Marchercooke1887
Injuries involving naviculocuneiform and the calcaneocuboid joint can occur following low-energy impact. Such complex injuries should be diagnosed and treated as early as possible. Initial open reduction and stable anatomical fixation are the keys to achieve a good functional outcome in such kind of injuries.
Periprosthetic patellar fracture after total knee arthroplasty (TKA) is an uncommon yet devastating complication, and management of these fractures is challenging with unreliable results. An isolated bilateral patellar fracture is often associated with systemic diseases, steroid usage, and repeated microtrauma. Isolated simultaneous bilateral periprosthetic patellar fracture after TKA is seldom reported in the literature.
This report consists of two cases of simultaneous isolated closed bilateral eriprosthetic patellar fracture after TKA, treated with open reduction and internal fixation of patella using tension band wiring. Union was achieved in both cases with satisfactory knee range of motion without significant extension lag.
Regardless of the fact that surgical outcome of periprosthetic fracture of the patella has unpredictable and poor results in past, it can be considered for acute traumatic periprosthetic patella fractures with less comminution and good bone stock to avoid revision arthroplasty and poor outcome.
Regardless of the fact that surgical outcome of periprosthetic fracture of the patella has unpredictable and poor results in past, it can be considered for acute traumatic periprosthetic patella fractures with less comminution and good bone stock to avoid revision arthroplasty and poor outcome.
Perthes disease often results in a non-spherical deformed femoral head which causes pain, dysfunction, early degeneration, and arthritis in young adults. The importance of preservation of native hip in young adults has been well proven. We report a case of deformed Perthes head treated with femoral head reduction osteotomy using Ganz safe surgical dislocation which is a technically demanding but highly rewarding surgical procedure.
A 18-year-old female suffering with hip pain and limp for the past 2 years was diagnosed as sequelae of Perthes disease with femoral head deformity. Pre-operative Harris hip score was 54. The patient was planned for joint preservation surgery considering the young age. Ganz safe surgical dislocation was used to expose the hip joint and femoral head reduction osteotomy was done to recreate the sphericity of the femoral head. see more After 3-year follow-up, the patient had significant pain relief and restoration of function with no evidence of avascular of the femoral head. Post-operative Harris hip score was 82. The treatment of deformed Perthes femoral head remains controversial with no gold standard treatment. Femoral head reduction osteotomy allows the surgeon to reduce the size of the femoral head and restore sphericity of the femoral head preserving the blood supply and helps to improve the functional outcome of the patient. Our case report with 3-year follow-up is evidence to prove the same.
Femoral head reduction osteotomy using Ganz safe surgical dislocation is a safe and effective joint preservation surgery to treat deformed Perthes femoral head in adolescent and young adults.
Femoral head reduction osteotomy using Ganz safe surgical dislocation is a safe and effective joint preservation surgery to treat deformed Perthes femoral head in adolescent and young adults.
Post-traumatic amputation neuroma is one of the common complications that involve optimal functional outcomes. The current literature has a few examples of late presentation of traumatic stump neuroma. However, no available examples of late presentation of recurrent symptomatic amputation neuroma causing impaired functional outcomes have been reported.
We present a case of recurrent symptomatic stump neuroma after above-knee amputation and neurectomy for 28 years.
Late presentation of recurrent stump neuroma is an unusual condition, requiring early detection and treatment to gain better functionality. The patient scenario is unique and valuable for future management, including case awareness regarding this unique pathology.
Late presentation of recurrent stump neuroma is an unusual condition, requiring early detection and treatment to gain better functionality. The patient scenario is unique and valuable for future management, including case awareness regarding this unique pathology.
Malignant bone tumors of the spine are extremely rare with an incidence of 0.05% of primary neoplasms. Solitary plasmacytoma of the vertebra accounts for about 30% of the total within this group.
A 23-year-old female presented to spine clinic, with complaints of low back pain, deformity in lower back, and difficulty in walking for 3 months duration. Radiological investigations revealed destruction of L3 vertebra with soft-tissue mass around it. USG-guided biopsy from the lesion was suggestive of plasma cell dyscrasia. Routine blood investigations showed no abnormality. Urine myeloma profile and immunoelectrophoresis were done which were within normal limit and ruled out multiple myeloma. Due to the profound neurological deficit and existing instability, the patient underwent decompression, resection of tumor, anterior column reconstruction with cage, and instrumented posterior and posterolateral fusion (360° fusion) from L1-L5, before radiotherapy. The patient was subjected to 23 cycles of intensity-modulated radiotherapy and is doing good on subsequent follow-ups with good fusion.
Solitary plasmacytoma of vertebra when associated with neurological deficit and/or instability should be treated with spinal stabilization surgery followed by radiotherapy to achieve good and overall predictable outcomes.
Solitary plasmacytoma of vertebra when associated with neurological deficit and/or instability should be treated with spinal stabilization surgery followed by radiotherapy to achieve good and overall predictable outcomes.
Osteoblastomas are primary bone tumors, rarer than osteoid osteomas, and <10% of these lesions occurs in the spine. Aneurysmal bone cysts (ABCs) are rare, benign lesion of the bone and approximately 8-30% of ABCs arise in the spine, mostly in the thoracic and the lumbar regions. The association between them is quite rare in the general population.
We report a case of a 14-year-old boy, soccer player, with an osteoblastoma of the left posterior neural arc of L2 and a secondary aneurismal bone cyst compressing the left L2 nerve root, causing severe antalgic scoliosis and back pain with radiculopathy. A complete surgical excision with radicular decompression has been performed, and the histologic examination confirmed the diagnostic hypothesis (osteoblastoma + ABC). At 6 months follow-up, the patient presented a complete resolution of symptoms, but the trunk imbalance was not completely resolved.
Spine localization of osteoblastoma + ABC is rare and its diagnosis and treatment are often challenging. Complete surgical excision seems to be confirmed as the gold standard of treatment, but the option of instrumented arthrodesis should be carefully evaluated.