Isolated Dorsoradial Capsular Tear of the Thumb Metacarpophalangeal Joint: Missed Diagnosis and the Management of Delayed Presentation

Isolated dorsoradial capsule injuries of the thumb metacarpophalangeal joint are different from those associated with collateral ligament disruption. Early suspicion of this rare injury is important because, if overlooked, ulnarward subluxation of extensor pollicis longus tendon can develop. Functionally, active thumb extension becomes impaired, and over the long term, a thumb Boutonniere's deformity becomes established. Joint hypermobility/instability may predispose to this injury. The 2 cases presented illustrate this through anatomic differences. At the time of acute injury, 3 presenting clinical features should raise suspicion of dorsoradial capsular rupture: a history of isolated hyperflexion injury to the thumb, stable collateral ligaments on examination, and x-ray evidence of palmar subluxation of the proximal phalanx on the metacarpal. Ulnarward subluxation of the extensor pollicis longus is a delayed sign. Diagnostic imaging, beyond x-ray studies, may not be helpful in defining the injury. Early exploration and repair of this injury give the best long-term outcome. Postrepair, metacarpophalangeal joint range of motion may not be fully restored, but stability and a preinjury level of hand function can usually be reestablished.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Hand Surgery Source Type: research

Related Links:

Publication date: Available online 14 October 2019Source: Biochemical Engineering JournalAuthor(s): Jinfeng Li, Guowei Shang, Yisheng Wang, Xiuli Wang, Yuanyuan Ji, Yuebai LiAbstractCalcitonin gene-related peptide (CGRP) promotes proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), which influence bone regeneration and reconstruction. We previously established CGRP-modified BMSCs that express the CGRP gene and demonstrated that this elevated CGRP expression promotes osteogenic differentiation of BMSCs. The current study investigated the therapeutic effects of CGRP-modified BMSCs combi...
Source: Biochemical Engineering Journal - Category: Biochemistry Source Type: research
Many, possibly even most, longevity enhancing interventions tested to date in short lived species produce their effects on aging and life span via an increase in the cellular maintenance processes of autophagy. The major focus of the research community over the past few decades in the matter of aging has been to replicate some of the calorie restriction response, or other responses to cellular stress. Cells responds to lack of nutrients, excessive heat, and so forth, by undertaking greater maintenance efforts for an extended period of time. If the stress is mild and transient, the result is a net benefit. Unfortunately thi...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
We report an unprecedented case of squamous cell carcinoma (SCC) in the floor of mouth of a 23-year-old woman with XP. The patient was referred to the oncologist and, two months after surgical resection, underwent a single chemotherapy and radiotherapy session. However, she died 73 hours after undergoing her first chemotherapy session. Considering the unexpected outcome of this case, we also investigated possible exacerbated adverse effects of antineoplastic treatments (especially cisplatin-based chemotherapy) in XP patients, and discussed the main characteristics of the disease, especially cases with oral manifestations d...
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
ConclusionSignificant metabolites could be considered as early repair markers for chronic periodontitis disease as they are being restored to achieve symbiosis. The study, therefore, concluded the early recovery process of the diseased subjects with the restoration of possible metabolomic profile similar to the healthy controls.Graphic abstract
Source: Metabolomics - Category: Biology Source Type: research
racias This paper addresses the problem of object recognition from colorless 3D point clouds inunderwater environments. It presents a performance comparison of state-of-the-art global descriptors,which are readily available as open source code. The studied methods are intended to assistAutonomous Underwater Vehicles (AUVs) in performing autonomous interventions in underwaterInspection, Maintenance and Repair (IMR) applications. A set of test objects were chosen as beingrepresentative of IMR applications whose shape is typically known a priori. As such, CAD modelswere used to create virtual views of the objects under re...
Source: Sensors - Category: Biotechnology Authors: Tags: Article Source Type: research
In conclusion, spironolactone is a safe candidate drug that exerts anti-cancer effects in combination with non-DNA-damaging drugs, such as gemcitabine and osimertinib, most likely through the suppression of survivin.
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
AbstractPurpose of ReviewDue to recent concerns over the use of synthetic mesh in pelvic floor reconstructive surgery, there has been a renewed interest in the utilization of non-synthetic repairs for pelvic organ prolapse. The purpose of this review is to review the current literature regarding pelvic organ prolapse repairs performed without the utilization of synthetic mesh.Recent FindingsNative tissue repairs provide a durable surgical option for pelvic organ prolapse. Based on recent findings of recently performed randomized clinical trials with long-term follow-up, transvaginal native tissue repair continues to play a...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
ConclusionsPostoperative quadriceps strength index at 6  months after double-bundle ACL reconstruction with hamstring tendon autografts was affected by preoperative quadriceps strength index. Adequate preoperative quadriceps strength may need to be considered in order to facilitate better recovery of quadriceps strength after ACL reconstruction and to s upport an earlier return to sports activities.
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
Conclusions: According to the data obtained from this study, it can be concluded that HA did not have a significant positive effect on the repair of defects around dental implants.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
by Weidao Zhang, Zhongliang Chen, Dengfeng Zhang, Bo Zhao, Lu Liu, Zhengyuan Xie, Yonggang Yao, Ping Zheng Recurrent pregnancy loss (RPL) is an important complication in reproductive health. About 50% of RPL cases are unexplained, and understanding the genetic basis is essential for its diagnosis and prognosis. Herein, we report causal KH domain containing 3 like (KHDC3L) mutations in RPL.KHDC3L is expressed in human epiblast cells and ensures their genome stability and viability. Mechanistically, KHDC3L binds to poly(ADP-ribose) polymerase 1 (PARP1) to stimulate its activity. In response to DNA damage, KHDC3L also locali...
Source: PLoS Biology: Archived Table of Contents - Category: Biology Authors: Source Type: research
More News: Gastroschisis Repair | Plastic Surgery | Study