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El síndrome del martillo hipotenar es una patología vascular poco frecuente que produce una degeneración aneurismática de la arteria cubital a su paso por el canal de Guyon. Se suele dar en trabajadores expuestos a microtraumatismos de repetición en eminencia hipotenar; por ello, algunos autores lo consideran una enfermedad profesional. La clínica varía según el tamaño del aneurisma y la inestabilidad de su contenido. Para el diagnóstico, es necesario realizar una adecuada anamnesis y exploración física del paciente, así como tener un elevado índice de sospecha. Su tratamiento varía desde el médico conservador hasta la cirugía reconstructiva, dependiendo de la permeabilidad y de la integridad vascular del arco palmar. Se presenta un caso clínico de varón de 67 años con aparición de tumoración pulsátil dolorosa en eminencia hipotenar tras realizar trabajos de reforma. Mediante angiorresonancia, se confirmó la sospecha clínica, y se procedió a la resección del aneurisma parcialmente trombosado con posterior reconstrucción arterial.

Los seudoaneurismas de las arterias de la mano son infrecuentes, se han publicado escasos reportes de casos de adultos, secundarios a un trauma cerrado o abierto. El diagnóstico se confirma mediante ecografía Doppler y otros estudios complementarios. Si no se trata, se puede complicar con trombosis, embolia distal de arterias digitales, lesión nerviosa o necrosis. La cirugía es el tratamiento recomendado y consiste en resección del segmento dañado y ligadura simple, arteriorrafia o reconstrucción vascular con injerto. Los objetivos de este reporte son describir un caso de seudoaneurisma hipotenar secundario a una herida penetrante en un niño y, dada la rareza de este cuadro, revisar, de manera no sistemática, la bibliografía actual.

Cubital tunnel syndrome is the second most common nerve compression syndrome seen in the upper limb. Paresthesia and weakness are the two most common presentations in the hand. If left untreated, compression can lead to irreversible nerve damage, resulting in a loss of function of the forearm and hand. Therefore, recognizing the various clinical presentations of cubital tunnel syndrome can lead to early detection and prevention of nerve damage. Conservative management is usually tried first and involves supporting the elbow using a splint. If this fails and symptoms do not improve, surgical management is indicated. There are 3 main surgical techniques used to relieve compression of the nerve. These are simple decompression, anterior transposition and medial epicondylectomy. Studies comparing the techniques have demonstrated particular advantages to using one or another. However, the overall technique of choice is based on both the clinical scenario and the surgeon's digression. Following primary cubital tunnel surgery, recurrent symptoms can often occur due to a variety of pathological and non-pathological causes and revision surgery is usually warranted. This article provides a complete review of cubital tunnel syndrome. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El dolor cubital de muñeca en el deportista es una causa frecuente de consulta médica. La presentación clínica puede variar desde un contexto agudo traumático a una lesión de evolución lenta y progresiva. Un diagnóstico diferencial preciso es fundamental para un pronóstico y tratamiento efectivo. Las lesiones del complejo fibrocartílago triangular, lesiones del ligamento semilunar-piramidal y el síndrome de impactación cubital son frecuentes. Los exámenes de imágenes como la radiografía simple, la resonancia magnética y el TAC son de gran ayuda, su interpretación debe ser en un contexto clínico y en comparación al lado sano. La toma de decisiones terapéuticas exige de un acertado criterio y juicio médico.

Foreign bodies are encountered on day to day basis by a surgeon. Usually foreign bodies are lodged in narrow cavities of the body and the common age group is in children. They may range from foreign bodies in ear, nose, cricopharynx and even in rectum. Iatrogenic foreign bodies are not uncommon. Unknowingly, surgeons have been known to leave sponges, artery forceps in the abdomen which lead to hazardous sequelae. Intravascular foreign bodies occurrence has increased from a decade or so.

All three major peripheral nerves to the forearm and hand traverse the elbow joint. Each nerve has a complex pathway intertwining between and around the other soft tissue structures around the joint that allow stability and mobility. Each nerve glides freely in a pulleyed tunnel that allows both efficiency of motion and provides soft tissue protection. The symptoms of nerve entrapment and compression vary with each nerve depending on the degree of compression and the nature of the nerve fascicles involved: altered sensation; tingling; weakness; pain. This article discusses entrapment syndromes of the median, ulnar and radial nerves at the elbow including cubital tunnel syndrome, radial tunnel syndrome, posterior interosseous nerve compression, anterior interosseous nerve compression and pronator syndrome. The anatomical course, clinical features, investigations and treatment strategies for management are all considered. [ABSTRACT FROM AUTHOR]

