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Muder, Daniel
Publications (2 of 2) Show all publications
Muder, D. & Vedung, T. (2014). Interosseous-lumbrical adhesions secondary to an infection: a case report. Journal of Medical Case Reports, 8, 301.
Open this publication in new window or tab >>Interosseous-lumbrical adhesions secondary to an infection: a case report
2014 (English)In: Journal of Medical Case Reports, ISSN 1752-1947, E-ISSN 1752-1947, Vol. 8, 301- p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Adhesions between the tendons to the interosseous muscles, the lumbrical muscles and occasionally the deep transverse metacarpal ligament can be symptomatic and cause chronic discomfort in the distal part of the hand. Reports about the condition are rare and the causal factors in previous publications are in principle limited to crush injuries and contusion from a direct blow to the hand. We present a case with typical clinic findings secondary to an infection after a cat bite. To the best of our knowledge symptomatic interosseus-lumbrical adhesions caused by an infection has never been described previously.

CASE PRESENTATION: Our case report describes a 25-year-old Caucasian woman with chronic pain and swelling between her second and third metacarpal heads. Symptoms occurred especially under stress and developed secondary to an infection after a cat bite. Surgical exploration revealed localized adhesions between her second lumbrical muscle, her first palmar interosseous muscle and her deep transverse metacarpal ligament. The symptoms were completely relieved by surgical release of the adhesions, partial resection of the deep transverse metacarpal ligament and immediate postoperative physiotherapy.

CONCLUSIONS: Physicians involved in hand surgery should be aware of the condition and look for it in patients complaining about distal intermetacarpal pain. The major causal factors for developing symptomatic interosseous-lumbrical adhesions are crush injuries or contusion to the distal part of the hand but it may also occur after an infection.

National Category
Orthopaedics
Identifiers
urn:nbn:se:uu:diva-232246 (URN)10.1186/1752-1947-8-301 (DOI)25200654 (PubMedID)
Available from: 2014-09-16 Created: 2014-09-16 Last updated: 2018-01-11Bibliographically approved
Schliemann, B., Muder, D., Gessmann, J., Schildhauer, T. A. & Seybold, D. (2011). Locked posterior shoulder dislocation: treatment options and clinical outcomes.. Archives of Orthopaedic and Trauma Surgery, 131(8).
Open this publication in new window or tab >>Locked posterior shoulder dislocation: treatment options and clinical outcomes.
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2011 (English)In: Archives of Orthopaedic and Trauma Surgery, ISSN 0936-8051, E-ISSN 1434-3916, Vol. 131, no 8Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Posterior dislocation of the shoulder is a rare injury and often misdiagnosed during the initial presentation to a physician. Misdiagnosis is due to a lack of clear clinical signs compared to anterior dislocation and inappropriate radiographs. In contrast to anterior dislocations, the humeral head defect accounts for recurrent instability. Depending on the size of the defect and the duration of dislocation, different treatment options include elevation of the defect, bone grafting, McLaughlin procedure, rotation osteotomy or arthroplasty.

METHODS: We reviewed 35 patients who presented to our institution with a locked posterior dislocation of the shoulder between January 1999 and August 2009. In 6 patients, the shoulder remained stable after closed reduction, so the treatment was conservative; 29 patients underwent surgery.

RESULTS: The mean follow-up was 55 months (range 11-132 months). The interval between trauma and the diagnosis of posterior shoulder dislocation was 66 days (min. 0, max. 365). Patients treated conservatively achieved a Constant Score of 85 points; patients who underwent operative treatment had a slightly worse outcome with an average Constant Score of 79 points. There was a high correlation between the time to the correct diagnosis and the outcome.

CONCLUSION: Although locked posterior shoulder dislocation is uncommon and often initially misdiagnosed, satisfying results can be achieved by different surgical treatment options. Early diagnosis by detailed clinical examination and sufficient radiographic evaluation with true anterior-posterior and axillary views is essential to improve clinical results. Levl of evidence: IV.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-269495 (URN)10.1007/s00402-011-1310-9 (DOI)21567148 (PubMedID)
Available from: 2015-12-16 Created: 2015-12-16 Last updated: 2017-12-01
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