Objective To pay attention to the diagnosis and treatment of the complications associated with closed multifractures in metacarpals. Methods From 1997 to 2000, out of 382 patients with closed multi-fractures in metacarpals, 12 had complications. In 7 cases of fractures at the second , third , fourth and fifth metacarpal shaft, complicated by acute compartment syndrome in hand, compartmental fascia were incised for decompress; open reduction and internal fixation were performed. In 4 cases of fractures at the metacarpal base, complicated by acute carpal tunnel syndrome, the fracture was reduced and fixed without transection of the transverse carpal ligament. In 1 case of fracture at metacarpalbase, complicated by direct contusion of the median nerve, the fracture was reduced without treatment of the median nerve. Results All patients were followed up for 3 months. Fracture healed 46 weeks postoperatively. No claw deformity anddysfunction of the median nerve occurred. The arc of motion of the proximal interphalangeal and distal interphalangeal joints were normal.Conclusion During fracture reduction, we should pay attention to the complications associated with closed multi-fractures at metacarpal to decrease hand malfunction.
Objective To study the feasibil ity of repairing the mild unilateral eclabium deformity of the upper l ip with the lateral columella base-labrum transposition flap. Methods From March 2006 to March 2008, 8 patients with mild unilateral eclabium of the upper l i p were repaired with the lateral columella base-labrum transposition flap. There were 4 males and 4 females, aging 18-51 years. There were 5 at left sides and 3 at right sides. All mild unilateral eclabium were attributed to the contracture of scar after trauma. The disease course was 1 to 5 years (average 2.5 years). The size ofthe transposition flaps ranged from 1.5 cm × 1.4 cm to 1.6 cm × 1.5 cm. Results All the flaps survived and incision healed by first intention. The eclabiun deformity was corrected. The postoperative follow-up period was 3-18 months with an average of 9.9 months. All the patients remained just soft l inear scars without hyperplasia. The nostril and columella hardly changed compared with the postoperative immediate view. Conclusion The mild unilateral eclabium deformity of upper l i p repairing with lateral columella base-labrum transposition flap is an easy, mininally invasive and nearly no secondary malformation method.
Objective To demonstrate the anatomical and biomechanical basis of scaphoid ring sign in advanced Kienbock’s disease. Methods The study consisted of two sections. The ligaments stabilizing the proximal pole of the scaphoid were observed in 5 specimens. Under 12 kg dead weight load through the tendons of the flexion carpal radial, the flexion carpal ulnar, the extension carpal radial, and the extension carpal ulnar for 5 minutes, the stresses of the scaphoid fossa and lunate fossa were measured in the case of neutral, flexion, extension, radial deviation and ulnar deviation of the wrist joint under normal and rupture conditions respectively by FUJI prescale film and FPD-305E,306E.Results Based on anatomical study, the ligaments stabilizing the proximal pole of the scaphoid consisted of the radioscaphocapitate ligament, long radiolunate ligament and scapholunate interosseous ligament; and the latter two ligaments restricted dorsal subluxation of the proximalpole of the scaphoid. When compared rupture condition with normal condition, thescaphoid fassa stress of radial subregion was not significantly different (0.90±0.43 vs 0.85±0.15), and the ones of palmar, ulnar and dorsal subregions decreased (0.59±0.20, 0.52±0.05 and 0.58±0.23 vs 0.77±0.13, 0.75±0.08 and0.68±0.09) in the case of extension; the scaphoid fassa stresses of all subregions increased or had no difference in the case of neural, flexion, radial deviation and ulnar deviation. The lunate fossa stresses of all subregions increased in thecase of neural, and the ones of all subregions decreased or had no difference inthe case of flexion, extension, radial deviation and ulnar deviation.Conclusion Rotary scaphoid subluxation should be treated operatively at Ⅲ B stage of Kienbock’s disease to avoid traumatic arthritis of theradioscaphoid joint.