MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext A Rare Cause of Chronic Flexor Tenosynovitis of the Finger

Sem SH, Chen Kang W

Cureus, 2023 Jun;15(6):e40175.
PMID: 37431353 DOI: 10.7759/cureus.40175

Cat scratch disease (CSD) is an uncommon condition. When a patient is infected, the disease is often self-limiting. Cat scratch disease involving the musculoskeletal system had been described, but the manifestation of the disease in hand remained unexplored. We report a case of chronic flexor tenosynovitis of the left index finger caused by cat scratch disease. In this case, the antibiotic treatment did not improve the clinical outcome. However, surgical debridement of the diseased finger resulted in a tremendous improvement in terms of pain and range of motion.
Irreducible Dorsal Distal Interphalangeal Joint Dislocation of Finger: A Case Report and Perspectives on Management

Sem SH, Omar MF, Muhammad Nawawi RF

Cureus, 2019 May 02;11(5):e4588.
PMID: 31309013 DOI: 10.7759/cureus.4588

Irreducible closed dorsal dislocation of distal interphalangeal (DIP) joint of the finger is a rare injury. The causes of irreducibility of the DIP joint are volar plate interposition, entrapment of flexor digitorum profundus tendon behind the head of middle phalanx, and buttonholing of the middle phalanx head through the volar plate or flexor tendon. Open reduction with a volar approach is recommended with the advantages of better wound healing, ease of releasing entrapped structures, and possibilities of a volar plate, collateral ligaments, and/or flexor tendon repair. We report a case of irreducible dorsal dislocation of left ring finger DIP joint secondary to volar plate interposition treated successfully with open reduction.
Fulltext Pearls and Pitfalls of Phrenic Nerve Transfer for Shoulder Reconstruction in Brachial Plexus Injury

Doi K, Sem SH, Ghanghurde B, Hattori Y, Sakamoto S

J Brachial Plex Peripher Nerve Inj, 2021 Jan;16(1):e1-e9.
PMID: 33584849 DOI: 10.1055/s-0041-1722979

Objectives The purpose of this study was to report the functional outcomes of phrenic nerve transfer (PNT) to suprascapular nerve (SSN) for shoulder reconstruction in brachial plexus injury (BPI) patients with total and C5-8 palsies, and its pulmonary complications. Methods Forty-four out of 127 BPI patients with total and C5-8 palsies who underwent PNT to SSN for shoulder reconstruction were evaluated for functional outcomes in comparison with other types of nerve transfers. Their pulmonary function was analyzed using vital capacity in the percentage of predicted value and Hugh-Jones (HJ) breathless classification. The predisposing factors to develop pulmonary complications in those patients were examined as well. Results PNT to SSN provided a better shoulder range of motion significantly as compared with nerve transfer from C5 root and contralateral C7. The results between PNT and spinal accessory nerve transfer to SSN were comparable in all directions of shoulder motions. There were no significant respiratory symptoms in majority of the patients including six patients who were classified into grade 2 HJ breathlessness grading. Two predisposing factors for poorer pulmonary performance were identified, which were age and body mass index, with cut-off values of younger than 32 years old and less than 23, respectively. Conclusions PNT to SSN can be a reliable reconstructive procedure in restoration of shoulder function in BPI patients with total or C5-8 palsy. The postoperative pulmonary complications can be prevented with vigilant patient selection.
Fulltext Hemi-hamate Arthroplasty in Chronic Fracture-dislocation of Proximal Interphalangeal Joint of Fingers: A Report of Two Cases

Arsad SR, Sem SH, Silvanathan JP, Muhammad Nawawi RF

Cureus, 2020 Jan 22;12(1):e6735.
PMID: 32140316 DOI: 10.7759/cureus.6735

Dorsal dislocations of proximal interphalangeal joint with palmar lip fractures base of middle phalanx of fingers are rare, complex, and often a challenging injury to the treating hand surgeons especially in those chronic cases. Hemi-hamate arthroplasty is the preferred surgical option in treating chronic dorsal fracture-dislocations of the proximal interphalangeal joint. We report two cases with a chronic injury that have been treated with hemi-hamate arthroplasty. Range of motion, pinch and grip strengths, QuickDASH scores, complications, and radiological findings were recorded at follow-up. Good functional outcomes were observed in both patients without major complications. Hemi-hamate arthroplasty can be a reliable surgical treatment for chronic proximal interphalangeal joint fracture-dislocations.
Contralateral Obturator Nerve to Femoral Nerve Transfer for Restoration of Knee Extension After Acute Flaccid Myelitis: A Case Report

Doi K, Sem SH, Hattori Y, Sakamoto S, Hayashi K, Maruyama A

JBJS Case Connect, 2019 Dec;9(4):e0073.
PMID: 31850914 DOI: 10.2106/JBJS.CC.19.00073

CASE: A 7-year-old boy presented with left femoral and obturator nerves (ONs) palsy after an asthmatic attack with a viral prodrome, and his right lower limb was unaffected. He was diagnosed with acute flaccid myelitis (AFM) after positive spinal magnetic resonance imaging findings. After contralateral ON to femoral nerve transfer (CONFNT), his left quadriceps was reinnervated at 5.5 months, full knee extension was recovered at 14 months, and good functional outcomes were achieved at 31 months.
CONCLUSIONS: This first clinical report on CONFNT demonstrated a feasible good alternative in treating young patients with AFM with unilateral L2-L4 palsy and short duration of deficit.
Fulltext Surgical Reconstruction for Upper-Extremity Paralysis Following Acute Flaccid Myelitis

Doi K, Sem SH, Hattori Y, Sakamoto S, Hayashi K, De la Red-Gallego MA

JB JS Open Access, 2019 10 24;4(4):e0030.
PMID: 32043059 DOI: 10.2106/JBJS.OA.19.00030

Acute flaccid myelitis (AFM) is a debilitating illness that is defined by the sudden onset of flaccid paralysis in the extremities with spinal magnetic resonance imaging (MRI) demonstrating a longitudinal lesion confined to the gray matter. The purpose of this study was to report the types of upper-extremity palsy and outcomes of surgical reconstruction in patients with AFM.
Methods: Eight patients with a median age at onset of 3.8 years (range, 2.3 to 9.9 years) were identified. There was loss of shoulder abduction and external rotation in all patients, loss of elbow flexion in 5 patients, complete or partial loss of hand function in 3 patients, and spinal accessory nerve palsy in 2 patients. All patients underwent surgical reconstruction, which was categorized into 3 main groups: nerve transfer, secondary muscle transfer, and free muscle transfer.
Results: The median follow-up period was 39 months (range, 30 to 94 months). Four patients obtained ≥90° of shoulder abduction whereas the other 4 patients had shoulder abduction of ≤70°. The 5 patients who received free muscle transfer or nerve transfer to restore elbow function obtained ≥140° of elbow flexion. Two patients treated with free muscle transfer to restore finger function obtained satisfactory total active motion of the fingers (180°).
Conclusions: The patterns of paralysis and the strategy and outcomes of surgical reconstruction for patients with AFM differed from those for traumatic and obstetric brachial plexus palsy. All patients had loss of shoulder abduction, and 2 had spinal accessory nerve palsy. Restoration of shoulder function was unpredictable and depended on the quality of the donor nerves and recovery of synergistic muscles. Restoration of elbow and hand function was more consistent and satisfactory.
Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete list of levels of evidence.