T. Lee, Junhyung Kim, Woonhyeok Jeong, Tae-Hee Jo, S. Park, Jaehoon Choi
Purpose: Infected malleolar bursitis sometimes requires multiple debridements, followed by soft tissue reconstruction with a flap. The purpose of this study was to evaluate the clinical outcomes of patients with infected lateral malleolar bursitis who were treated using peroneal artery perforator-based propeller flaps.Methods: We retrospectively included 10 patients who underwent reconstruction of the lateral malleolus with a peroneal artery perforator-based propeller flap due to infected lateral malleolar bursitis between 2014 and 2022. Results: The average follow-up time was 77.2 weeks. Six patients experienced complete healing; three developed partial flap necrosis, and one had a long-lasting seroma. All patients with complications had long-term diabetes. Conclusion: Partial flap necrosis in patients with diabetes may occur because of impaired microcirculation. A peroneal artery perforator-based propeller flap could be useful for soft tissue reconstruction in select patients without diabetes or in patients with diabetes who have infected lateral malleolar bursitis.
{"title":"The outcomes of peroneal artery perforator-based propeller flaps for the treatment of infected lateral malleolar bursitis","authors":"T. Lee, Junhyung Kim, Woonhyeok Jeong, Tae-Hee Jo, S. Park, Jaehoon Choi","doi":"10.12790/ahm.23.0020","DOIUrl":"https://doi.org/10.12790/ahm.23.0020","url":null,"abstract":"Purpose: Infected malleolar bursitis sometimes requires multiple debridements, followed by soft tissue reconstruction with a flap. The purpose of this study was to evaluate the clinical outcomes of patients with infected lateral malleolar bursitis who were treated using peroneal artery perforator-based propeller flaps.Methods: We retrospectively included 10 patients who underwent reconstruction of the lateral malleolus with a peroneal artery perforator-based propeller flap due to infected lateral malleolar bursitis between 2014 and 2022. Results: The average follow-up time was 77.2 weeks. Six patients experienced complete healing; three developed partial flap necrosis, and one had a long-lasting seroma. All patients with complications had long-term diabetes. Conclusion: Partial flap necrosis in patients with diabetes may occur because of impaired microcirculation. A peroneal artery perforator-based propeller flap could be useful for soft tissue reconstruction in select patients without diabetes or in patients with diabetes who have infected lateral malleolar bursitis.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116816199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang-Hyun Park, Lan Sook Chang, Hyo Seong Kim, Seong Oh. Park, Youn Hwan Kim
Post-burn scar contracture associated with deep second-degree or higher burns in the joint area can lead to joint immobility and may cause chronic ulcers, substantially impacting patients’ quality of life. Surgical intervention is necessary, with local flaps or skin grafts being the first option. In extreme cases, free flap transfer may be required to address large defects that occur after contracture release. This study presents a successful case of reconstruction using free flap transfer in a patient with severe post-burn scar contracture, which resulted in a club-like deformed ankle with a nonfunctional joint. Despite the extreme deformity and nonfunctioning joint, we utilized a thoracodorsal artery perforator flap to stably cover the newly fused joint in a neutral position. After reconstruction, the patient was able to wear shoes and ambulate. This case highlights the potential of free flap transfer even in the most challenging situations where joint function is severely compromised.
{"title":"Reconstruction of extreme post-burn scar contracture of the ankle using a thoracodorsal artery perforator flap: a case report","authors":"Sang-Hyun Park, Lan Sook Chang, Hyo Seong Kim, Seong Oh. Park, Youn Hwan Kim","doi":"10.12790/ahm.23.0012","DOIUrl":"https://doi.org/10.12790/ahm.23.0012","url":null,"abstract":"Post-burn scar contracture associated with deep second-degree or higher burns in the joint area can lead to joint immobility and may cause chronic ulcers, substantially impacting patients’ quality of life. Surgical intervention is necessary, with local flaps or skin grafts being the first option. In extreme cases, free flap transfer may be required to address large defects that occur after contracture release. This study presents a successful case of reconstruction using free flap transfer in a patient with severe post-burn scar contracture, which resulted in a club-like deformed ankle with a nonfunctional joint. Despite the extreme deformity and nonfunctioning joint, we utilized a thoracodorsal artery perforator flap to stably cover the newly fused joint in a neutral position. After reconstruction, the patient was able to wear shoes and ambulate. This case highlights the potential of free flap transfer even in the most challenging situations where joint function is severely compromised.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122417122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mallet finger deformities can be divided into tendinous deformities caused by tendon rupture and bony deformities caused by fracture. In many cases, conservative treatment is possible. The goal of treating traumatic mallet finger deformities is to accurately restore the ruptured tendon or fractured bone to its proper position, correct extension lag or flexion contracture, prevent joint arthritis, and restore the full range of motion through appropriate range of motion exercises at the right time. In cases of tendinous mallet finger, immobilization with a splint or cast for at least 6 weeks in the extended position is required. During this period, flexion at the distal interphalangeal joint should be strictly limited, while movement at the proximal interphalangeal joint is allowed. Patient compliance with the protocol is essential for achieving good treatment outcomes. If conservative treatment fails or if the deformity recurs after initial surgery, satisfactory results can be achieved through tenodermodesis surgery. If the bony mallet finger involves a bone fragment of 3 mm or more or subluxation of the distal phalanx, surgical treatment is recommended. The primary surgical treatment involves closed reduction and percutaneous pinning with the extension block technique.
