- Pterygoid Hamulus Bursitis: A Rare Intra-Oral Pain Syndrome. [Journal Article]
- JCJ Craniofac Surg 2019 Jun 20
- Pterygoid hamular bursitis is a rare craniofacial pain syndrome used to describe palatal and pharyngeal pain due to an enlarged pterygoid hamulus. The pterygoid hamulus is a hook-shaped bony process …
Pterygoid hamular bursitis is a rare craniofacial pain syndrome used to describe palatal and pharyngeal pain due to an enlarged pterygoid hamulus. The pterygoid hamulus is a hook-shaped bony process located bilaterally on each medial pterygoid plate of the sphenoid bone, posterior and medial to each maxillary tuberosity. These processes project downward and anterolaterally; serve as attachment for ligaments and a network of muscles. It can be palpated in patients with a finger palpating the posteromedial to maxillary tuberosity. The pathogenesis is elusive and varies from bursitis of tensor veli palatine, elongated pterygoid hamulus, persistent trauma to the mucosa overlying the pterygoid hamulus. The clinical features include strange chronic sensation, burning, swelling, and erythema of the pterygoid hamulus region. The pain often radiates to pharynx, ipsilateral face and sometimes radiating to temporal region making it difficult to diagnose from headache, temporomandibular disorders, and dental infections like pericoronitis. The anatomical neighboring structures in relation to oropharyngeal region may give a misleading diagnosis to dentist in case of Pterygoid Hamulus Bursitis. The understanding of pterygoid hamulus anatomy and its relation to surrounding structures is necessary to get the correct diagnosis of the inflammatory or traumatic pain in oropharyngeal region.
- Diagnosis of a hamate hook fracture with 3D reconstruction of computed tomography images: A case report and review of literature. [Journal Article]
- JXJ Xray Sci Technol 2019 May 30
- We report the case of a 19-year old man who presented to our institution with a history of pain of one week in the ulnar side of the left wrist and continuous pressing sensation in the palm. Accordin…
We report the case of a 19-year old man who presented to our institution with a history of pain of one week in the ulnar side of the left wrist and continuous pressing sensation in the palm. According to patient, there was no history of acute hand trauma. The conventional roentgenograms did not show the fracture and computerized tomographic (CT) scanning demonstrated a complete fracture of the hook of the hamate. The patient was given a surgical intervention and the hamate bone was reduced through a palmar skin incision. After surgery, the operated hand was immobilized in a wrist brace and the patient was put on a rehabilitation protocol. At the last follow-up, the patient was able to return to normal living activities without any symptoms. We reviewed the latest articles of the past 18 years and compared the research studies related to the diagnosis and treatment of the hamate hook fracture. Our conclusion is that CT scan is the most effective diagnostic tool for detecting the hamate hook fracture. Three-dimensionally (3D) reconstructed images based of CT could provide more accurate and insight illustration for better evaluation in surgical planning.
- The Use of the Proximal Hamate as an Autograft for Proximal Pole Scaphoid Fractures: Clinical Outcomes and Biomechanical Implications. [Review]
- HCHand Clin 2019; 35(3):287-294
- Scaphoid proximal pole fractures remain a surgical challenge because of high propensity for nonunion, osteonecrosis, and ultimately carpal collapse. Options for management of nonsalvageable proximal …
Scaphoid proximal pole fractures remain a surgical challenge because of high propensity for nonunion, osteonecrosis, and ultimately carpal collapse. Options for management of nonsalvageable proximal pole fractures include non-vascularized bone grafts, vascularized pedicled bone grafts, free vascularized bone flaps, and rib cartilage grafts. The proximal pole of the hamate can also serve as a replacement arthroplasty in the setting of proximal pole scaphoid nonunions with collapse, bone loss, and/or osteonecrosis. This novel graft addresses shortcomings of other graft choices by providing a local structural autograft solution with minimal donor site morbidity, correcting carpal collapse, reconstructing the scapholunate ligament, and mitigating the need for microvascular anastomosis.
- Abnormalities of the muscles of the soft palate and their impact on auditory function in patients operated on for cleft palate: a case-control study. [Journal Article]
- BJBr J Oral Maxillofac Surg 2019 May 31
- Patients with cleft palate have a high incidence of otitis media (OM), which, even after palatal repair, can persist and lead to auditory dysfunction. We aimed to identify what predisposes such patie…
Patients with cleft palate have a high incidence of otitis media (OM), which, even after palatal repair, can persist and lead to auditory dysfunction. We aimed to identify what predisposes such patients to develop OM and correlate it with auditory function. We designed a prospective case-control study of adults who had had their cleft palates repaired in childhood. We examined the anatomy of the eustachian tube and the paratubal muscles of the soft palate with magnetic resonance imaging (MRI), assessed auditory function, and correlated the results to evaluate the impact of the pathological anatomy on the function of the middle ear. A total of 64 ears in 32 patients were evaluated (Group A, n = 16) (Group B, controls = 16). MRI showed a short eustachian tube with a shortened tensor attachment in Group A when compared with Group B. The pterygoid hamulus was found to be intact in both groups, but extensive perihamular fibrosis was seen in Group A. A total of 15 ears in Group A had loss of hearing (prevalence ratio (PR) 1.08), (13 mild loss, and 2 moderate loss), and impedance audiometry showed effusion of the middle ear in 12 ears in 16 patients, and dysfunction of the eustachian tube with high negative pressure in the middle ear in four ears in the 16 patients (PR 4.6). These could be positively correlated with the pathological anatomy using Pearson's correlation coefficient. Otitis media is persistent and can lead to conductive hearing loss in adults who have been operated on for cleft palate. This can be attributed to abnormalities in the development of the eustachian tube and the paratubal musculature.
