Cubital Tunnel Syndrome Due to Multiple Intraneural Cysts at Elbow: A Case Report and Review of Literature

Cubital tunnel syndrome is a common disorder that affects the upper limb and involves compression of the ulnar nerve. However, this syndrome is rarely caused by multiple intraneural ganglion cysts. Of all intraneural ganglion cysts, only 9% affect the elbow. This study presents a case report of a 73-year-old female patient who manifested pain, numbness, tingling, and paralysis of the medial aspect of her left forearm, fourth, and fifth fingers of the left hand for six months. Intraoperative findings showed multiple intraneural cysts at the left elbow, which were confirmed via histopathology. The cysts were surgically excised, whereas the ulnar nerve was released into the cubital tunnel and anteriorly transposed. Complete sensory and motor recovery were achieved. Although similar cases of intraneural cysts were reported in the literature, this case has the uniqueness of the unusual number and site of intraneural cysts in the ulnar nerve on the background of osteoarthritic changes. Therefore, the aim of reporting this case is to increase awareness of the presence of these cysts when the symptoms are severe.

Prevalence and Predictors of Carpal Tunnel Syndrome Symptoms Among Teachers in Riyadh: A Cross-Sectional Study

Background Carpal tunnel syndrome (CTS) is a musculoskeletal disorder (MSD) afflicting the upper limbs with a prevalence of approximately 14.4% in the general population. Previous studies have noted the increasing prevalence of MSDs among teachers but have not investigated in depth the prevalence and predictors of CTS symptoms in this population. The aim of this study was to help fill this gap in the literature by investigating teachers working in Riyadh, Saudi Arabia. Methods We conducted this cross-sectional study in Riyadh using an online survey. We distributed the Boston carpal tunnel questionnaire (BCTQ) to schoolteachers in the city through the social media applications Twitter, WhatsApp, and Telegram. We assessed the respondents' symptoms using Univariate association analyses with a Wilcoxon rank sum test for the continuous variables and Fisher's exact test and Pearson's chi-squared test for the categorical variables. We assessed the independent risk factors for CTS by constructing multivariate binary logistic regression models and expressed the results using the odds ratio (OR) and 95% confidence intervals (95% CIs), with p < 0.05 indicating statistical significance. Results The sample for this study included 490 teachers. Among them, the prevalence of moderate to severe CTS symptoms was 40.0%, and self-reported CTS was 9.1%. The teachers who were female, relatively old, left-handed, retired, and spent significant time using a pen, keyboard, and/or blackboard were more likely than those who were male, relatively young, right-handed, and did not spend significant time using a pen, keyboard, and/or blackboard to self-report CTS and exhibit moderate to severe symptoms. Conclusions We found a relatively high percentage (40.0%) of CTS symptoms among teachers working in Riyadh. This finding suggests that any sign of CTS symptoms should be checked to ensure early diagnosis and treatment, which contribute to positive outcomes, particularly given the recent increase in such risk factors for CTS as diabetes, hypothyroidism, and high BMI in populations worldwide.

A unique scaphocapitate fracture syndrome in an adolescent: a case report and a review of literature from the last decade

Scaphocaptiate fracture syndrome is a unique condition and is challenging to manage. This rare fracture develops after high-energy wrist trauma. We reported a patient with a history of falling on an outstretched hand. A 15-year-old boy had scaphocapitate fracture syndrome, which included a displaced fracture of the capitate, an avulsion fracture at the distal tubercle of the scaphoid bone with an extension to the articular surface, and a perilunate fracture. A few months after open reduction and internal fixation were performed, the patient had a satisfying outcome. In addition, we have conducted a review of the literature regarding the mechanism of injury, diagnosis and outcome of published cases in correlation to our discussed case.

Primary Psoas Abscess Complicated by Septic Arthritis Due to Community-Acquired Methicillin-Resistant Staphylococcus aureus: A Case Report and Review of Literature

This is a report of an unusual case of a primary psoas abscess due to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in an immunocompetent man. The course of the disease is expressed as septic arthritis of the hip joint with avascular necrosis. Diagnosed one month after symptoms began, the patient was treated by surgical evacuation of the abscess and appropriate antibiotics. Full recovery and return to his usual activity followed total hip replacement.

Short leg cast versus orthotic removable support for the management of pseudo-Jones avulsion fracture: A systematic review and meta-analysis

BACKGROUND

The fifth metatarsal base avulsion fracture (i.e., Pseudo-Jones fracture) is one of the most common foot fractures. The management of pseudo-Jones fractures could be carried out surgically or conservatively. This systematic review and meta-analysis aimed to provide an update about the efficacy of orthotic removable support compared to short-leg casting for individuals with pseudo-Jones fracture.

METHODS

We searched Embase, Medline, and Cochrane Central register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) that compared the clinical outcomes of orthotic removable support and short-leg cast for adult individuals with a fifth metatarsal base avulsion fracture. We used 95% as a confidence level and P <0.05 as a threshold. The standardized mean difference (SMD) was used for the continuous outcomes, and the risk ratio (RR) was used for the dichotomous outcomes.

RESULTS

A total of 6 RCTs incorporating 403 individuals out were deemed eligible. There was no significant difference between orthotic removable support and short-leg casting regarding AOFAS score (standardized mean difference (SMD)= 0.31, 95% CI -0.17 to 0.8), pain on VAS score (SMD= -0.08, 95% CI -0.39 to 0.22), VAS-FA score (SMD= 0.22, 95% CI -0.19 to 0.62) EQ-5D VAS score, and non-union rate (RR=0.37, 95% CI 0.05 to 2.74).

CONCLUSION

The current meta-analysis reveals that there is no difference between orthotic removable support and short-leg casting for the conservative management of individuals sustaining pseudo-Jones fracture.