Case Report
Management of Distal Phalanx Intraarticular Comminuted Fracture of Small Finger with Zone I Flexor Tendon Avulsion: A Case Report
Wharton Benjamin,
Labor Madeline,
Johnston Patrick*
Issue:
Volume 3, Issue 2, June 2024
Pages:
13-17
Received:
23 April 2024
Accepted:
17 May 2024
Published:
15 August 2024
Abstract: Distal phalanx fractures are a common injury in both athletes and civilians. These fractures can differ greatly in severity and treatment indications depending on the size, location, and stability of the fracture in addition to appreciation of any bony comminution. Tendon avulsion in conjugation with a fracture complicates treatment and outcomes further. The classification system for these fractures have been well classified to include Type I, II, II, and IV with IV having subtypes. More recently, Type V has been added to the classification system. Designated as a comminuted distal phalanx fracture with flexor digitorum profundus avulsion, this Leddy-Packer type has two subgroups: namely, comminution without intra-articular involvement (Va) and comminution that includes the articular surface. We report the case of a 42-year-old female presenting with injury to the distal phalanx of the right small finger sustained after her dog ran away from her as she held the collar, exerting significant force in opposition to her flexed fingers. Upon exam and following appropriate imaging, her injury was defined as a Leddy and Packer Type Vb jersey finger injury. This was effectively treated with open reduction, internal fixation of the comminuted distal phalanx base and avulsion fragment. A notably rare injury, Leddy-Packer Type Vb distal phalanx avulsion injuries must be treated in a case-by-case basis, but open reduction internal fixation with plating proves an appropriate and effective means of repair in the correct patient.
Abstract: Distal phalanx fractures are a common injury in both athletes and civilians. These fractures can differ greatly in severity and treatment indications depending on the size, location, and stability of the fracture in addition to appreciation of any bony comminution. Tendon avulsion in conjugation with a fracture complicates treatment and outcomes fu...
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Case Report
Case Report: Radiofrequency Pulsed Therapy for Glossopharyngeal Neuralgia with Associated Syncope
Wang Jia
,
Yu Xiaoqian,
Li Jun*
Issue:
Volume 3, Issue 2, June 2024
Pages:
18-21
Received:
10 July 2024
Accepted:
29 July 2024
Published:
15 August 2024
Abstract: Glossopharyngeal neuralgia (GPN) is characterized by paroxysmal, severe, and lancinating pain at the base of the tongue and throat on one side, often radiating to the oropharynx or ear. The intensity of the pain can be debilitating and, in severe cases, may be accompanied by potentially life-threatening conditions such as cardiac arrhythmias and syncope, significantly impacting the patient's quality of life. The incidence of GPN is low, and there is limited clinical awareness and understanding of the condition, leading to a high rate of misdiagnosis. In recent years, pulsed radiofrequency has emerged as an effective and minimally invasive treatment modality for the management of GPN. We report a case of a 56-year-old male patient with recurrent glossopharyngeal neuralgia accompanied by syncope. The patient tested positive for the topical application of local anesthetics, and cranial nerve magnetic resonance imaging (MRI) revealed compression of the right glossopharyngeal nerve by a small blood vessel. Both 24-hour Holter monitoring and video electroencephalography (EEG) showed no abnormalities. In addition to treatment with carbamazepine and pregabalin, the patient's pain as well as syncope resolved after two sessions of CT (ComputedTomography)-guided pulsed radiofrequency (PRF) therapy of the glossopharyngeal nerve. Clinicians should be aware of the rare clinical occurrence of glossopharyngeal neuralgia with syncope. PRF is a measure of safe and effective which could be considered the first choice for minimally invasive therapy.
Abstract: Glossopharyngeal neuralgia (GPN) is characterized by paroxysmal, severe, and lancinating pain at the base of the tongue and throat on one side, often radiating to the oropharynx or ear. The intensity of the pain can be debilitating and, in severe cases, may be accompanied by potentially life-threatening conditions such as cardiac arrhythmias and sy...
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