reduction of the metacarpophalangeal joint injury, open reduction of the wrist injury through volar approach was done, and a K-wire fixation was used to stabilize the scaphoid fracture and lunotriquetral joint. After a 16 months?follow-up period, the wrist regained a full range of motion without symptoms, and the fractured bone was strengthened in a good position.
Adult ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Metacarpophalangeal Joint ; injuries ; Wrist Injuries ; surgery

OBJECTIVETo evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid.

METHODSThis is a retrospective study of 26 scaphoid nonunion cases treated by this technique between 2004 and 2009. The mean age was 38 years. Nonunion was of types IIA and IIB according to the Alnot's classification and only one case showed a proximal pole necrosis (type IV). The fixation was ensured by K-wire. The mean immobilization period was 9 weeks.

RESULTSAt mean 19 months follow-up, the bone union rate was 88.5%. Failure was noted in three cases. No significant complications secondary to this technique were observed. The mobility in extension and flexion had an average recovery of 18 degree Nineteen patients (73%) were free of pain, and the others had occasional pain.

CONCLUSIONSIt is a meticulous surgical technique that provides better union rates than those of conventional scaphoid graft. This technique is first adopted in cases of failure of conventional grafts in the treatment of scaphoid nonunion but the encouraging results suggest expanding indications to primitive nonunion.

Bone Transplantation ; Bone Wires ; Fractures, Ununited ; surgery ; Humans ; Retrospective Studies ; Scaphoid Bone

Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence. Elevated compartment pressure was documented and immediate surgical fasciotomy was practiced. The patient achieved complete recovery with a good functional result. We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compartment syndrome following adder bites.
Adult ; Animals ; Compartment Syndromes ; etiology ; Humans ; Male ; Snake Bites ; complications ; Upper Extremity ; Viperidae