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Biomedical subjects

L De Smet

Publications and source records attributed to L De Smet.

At least 19 recordsLinked to original sources
PubMed2001

Fracture of the hook of the hamate, often misdiagnosed as "wrist sprain".

A patient with fracture of the hook of the hamate is described, in whom the diagnosis was delayed for 1 year after the initial trauma. This delay in correct diagnosis is often seen, as routine anteroposterior and lateral roentgenograms of the wrist are unlikely to show the fracture. The trauma is often misinterpreted as a "wrist sprain." Nevertheless, with a careful trauma history and a detailed clinical examination and with minimal additional roentgenographic views, it should be possible to correctly diagnose the fracture. Relief of the disabling pain can then be offered by removal of the un-united fracture fragment.

Diagnosis, Differential↗
PubMed2001

Kienbock disease in cerebral palsy.

A 48-year-old woman with cerebral palsy (CP) and lunatomalacia in her paralytic arm is reported. We performed a proximal row carpectomy with good pain resolution. One should be aware of this association in a CP patient complaining of wrist pain.

Cerebral Palsy↗
PubMed2000

A young female with asymmetric manifestations of larsen syndrome: another example of unilateral somatic cell-line mosaicism.

Larsen syndrome is characterized by multiple congenital joint dislocations, typical skeletal defects and facial dysmorphism. In this article, we present a female patient with asymmetric Larsen syndrome. We hypothesise that the asymmetric distribution of clinical features in our patient is likely caused by post-zygotic somatic cell-line mosaicism of a dominant gene mutation.

Abnormalities, Multiple↗
PubMed2000

Consequences of a fracture through a minimally ossified apophysis of the olecranon.

The case of a 12-year old boy with a missed olecranon fracture after an elbow trauma is presented. Knowledge of the ossification patterns around the elbow is essential in evaluating elbow trauma in children. Certain fractures of the immature elbow present diagnostic difficulty, which can lead to missed or delayed diagnosis, with possible permanent functional loss that timely diagnosis and treatment might avoid. This is particularly true for those fractures running through unossified portions of the elbow. Such a case is described.

Child↗
PubMed2000

Glomus tumors.

The authors report a series of 12 consecutive patients with 13 glomus tumors operated from July 1991 until February 1999. Symptoms were present for an average of 1.9 years before surgery. Women were more frequently affected. The mean age was 44 years. In 12 of the 13, the tumor was located in the distal phalanx and one patient had a glomus tumor on the dorsum of the hand. One glomus tumor was found in the right hallux of a two-year-old child. Both hands and all fingers were equally involved. One bilateral glomus tumor was associated with neurofibromatosis. All tumors were resected and histology confirmed the diagnosis. The result was good with immediate pain relief. No recurrence has been noted to date.

Adolescent↗
PubMed2000

Intraosseous ganglion of the triquetrum. A transpisiformal approach.

A cystic subchondral bone defect without joint pathology is called an intraosseous ganglion. Most occur in the lower limb. In the wrist the scaphoid and lunate are most often involved. We report a case of an intraosseous ganglion within the triquetrum, treated by curettage and grafting with the pisiform that had been removed.

Adult↗
PubMed2000

Metallosis mimicking osteomyelitis from a forearm plate retained for 50 years.

A forearm plate retained for 50 years was removed because an acute inflammation mimicked chronic infection. The radiographs were very confusing. During the operation metallosis was obvious. Despite the general opinion that forearm plates should be kept in place, this probably should not apply to old "historical" hardware of uncertain chemical composition.

Aged↗
PubMed2000

Radial head dislocation with plastic deformation of the ulna in children. A rare and frequently missed condition.