{"title":"Current concepts in traumatic mallet finger management","authors":"Jun-Ku Lee, S. Kang, Jong Woong Pak","doi":"10.12790/ahm.23.0016","DOIUrl":"https://doi.org/10.12790/ahm.23.0016","url":null,"abstract":"Mallet finger deformities can be divided into tendinous deformities caused by tendon rupture and bony deformities caused by fracture. In many cases, conservative treatment is possible. The goal of treating traumatic mallet finger deformities is to accurately restore the ruptured tendon or fractured bone to its proper position, correct extension lag or flexion contracture, prevent joint arthritis, and restore the full range of motion through appropriate range of motion exercises at the right time. In cases of tendinous mallet finger, immobilization with a splint or cast for at least 6 weeks in the extended position is required. During this period, flexion at the distal interphalangeal joint should be strictly limited, while movement at the proximal interphalangeal joint is allowed. Patient compliance with the protocol is essential for achieving good treatment outcomes. If conservative treatment fails or if the deformity recurs after initial surgery, satisfactory results can be achieved through tenodermodesis surgery. If the bony mallet finger involves a bone fragment of 3 mm or more or subluxation of the distal phalanx, surgical treatment is recommended. The primary surgical treatment involves closed reduction and percutaneous pinning with the extension block technique.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130564034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nail melanoma (NM) must be suspected in the initial workup of patients with pigmented nails. However, the differential diagnosis of NM from other nail disorders that involve nail pigmentation is challenging. Dermoscopic, clinical, and histopathological features are integrated for a definite diagnosis. The primary treatment of NM is surgery. Depending on the depth of invasion, amputation or functional surgery can be chosen. This article reviews the clinical, dermoscopic, and histopathological features of NM, as well as its diagnosis and treatment.
{"title":"Diagnosis and treatment of subungual melanoma","authors":"J. Oh, Byung Jun Kim","doi":"10.12790/ahm.22.0072","DOIUrl":"https://doi.org/10.12790/ahm.22.0072","url":null,"abstract":"Nail melanoma (NM) must be suspected in the initial workup of patients with pigmented nails. However, the differential diagnosis of NM from other nail disorders that involve nail pigmentation is challenging. Dermoscopic, clinical, and histopathological features are integrated for a definite diagnosis. The primary treatment of NM is surgery. Depending on the depth of invasion, amputation or functional surgery can be chosen. This article reviews the clinical, dermoscopic, and histopathological features of NM, as well as its diagnosis and treatment.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124144607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive soft tissue sarcomas with a high rate of recurrence and metastasis. Limb salvage surgery with free flap reconstruction is a viable option for selected patients with MPNSTs, but careful consideration should be given to the risk of recurrence. This case report describes a 26-year-old male patient with a recurrent, aggressive, high-grade MPNST who underwent limb salvage surgery with thoracodorsal artery perforator free flap reconstruction. Despite the surgical intervention, local recurrence of the MPNST was detected, and below-knee amputation was ultimately recommended. This case highlights the importance of early, definitive treatment decision-making in cases of aggressive, high-grade MPNSTs. Close postoperative monitoring and early detection of recurrence are crucial for achieving optimal outcomes in patients with MPNSTs undergoing limb salvage surgery with free flap reconstruction.
