Malunion of metacarpal fractures can result in severe functional and esthetic impairment to the patient, thus requiring surgical correction. Traditionally, the fixation methods most commonly used for these fractures are the Kirschner wires or the plates and screws. However, one of the options for the fixation of metacarpal fractures is intramedullary fixation with a headless screw. This minimally invasive method can also be used for corrective metacarpal osteotomies. It has the advantages of being a minimally invasive technique and allowing the early range of motion. This minimally invasive method can also be used to stabilize the corrective metacarpal osteotomies for malunion. This case report presents a minimally invasive technique for corrective dorsal metacarpal osteotomy and fixation with a headless intramedullary screw. This alternative fixation method has the advantage of low damage to soft tissues and good functional outcomes.
A lesão do ligamento colateral ulnar da articulação metacarpofalangeana do polegar é uma lesão comum no esquiador e outros esportes que envolvem trauma do polegar. Estas lesões, quando negligenciadas acarretam instabilidade articular, trazendo prejuízo funcional e debilidade aos pacientes. O diagnóstico precoce é fundamental, para caracterizar o padrão da lesão. As lesões completas são manejadas preferencialmente de forma cirúrgica, geralmente com excelentes resultados funcionais pós-operatórios. Apresentamos o relato de caso de quatro pacientes do sexo feminino, praticantes de esportes de diferentes modalidades com lesões do ligamento colateral ulnar da articulação metacarpofalangeana do polegar. Uma das pacientes apresentava lesão bilateral. O tratamento foi realizado de forma cirúrgica e todos os pacientes apresentaram bons resultados funcionais pós-operatórios. Nossos resultados são condizentes com os resultados observados na literatura, onde o tratamento cirúrgico acarreta bom resultado funcional, possibilitando, inclusive, o retorno ao esporte.
Reconstruction surgeries for malignant soft tissue tumors challenges many surgeons and orthopedic centers. Few cases of triceps brachii leiomyosarcoma reconstruction have been described. There are tunneling techniques already described by other authors. This study aims to report a case of oncological reconstruction of the triceps brachii using the large Latissimus Dorsi flap in a 60 years-old male patient with leiomyosarcoma in the triceps brachii. The patient achieved full recovery of triceps brachii function after eight weeks. The microsurgical options could be helpful in the management and reconstruction of the leiomyosarcomas in patients without limb amputation indication.
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