Although often reported in the literature, 'isolated' traumatic radial head dislocation in children is a rare condition which has not been studied extensively. There is very often a delay in diagnosis and treatment. Lincoln and Mubarak described the 'ulnar bow sign' in 1994. They accurately described the plastic deformity of the ulna and explained how to make a correct diagnosis from the radiographs. Probably most 'isolated' radial head dislocations in children are associated with plastic deformation of the ulna as stated in 1984 by Dubuc et al. (2). The recognition of these "plastic" Monteggia fractures is mandatory, as action on the ulna plays a central role in the treatment. On the other hand, the 'ulnar bow sign' may be used to detect subtle changes in the position of the radial head. We present 4 cases of chronic radial head dislocation associated with plastic deformation of the ulna. Open reduction of the radial head and reconstruction of the annular ligament was performed. An osteotomy of the ulna was deemed necessary in 3 cases.

Bone Nails↗
PubMed1999

Trisomy 7 and trisomy 8 in dividing and non-dividing tumor cells in Dupuytren's disease.

Cytogenetic and molecular cytogenetic analysis is reported in a series of 40 tissue samples from 36 patients with Dupuytren's disease, presenting as palmar and/or finger nodules. No consistent structural chromosome changes could be found. Instead, recurrent clonal numerical abnormalities were demonstrated in 22 of 40 tissue nodules, involving trisomies of chromosome 7 or 8 and loss of the Y chromosome. In addition, we showed that trisomy 7 and trisomy 8 were also present in non-dividing cells.

Adult↗
PubMed1999

The Herbert screw for delayed union and non-union of scaphoid fractures: a review of twenty-two cases.

We retrospectively reviewed 22 patients with delayed or non-union of scaphoid fractures treated with the Herbert screw. In 15 cases, we used an additional bone graft, taken from the iliac crest in all but two cases. The mean follow-up was 18 months (range: 6-40 months). Twelve of the 14 non-unions and 7 of the 8 delayed unions healed. Eleven patients were pain-free, 7 had minor symptoms, one had major symptoms but still considered his situation to be improved and two did not obtain any clinical improvement.

Adolescent↗
PubMed1999

Are there still indications for the Krukenberg kineplasty? Report of two patients.

Krukenberg's operation was actually described by Vanghetti in 1989. Three cases, including one bilateral case, are reported. The first case was a 36-year-old patient from a developing country. At the sixth postoperative week, the patient had regained his independence and gained 1.5 kg. The second case was a child with multiple malformations, who presented, in addition to amputation of both legs, a high amputation of the left forearm and distal fold of the right forearm. Krukenberg's operation was performed at the age of 8 months. At the age of 2 years, the child was able to eat and drink independently.

Abnormalities, Multiple↗
PubMed1999

Avascular necrosis of multiple carpal bones. A case report.

A case of a 66-year-old female patient with hyperlipaemia, corticosteroid osteoporosis and chronic obstructive lung disease with avascular necrosis of the proximal row of the carpus and hamate is described. No other sites of avascular bone necrosis were found. A proximal row carpectomy was performed with an excellent outcome.

Aged↗
PubMed1999

Avulsion of both extensor carpi radialis tendons: a case report.

Closed traumatic avulsion of both extensor carpi radialis tendons is reported in a young healthy patient. Early diagnosis important because the tendons tend to retract and anatomic repositioning is more difficult to perform with passing time. Diagnostic markers are the inability to actively extend the wrist and the presence of dorsal bone fragments on the lateral radiograph of the wrist. We recommend fixation of the avulsed fragments to restore the length and strength of the wrist extensors.

Adult↗
PubMed1999

Cutaneous sclerosing perineurioma with cryptic NF2 gene deletion.

Sclerosing perineurioma is a recently described variant of perineurioma that characteristically occurs in the fingers and palms of young adults. We report a cutaneous sclerosing perineurioma with preservation of the axons and Schwann cells in the center of the whorls of perineurial cells, a feature that previously was reported to be typically absent in these lesions. Additionally, clonal chromosomal abnormalities of chromosome 10 and a cryptic deletion of the 5'BCR and NF2 loci on chromosome 22 were present. These findings further support the hypothesis that a gene on chromosome 22 may play a role in the pathogenesis of perineurioma. The NF2 gene is a logical candidate because of its involvement in other nerve sheath tumors.

Adolescent↗