- Comparison of Magnetic Resonance Imaging and Ultrasonography in Diagnosing and Grading Carpal Tunnel Syndrome: A Prospective Study. [Journal Article]
- CPCurr Probl Diagn Radiol 2019 Apr 10
- CONCLUSIONS: CA of median nerve is the most useful parameter to diagnose and grade CTS and USG and MRI are comparable for measurements. Increased retinacular bowing on USG and hypoechogenicity of median nerve increase the diagnostic confidence while MRI helps in picking up important associated conditions.
- [Klippel-Feil autosomal dominant syndrome: A malformation of vertebral segmentation]. [Journal Article]
- RCRev Chil Pediatr 2019; 90(2):194-201
- CONCLUSIONS: The malformation of congenital vertebral segmentation is a case of interest since it is an uncommon diagnosis in the pediatric age and whose clinical suspicion can be generated from the clinical examination, radiological study com plemented with the pedigree interpretation in Mendelian inheritance disorders, allowing to provide opportunely genetic counseling to the family.
- Multiple open wrist fractures and dislocation of the distal radioulnar joint from a dog bite injury. [Case Reports]
- RCRadiol Case Rep 2019; 14(7):837-841
- Dogs are commonly kept as household pets, but sometimes pet dogs bite people. We report the case of a 69-year-old man who was bitten by his pet pit bull terrier. The dog bite resulted in multiple ope…
Dogs are commonly kept as household pets, but sometimes pet dogs bite people. We report the case of a 69-year-old man who was bitten by his pet pit bull terrier. The dog bite resulted in multiple open wrist fractures and dislocation of the distal radioulnar joint, requiring surgical debridement, open reduction and internal fixation, and bone grafting. CT of the fractures showed that the dog's maxillary canine teeth had been deeply embedded in the hamate and second metacarpal bones, requiring that the dog's mouth be opened and the teeth disengaged in order to remove the injured limb from the dog.
- Radiomorphometric assessment of the pterygoid hamulus as a factor promoting the pterygoid hamulus bursitis. [Journal Article]
- FMFolia Morphol (Warsz) 2019 Apr 26
- The pterygoid hamulus (PH) is a small protrusion on the base of the pterygoid process of the sphenoid bone. PH is a site of insertion of many muscles and ligaments. Its topography can determine predi…
The pterygoid hamulus (PH) is a small protrusion on the base of the pterygoid process of the sphenoid bone. PH is a site of insertion of many muscles and ligaments. Its topography can determine predilection for developing the pterygoid hamulus bursitis (PHB). The study was conducted based on the morphometric analysis of 100 PHs on cone beam computed tomography (CBCT) scans. Based on statistical analysis, we found numerous significant correlations between the morphometric parameters. Considering our results, it can be concluded that the main pathogenic factor in PHB is an extensive medial deviation of the pterygoid hamulus in the frontal plane.
- Concurrent Index-to-Little Finger Dorsal Dislocations of the Carpometacarpal Joints with Carpal Bone Fractures. [Case Reports]
- IJIndian J Orthop 2019 Mar-Apr; 53(2):374-376
- A 32-year-old man presented with simultaneous dorsal dislocations of the index-to-little finger carpometacarpal (CMC) joint with carpal bone fractures. Closed reduction was unsuccessful even after ge…
A 32-year-old man presented with simultaneous dorsal dislocations of the index-to-little finger carpometacarpal (CMC) joint with carpal bone fractures. Closed reduction was unsuccessful even after general anesthesia. During open dorsal approach, we found interposed joint capsule in the CMC joints and after removal of the joint capsule open reduction was easily achieved. We placed four Kirschner wires through the CMC joint. Furthermore, the fractured dorsal fragments of the trapezoid and hamate were fixed with mini screw in each. During 1-year followup, the patient showed good recovery and no evidence of posttraumatic arthritic changes in plain X-ray. We recommend to fix the dorsal fragment of the carpal bone with screws as well as the transarticular fixation of the CMC joint in case of concurrent CMC joint fracture-dislocation of all four fingers.
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- Fracture of an Os Hamulus Proprium: A Case Report. [Journal Article]
- JCJBJS Case Connect 2019 Jan-Mar; 9(1):e16
- CONCLUSIONS: An os hamulus proprium is often confused with a fracture of the hook of the hamate, and little information exists in the literature regarding these accessory ossicles. To our knowledge, an os hamulus proprium fracture has not previously been described in the literature.