Late presentation of superior mesenteric artery syndrome following scoliosis surgery: a case report

<p>Abstract</p> <p>Introduction</p> <p>Obstruction of the third part of the duodenum by the superior mesenteric artery (SMA) can occur following surgical correction of scoliosis. The condition most commonly occurs in significantly underweight patients with severe deformities during the first few days to a week following spinal surgery.</p> <p>Case presentation</p> <p>We present the atypical case of a patient with normal body habitus and a 50° adolescent idiopathic thoracolumbar scoliosis who underwent anterior spinal arthrodesis with instrumentation and developed SMA syndrome due to progressive weight loss several weeks postoperatively. The condition manifested with recurrent vomiting, abdominal distension, marked dehydration, and severe electrolyte disorder. Prolonged nasogastric decompression and nasojejunal feeding resulted in resolution of the symptoms with no recurrence at follow-up. The spinal instrumentation was retained and a solid spinal fusion was achieved with good spinal balance in both the coronal and sagittal planes.</p> <p>Conclusion</p> <p>SMA syndrome can occur much later than previously reported and with potentially life-threatening symptoms following scoliosis correction. Early recognition of the condition and institution of appropriate conservative measures is critical to prevent the development of severe complications including the risk of death.</p

Delayed ulnar nerve palsy after open reduction and internal fixation of medial epicondylar fractures

We present two cases of patients with delayed ulnar nerve palsies after operative fixation of displaced medial epicondyle fractures. These fractures are common childhood injuries and the optimal management for the ulnar nerve is not universally agreed. The ulnar nerve is at risk of compression distal to the elbow and where surgical decompression is selected, care must be taken to ensure that this is complete.</p

Vascular Compromise Secondary to Acromioclavicular Joint Injury:A Case Report

Acromioclavicular dislocation is a common injury in young males. We present an unusual complication of vascular compromise occurring in a 27-year-old male manual labourer with a grade V acromioclavicular joint dislocation. Following modified Weaver–Dunn reconstruction, the patient had a good outcome, with total relief of symptoms, and returned to his previous occupation.</p

Acute Carpal Tunnel Syndrome: Early Nerve Decompression and Surgical Stabilization for Bony Wrist Trauma

Background:. We undertook this study to investigate the outcomes of surgical treatment for acute carpal tunnel syndrome following our protocol for concurrent nerve decompression and skeletal stabilization for bony wrist trauma to be undertaken within 48 hours. Methods:. We identified all patients treated at our trauma center following this protocol between January 1, 2014 and December 31, 2019. All patients were clinically reviewed at least 12 months after surgery and assessed using the Brief Michigan Hand Outcomes Questionnaire, the Boston Carpal Tunnel Questionnaire, and sensory assessment with Semmes-Weinstein monofilament testing. Results:. The study group was made up of 35 patients. Thirty-three patients were treated within 36 hours. Patients treated with our unit protocol for early surgery comprising nerve decompression and bony stabilization within 36 hours report excellent outcomes at medium term follow-up. Conclusions:. We propose that nerve decompression and bony surgical stabilization should be undertaken as soon as practically possible once the diagnosis is made. This is emergent treatment to protect and preserve nerve function. In our experience, the vast majority of patients were treated within 24 hours; however, where a short period of observation was required, excellent results were generally achieved when treatment was completed within 36 hours