A sequel of supracondylar fractures of distal humerus in children is the angular deformity. It is usually more frequent cubitus varus, but there are reported cases of cubitus valgus. The latter may be the cause of the occurrence of a late ulnar nerve neuropathy, which will require treatment. There is controversy as to whether it is possible to successfully treat both problems at the same surgical procedure. This article describes the case of a girl of 11 years old, who has a cubitus valgus deformity secondary to supracondylar fracture of distal humerus of right elbow at the age of seven years, associated with progressive symptoms of ulnar nerve neuropathy. This patient was treated successfully by a single procedure for corrective dome-shaped supracondilar osteotomy associated with subcutaneous anterior transposition of the ulnar nerve through a posterior approach. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Data on catheter-related bloodstream infection (CRBSI) in cubital artery access are scarce. Thus, the objective of this study was to compare the incidence of CRBSI in a large series of patients with femoral or cubital artery catheters. We found 11 events of CRBSI in 1085 femoral artery catheters during 6497 days and none in 449 cubital artery catheters during 2709 days. Poisson regression analysis showed a higher incidence of CRBSI in femoral than in cubital artery site access (1.69 vs 0 CRBSI events per 1000 catheter-days; odds ratio 6.41, 95% confidence interval 1.05-infinite; p == 0.02). In conclusion, according to the results of our observational study, cubital artery access could have a lower risk of CRBSI than femoral artery access. However the development of randomized controlled trials is necessary before this conclusion can be definitively established. In addition, it is necessary to consider other potential mechanical complications when decision-making. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess subjective and objective outcomes in treating recurrent cubital tunnel at secondary neurolysis by nerve wrapping with a tissue engineered three-dimensional biomatrix. Five patients with a mean age of 44.1 years and an average follow-up of 13.3 months were included in the study. All patients had improvement in visual analogue scales. Four patients that had preoperative intrinsic atrophy with clawing had no clawing or intrinsic atrophy at final follow-up. Postoperatively, four of the five patients had two-point discrimination of 5 mm. Grip strength on average increased 90%. Three patients had an excellent outcome, one patient had a good outcome, and one patient had a fair outcome. All five patients said they would have surgery again. [ABSTRACT FROM PUBLISHER]

Objective: To show the efficacy of LCP plates versus LC-DCP plates in radial and ulnar shaft fractures. Material and methods: 78 radial and/or ulnar fractures were reviewed prospectively in 54 patients; 42 were treated with LCP and 36 with LC-DCP in a 24-month period (from January 1st to December 31st, 2004). X-ray controls were obtained at 4, 8 and 12 weeks in all patients. Results: 30.76% of the fractures were of the radius and ulna, and 69.23% (54 fractures) involved a single bone. Ulnar fractures accounted for 53.84% (42); 42.85% (18) were treated with LCP plates and 57.14% (24) with LC-DCP. Fracture healing occurred within 4-7 weeks in 38.46% (30) of the fractures; 70% (21) of them were treated with LCP and 30% (9) with LC-DCP. It was found that 2.77% (1) of those treated with LC-DCP had pseudoarthrosis, and none of the patients treated with LCP reported this complication. Conclusions: Healing time is shorter with LCP versus LC-DCP plates, including open fractures. Complications were considerably less frequent with LCP than for LC-DCP plates. The pseudoarthrosis rate tended to be lower with LCP plates. [ABSTRACT FROM AUTHOR]

Background. Few articles have reported the location of sentinel lymph nodes (SLNs) in relation to skin-tumor location. We examined the location of SLNs in relation to skin-tumor location in the axillary and cubital regions. Methods. We attempted to detect SLNs of the axillary and cubital regions using 1% sulfan blue dye in 15 patients with melanoma and other skin cancers. Results. SLNs were detected in 12 patients: in 10 patients, one SLN was detected; in 2 patients, two SLNs were detected. In 4 patients, tumor metastasis in SLNs was positive. In 69 samples, 16 metastatic lymph nodes were detected: tumor metastasis was recognized in 4 SLNs and in 12 other lymph nodes. In 8 patients, the SLNs were negative for tumor metastasis. Ten SLNs were found in 45 other samples; all lymph nodes were negative for tumor metastasis (false-negative rate, 0%). The SLNs were located in the following regions: central axillary nodes, 6 cases; lateral axillary nodes, 4 cases; subscapular nodes, 1 case; cubital node, 2 cases. Conclusions. Because the lateral and central lymph nodes drain the lymph channels of the upper extremity, the SLNs were mainly located in the central and lateral lymph nodes in the axillary region. However, the ulnar dorsal hand tumors and the dorsal little-finger skin tumors were connected to the cubital lymph node. It is necessary to check both the cubital and axillary regions when dyed lymph vessels are going toward the cubital region. [ABSTRACT FROM AUTHOR]

Foreign bodies are encountered on day to day basis by a surgeon. Usually foreign bodies are lodged in narrow cavities of the body and the common age group is in children. They may range from foreign bodies in ear, nose, cricopharynx and even in rectum. Iatrogenic foreign bodies are not uncommon. Unknowingly, surgeons have been known to leave sponges, artery forceps in the abdomen which lead to hazardous sequelae. Intravascular foreign bodies occurrence has increased from a decade or so. [ABSTRACT FROM AUTHOR]

A sequel of supracondylar fractures of distal humerus in children is the angular deformity. It is usually more frequent cubitus varus, but there are reported cases of cubitus valgus. The latter may be the cause of the occurrence of a late ulnar nerve neuropathy, which will require treatment. There is controversy as to whether it is possible to successfully treat both problems at the same surgical procedure. This article describes the case of a girl of 11 years old, who has a cubitus valgus deformity secondary to supracondylar fracture of distal humerus of right elbow at the age of seven years, associated with progressive symptoms of ulnar nerve neuropathy. This patient was treated successfully by a single procedure for corrective dome-shaped supracondilar osteotomy associated with subcutaneous anterior transposition of the ulnar nerve through a posterior approach.