{"title":"Resurfacing the defect from wide excision of a malignant peripheral nerve sheath tumor based on a thoracodorsal artery perforator free flap: a case report","authors":"Jung Kwon An, Youn Hwan Kim","doi":"10.12790/ahm.23.0007","DOIUrl":"https://doi.org/10.12790/ahm.23.0007","url":null,"abstract":"Malignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive soft tissue sarcomas with a high rate of recurrence and metastasis. Limb salvage surgery with free flap reconstruction is a viable option for selected patients with MPNSTs, but careful consideration should be given to the risk of recurrence. This case report describes a 26-year-old male patient with a recurrent, aggressive, high-grade MPNST who underwent limb salvage surgery with thoracodorsal artery perforator free flap reconstruction. Despite the surgical intervention, local recurrence of the MPNST was detected, and below-knee amputation was ultimately recommended. This case highlights the importance of early, definitive treatment decision-making in cases of aggressive, high-grade MPNSTs. Close postoperative monitoring and early detection of recurrence are crucial for achieving optimal outcomes in patients with MPNSTs undergoing limb salvage surgery with free flap reconstruction.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130857651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
High-intensity focused ultrasound (HIFU) ablation is a safe and effective minimally invasive option for treating uterine fibromas, but it can cause complications such as abdominal wall defects. Reconstruction of such defects can be challenging, but a latissimus dorsi musculocutaneous free flap can be used to restore the integrity of the myofascial layer and provide external cutaneous coverage. Herein, we present a case report of a 37-year-old woman who underwent HIFU for an 8-cm uterine fibroma and subsequently developed a large abdominal wall defect with necrosis of the rectus muscle. The latissimus dorsi musculocutaneous free flap was used to reconstruct the rectus muscle and cover the abdominal soft tissue, resulting in successful engraftment without complications. We present our experience using a latissimus dorsi musculocutaneous free flap to reconstruct a large HIFU-induced composite defect in the abdominal wall.
{"title":"Reconstruction of an abdominal wall defect using a latissimus dorsi musculocutaneous free flap after high-intensity focused ultrasound","authors":"D. Kim, Youn Hwan Kim","doi":"10.12790/ahm.23.0008","DOIUrl":"https://doi.org/10.12790/ahm.23.0008","url":null,"abstract":"High-intensity focused ultrasound (HIFU) ablation is a safe and effective minimally invasive option for treating uterine fibromas, but it can cause complications such as abdominal wall defects. Reconstruction of such defects can be challenging, but a latissimus dorsi musculocutaneous free flap can be used to restore the integrity of the myofascial layer and provide external cutaneous coverage. Herein, we present a case report of a 37-year-old woman who underwent HIFU for an 8-cm uterine fibroma and subsequently developed a large abdominal wall defect with necrosis of the rectus muscle. The latissimus dorsi musculocutaneous free flap was used to reconstruct the rectus muscle and cover the abdominal soft tissue, resulting in successful engraftment without complications. We present our experience using a latissimus dorsi musculocutaneous free flap to reconstruct a large HIFU-induced composite defect in the abdominal wall.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116444324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Seo, Kang Lee, S. Chung, Sang-Woo Son, Hyun-Joo Lee
Purpose: Although closed reduction and extension block pinning have been widely used for acute mallet finger fracture, the problem of reduction remains a concern. We describe a tip for the reduction technique using a towel clamp, which provides a longitudinal traction force to the distal phalanx, and report the results of the technique.Methods: The medical records of 14 consecutive cases from 12 patients with acute mallet fractures were retrospectively reviewed. Reduction was achieved using the towel clamp reduction technique. The radiologic results were evaluated by simple radiographs, the functional results were analyzed in terms of range of motion, and remaining pain was assessed using Crawford criteria.Results: The mean follow-up period was 8.4 months. The mean union duration was 6 weeks. The mean range of motion was 73°. Eight cases had excellent outcomes, one had good outcomes, four had fair outcomes, and one had poor outcomes. One case of superficial infection and one case of skin necrosis developed, and three cases showed arthritic changes in the distal interphalangeal joint. Conclusion: The towel clamp technique can provide good reduction during surgery, with favorable radiologic and clinical results.
