Sermon Injury: A Case Report

DOI: 1/23/2014. This is a 36- year old male relief driver who sustained injury while he was putting away the automatic tarper when he was struck on the right shoulder and got driven into the ground and twisted his right foot. Per OMNI, he was diagnosed with right shoulder strain, and back/neck/right foot fracture. As per office notes dated 6/3/16, the patient is complaining of numbness in all extremities specifically the bilateral feet, arms and bilateral elbows. He has had a flare-up of pain that past couple of weeks around lateral column of the right foot made worse with walking and standing. He has been taking Neurontin 300 mg thrice a day which is helping control his symptoms. He apparently had a bilateral upper extremity upper extremity

Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent

The patient notes that the injury happen when he was lifting some metal trash trays into a trash bin when he felt a sharp pain in his shoulders. Treatment history notes that the treatment to date has consisted of medications. Of note, the MRI done showed a large full thickness tear with retraction of the tendon. Physical examination of the left shoulder revealed that the range of motion has forward flexion of 0-175 degrees, external rotation of 0-40 degrees, and internal rotation to T12. There is positive Hawkins’ and Neer’s sign for impingement. There is weakness with abduction testing. Treatment plan notes recommendation, surgical intervention in the form of a left shoulder, subacromial decompression, rotator cuff repair surgery as necessary. A follow up of 2 to 3 weeks if surgery is authorized. As per medical summary and work status dated 6/14/16, it was noted that the patient has not improved significantly and would be needing surgery. The patient’s return to work date is 6/14/16 with no lifting over 10 pounds and no overhead reach. Follow up to clinic date is on

DOI: 06/04/2008. The patient is a 61-year-old female dispatcher who sustained a work-related injury to her right hand and arm due to repetitive duties. As per OMNI entry, she is status post right proximal median nerve decompression on 05/12/11 and right carpal tunnel release on 09/26/11.

DOI: 6/12/2014. Patient is a 59-year-old right-handed male machine operator who sustained work-related injuries to his right arm, shoulder and neck when his right hand got caught in a mixer. As per office notes dated 9/6/16, the patient returns complains of continued neck pain with burning hot pain extending into the forearm down to the hand along the C6 and C7 distribution with numbness and tingling in the hand. The patient has undergone multiple medications, physical therapy, TEN both in physical therapy and home use. It was also noted that the pateint denies having cognitive behavioral therapy. The provider notes, that it would be appropriate as based on the history including postoperative right forearm fracture repair and forearm open reduction and internal fixation of the right distal radius that an additional surgery to the right arm and continue physical therapy, yet continues to have swelling

An intermetacarpal sprain happens when connective tissues (intermetacarpal ligaments) between bones in the hand (metacarpals) become torn (ruptured) or overstretched. This usually happens because of an injury to the hand.

DOI: 12/23/2013. The patient is a 64-year-old male foreman who sustained injury when he was involved in a motor vehicular accident. Per OMNI, he has had multiple injuries to the right shoulder, right knee, back and right arm/elbow. He is status post arthroscopic surgery for the right shoulder on 05/30/2014.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal

DOI: 6/23/2015. Patient is a 44-year-old male assembler who sustained injury while he was reaching for a part, pulled axle from rack and felt pain in the cervical spine. Per OMNI, the patient is diagnosed with acute cervical sprain and cervical radiculopathy.

Some of the injuries that can occur in the hand are Cubital Tunnel Syndrome and Carpal Tunnel Syndrome along with many more. Cubital Tunnel Syndrome causes pain or numbness in the ring and little fingers, but could also go to the arm (Types of RSI, 2010). Occurs when the ulnar nerve is pinched along the elbow’s edge (“funny bone”), and has tingling or painful feeling (Types of RSI, 2010). Cubital Tunnel Syndrome can be treated by avoiding putting pressure on the “funny bone” (Types of RSI, 2010). Cubital could lead to surgery if the nerve needs to be relieved. Carpal Tunnel Syndrome is similar to Cubital but occurs in the three first fingers. A major nerve is compressed which passes over the carpal bones through the front of the wrist (ASSH, 2015). When the nerve is compressed it causes painful, tingling and numbness in the first three fingers (ASSH, 2015). Carpal Tunnel Syndrome can be treated without surgery by changing the patterns of hand use and/or wearing wrist splints at night (ASSH, 2015). If severe then surgery can take place to make the nerve have more

HISTORY OF PRESENT ILLNESS: This patient is a 40-year-old male. Industrial injury, he got his finger caught in something at work. He sustained an open fracture, distal phalanx of the left small finger. He was seen in the ER. The finger was sutured in the ER. He presents for followup here.

The clinical signs of this fracture are swelling and pain in the scaphoid region, tenderness in the “anatomical snuffbox”, pain on axial compression, pain while pronating the hand, and painful pinch grip2. Radiological diagnosis consists of a scaphoid series of X-rays: Anterior-Posterior, lateral, semipronated and semisupinated views2. In cases of so-called "occult" fractures, the fracture is not visible on the radiographs, if the clinical signs are highly suggestive of fracture a 2 week period of cast immobilization is recommended, followed by a repeat X-ray series2. If further investigation is required, CT and MRI scans can also be implemented.

DOI: 10/01/2012. This is a case of 63-year-old male welder who sustained bilateral hand injuries due to repetitive motion injury from grinding. The patient is subsequently diagnosed with primary osteoarthritis, left hand. As per office notes dated 6/27/16, the patient is 87 days status post left thumb carpometacarpal joint arthroplasty. The patient complains of pain over the metacarpophalangeal joint and occasionally over the interphalangeal joint. The patient still has 3 sessions to complete. Objective findings revealed that the left anterior forearm, dorsal radial wrist, dorsal hand, the scars are healing nicely with no evidence of hypertrophic scarring or pigmentation changes. There is tenderness to palpation over the carpal metacarpal joint

The term “Lisfranc” refers to the tarso-metatarsal articulation. These injuries may include sprains, fractures, and/or dislocations. The term was coined from the name of the French field surgeon Jacques Lisfranc, who first discovered the amputation technique through this joint. Lisfranc injuries are rare (0.2% of all fractures) and commonly missed. Approximately 20% of all Lisfranc injuries remain undiagnosed. Although there is low incidence and prevalence, overlooked Lisfranc injury is cited as one of the most common reasons for malpractice lawsuits against radiologists and emergency medicine physicians. These injuries occur in an area whose bony anatomy is not clearly visualized. Lack of a properly diagnosing the injury and delayed treatment

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this