{"title":"Extension block pinning combined with traction using towel clamps for effective reduction of mallet fracture: a technical tip","authors":"I. Seo, Kang Lee, S. Chung, Sang-Woo Son, Hyun-Joo Lee","doi":"10.12790/ahm.23.0009","DOIUrl":"https://doi.org/10.12790/ahm.23.0009","url":null,"abstract":"Purpose: Although closed reduction and extension block pinning have been widely used for acute mallet finger fracture, the problem of reduction remains a concern. We describe a tip for the reduction technique using a towel clamp, which provides a longitudinal traction force to the distal phalanx, and report the results of the technique.Methods: The medical records of 14 consecutive cases from 12 patients with acute mallet fractures were retrospectively reviewed. Reduction was achieved using the towel clamp reduction technique. The radiologic results were evaluated by simple radiographs, the functional results were analyzed in terms of range of motion, and remaining pain was assessed using Crawford criteria.Results: The mean follow-up period was 8.4 months. The mean union duration was 6 weeks. The mean range of motion was 73°. Eight cases had excellent outcomes, one had good outcomes, four had fair outcomes, and one had poor outcomes. One case of superficial infection and one case of skin necrosis developed, and three cases showed arthritic changes in the distal interphalangeal joint. Conclusion: The towel clamp technique can provide good reduction during surgery, with favorable radiologic and clinical results.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129041802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toe injuries frequently occur as traumatic or oncologic defects. Compared with finger reconstruction, toe reconstruction has been rarely reported in the literature, because of the difficulty of toes’ relatively thin soft tissue envelope, their requirement for relatively challenging surgical techniques, and the slight improvements in gait. Therefore, toe reconstruction can be challenging for plastic surgeons, especially in cases with exposure of a tendon, bone, or joint. Herein, we present a case study of a 54-year-old woman with squamous cell carcinoma in situ (Bowen disease) that subsequently resulted in a defect on her second toe. A serratus anterior fascia free flap could be a good option for toe reconstruction due to its large caliber, lengthy pedicle, relatively easy dissection, and thin muscle bulk. We present our unique experience using the serratus anterior fascia free flap for the reconstruction of an oncologic toe defect.
{"title":"Reconstruction of a soft tissue defect in the toe using a serratus anterior fascia free flap","authors":"D. Kim, Youn Hwan Kim","doi":"10.12790/ahm.23.0010","DOIUrl":"https://doi.org/10.12790/ahm.23.0010","url":null,"abstract":"Toe injuries frequently occur as traumatic or oncologic defects. Compared with finger reconstruction, toe reconstruction has been rarely reported in the literature, because of the difficulty of toes’ relatively thin soft tissue envelope, their requirement for relatively challenging surgical techniques, and the slight improvements in gait. Therefore, toe reconstruction can be challenging for plastic surgeons, especially in cases with exposure of a tendon, bone, or joint. Herein, we present a case study of a 54-year-old woman with squamous cell carcinoma in situ (Bowen disease) that subsequently resulted in a defect on her second toe. A serratus anterior fascia free flap could be a good option for toe reconstruction due to its large caliber, lengthy pedicle, relatively easy dissection, and thin muscle bulk. We present our unique experience using the serratus anterior fascia free flap for the reconstruction of an oncologic toe defect.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124782622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donghee Kwak, Seung Min Shin, Hyun Jae Ryoo, In Cheul Choi, Jong Woong Park
Purpose: Understanding the configuration and characteristics of the comminuted fifth metacarpal neck fractures is essential for successful operative treatment, especially for antegrade intramedullary Kirchner wire (K-wire) fixation. This study aimed to investigate the characteristics and shape of comminuted fragments in fifth metacarpal neck fractures and suggest the appropriate K-wire position. Methods: Forty-one cases of fifth metacarpal neck fractures operated from January 2010 to April 2022 were enrolled in this study. The length and width of the comminuted fragments were measured, as well as the distance from the articular surface of the fifth metacarpal head to the comminuted fragment (Da-c) and the distance from the articular surface to the proximal end of the metacarpal head (Da-h). The location of the comminuted fragments was categorized in terms of four quadrants: dorsal-ulnar (DU), dorsal-radial (DR), palmar-radial, and palmar-ulnar.Results: Among 41 patients with fifth metacarpal neck fractures, comminuted fracture fragments were observed in 35 cases (85.4%). The mean length and width of the comminuted fragments were 7.5±2.3 mm and 3.2±0.8 mm, respectively. The comminuted fragments were on the dorsal aspect of the fracture in all cases; 27 (77.1%) in the DU quadrant and 8 (22.9%) in the DR quadrant. The mean Da-c and Da-h were 5.3±1.6 mm and 10.9±1.5 mm, respectively.Conclusion: To ensure stable K-wire fixation, it is essential to identify the location and characteristics of the comminuted fracture fragments before surgery and subsequently choose an appropriate K-wire position.
目的:了解粉碎性第五掌骨颈骨折的形态和特征对于成功的手术治疗至关重要，特别是顺行髓内基什内尔钉(k -丝)固定。本研究旨在探讨第五掌骨颈骨折中粉碎性碎片的特征和形状，并提出合适的k针位置。方法:选取2010年1月至2022年4月手术治疗的41例第五型掌骨颈骨折患者。测量粉碎碎片的长度和宽度，以及第五掌骨头关节面到粉碎碎片的距离(Da-c)和关节面到掌骨头近端的距离(Da-h)。粉碎碎片的位置分为四个象限:背尺侧(DU)、背桡侧(DR)、掌桡侧和掌尺侧。结果:41例第5掌骨颈骨折患者中，35例(85.4%)出现粉碎性骨折碎片。粉碎碎片的平均长度为7.5±2.3 mm，平均宽度为3.2±0.8 mm。粉碎性碎片均位于骨折的背侧;DU象限27例(77.1%)，DR象限8例(22.9%)。平均Da-c为5.3±1.6 mm, Da-h为10.9±1.5 mm。结论:术前确定粉碎骨折碎片的位置和特征，选择合适的k针位置，是保证k针固定稳定的关键。
{"title":"Computed tomography-based analysis of the characteristics of fifth metacarpal neck fractures and its clinical applications","authors":"Donghee Kwak, Seung Min Shin, Hyun Jae Ryoo, In Cheul Choi, Jong Woong Park","doi":"10.12790/ahm.23.0006","DOIUrl":"https://doi.org/10.12790/ahm.23.0006","url":null,"abstract":"Purpose: Understanding the configuration and characteristics of the comminuted fifth metacarpal neck fractures is essential for successful operative treatment, especially for antegrade intramedullary Kirchner wire (K-wire) fixation. This study aimed to investigate the characteristics and shape of comminuted fragments in fifth metacarpal neck fractures and suggest the appropriate K-wire position. Methods: Forty-one cases of fifth metacarpal neck fractures operated from January 2010 to April 2022 were enrolled in this study. The length and width of the comminuted fragments were measured, as well as the distance from the articular surface of the fifth metacarpal head to the comminuted fragment (Da-c) and the distance from the articular surface to the proximal end of the metacarpal head (Da-h). The location of the comminuted fragments was categorized in terms of four quadrants: dorsal-ulnar (DU), dorsal-radial (DR), palmar-radial, and palmar-ulnar.Results: Among 41 patients with fifth metacarpal neck fractures, comminuted fracture fragments were observed in 35 cases (85.4%). The mean length and width of the comminuted fragments were 7.5±2.3 mm and 3.2±0.8 mm, respectively. The comminuted fragments were on the dorsal aspect of the fracture in all cases; 27 (77.1%) in the DU quadrant and 8 (22.9%) in the DR quadrant. The mean Da-c and Da-h were 5.3±1.6 mm and 10.9±1.5 mm, respectively.Conclusion: To ensure stable K-wire fixation, it is essential to identify the location and characteristics of the comminuted fracture fragments before surgery and subsequently choose an appropriate K-wire position.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116734286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Jung, Byung-Kook Kim, Jinmyoung Dan, Cheungsoo Ha, H. Lee
Ancient schwannomas are benign long-standing schwannomas of the neural sheaths. This schwannoma subtype is characterized by cystic and hemorrhagic changes. These degenerative changes are thought to result from the tumor’s long-term progression and have the potential to be misdiagnosed as other soft tissue tumors or sarcomas. A thorough examination, including magnetic resonance imaging, is necessary to identify these tumors, preventing potential misdiagnosis and treatment.
{"title":"An ancient schwannoma misdiagnosed as a dermoid cyst on ultrasound examination: a case report","authors":"S. Jung, Byung-Kook Kim, Jinmyoung Dan, Cheungsoo Ha, H. Lee","doi":"10.12790/ahm.21.0145","DOIUrl":"https://doi.org/10.12790/ahm.21.0145","url":null,"abstract":"Ancient schwannomas are benign long-standing schwannomas of the neural sheaths. This schwannoma subtype is characterized by cystic and hemorrhagic changes. These degenerative changes are thought to result from the tumor’s long-term progression and have the potential to be misdiagnosed as other soft tissue tumors or sarcomas. A thorough examination, including magnetic resonance imaging, is necessary to identify these tumors, preventing potential misdiagnosis and treatment.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129119647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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