Bockbarron4947
The patient had dramatic alleviation of pain without the need for any further treatment till 1 year follow-up.
Although there is no specific treatment available for this disease, the intravenous infusion of zolendronic acid has dramatically improved the patient clinically.
Although there is no specific treatment available for this disease, the intravenous infusion of zolendronic acid has dramatically improved the patient clinically.
Minimally invasive percutaneous CT-guided biopsies of the spine are well established. Although, technical difficulties with CT-guided percutaneous intervention of the C2 body present due to the smaller size of the vertebral elements and potential injury of the critical adjacent structures such as Carotid arteries laterally, vertebral artery, and cervical nerve posterolaterally, pharynx and larynx anteriorly, and spinal cord in the cervical spinal canal. Routinely transoral approach is used for the percutaneous intervention of the C2 body. Literature on the posterolateral approach for biopsies of the C2 vertebral body is sparse as compared to other approaches. This case report presents a case of adenocarcinoma diagnosed with CT-guided percutaneous biopsy of the C2 body using a posterolateral approach under local anesthesia.
A 70-year-old female presented to our outpatient clinic with complaints of progressively increasing neck pain with a visual analog score (VAS) 7/10. Neck pain was radiating to the base , and high yield. Stepwise approach to the procedure aids in getting repeatable and high-yielding results especially in a technically challenging area such as C2 vertebrae.
Understanding the detailed anatomy prior to CT guided minimally invasive percutaneous C2 biopsy procedure helps in increasing its safety, precision, and high yield. Stepwise approach to the procedure aids in getting repeatable and high-yielding results especially in a technically challenging area such as C2 vertebrae.
Traumatic injuries of to hand are not uncommon in the pediatric population and most of them are managed by conservative means and rarely surgical intervention required. There is a very rare incidence of delayed union or non-union in these fractures and found a very few numbers of sporadic cases documented in English literature.
We described delayed presentation of post-traumatic gap non-union of proximal phalanx of thumb in a child who presented with severe disability of hand especially writing and grasping. He was managed as open reduction, tibial strut bone grafting, and internal fixation with crossed Kirchner wire and followed for a period of minimum of 2 years. The fracture united radiologically and healed well clinically, whereas functional outcomes were excellent. There was no difficulty in writing and activity of daily living with operated hand while having comparative cosmetic appearance to other hand.
Non-union of phalanx fractures are very rare in the pediatric population whereas excellent clinical and functional outcomes can be achieved with adequate stable fixation and autologous bone grafting.
Non-union of phalanx fractures are very rare in the pediatric population whereas excellent clinical and functional outcomes can be achieved with adequate stable fixation and autologous bone grafting.
Hip bipolar hemiarthroplasty is commonly done for elderly patients who suffer from femoral neck fractures, with good functional outcomes. Prosthetic acetabular protrusio is a rare complication following bipolar hemiarthroplasty and can occur in prosthetic joint infections (PJIs) due to destructive osteolysis and resorption of surrounding bone. Among PJI pathogens, Cutibacterium acnes is increasingly being implicated. In our paper, we review the current literature of C. acnes PJIs and report a unique case of C. OSMI-1 acnes infection of hip bipolar hemiarthroplasty complicated by protrusio acetabuli.
The patient is a 77-year-old Asian-Chinese man who suffered from left hip pain 10 years after bipolar hemiarthroplasty surgery. Radiographic evaluation showed acetabular protrusio with extensive femoral osteolysis. Subsequent intraoperative cultures revealed C. acnes infection. The patient successfully underwent antibiotic treatment and a two-staged revision total hip arthroplasty.
C. acnes is an increasingly recognized cause of PJIs and can cause significant morbidity. It should not be simply regarded as a contaminant of tissue or cultures. C. acnes PJIs require antibiotic treatment and early surgery with debridement and revision. This reported case presented technical challenges due to the infection resulting in prosthetic acetabular protrusio.
C. acnes is an increasingly recognized cause of PJIs and can cause significant morbidity. It should not be simply regarded as a contaminant of tissue or cultures. C. acnes PJIs require antibiotic treatment and early surgery with debridement and revision. This reported case presented technical challenges due to the infection resulting in prosthetic acetabular protrusio.
Hip pain in children and adolescents may become a diagnostic challenge. A wide range of causes must be considered in the deferential diagnosis. Ischiofemoral impingement (IFI) is a pathological condition defined by hip pain associated with narrowing of the ischiofemoral (IF) space. We report the case of an adolescent patient with non-traumatic quadratus femoris (QF) tear secondary to an occult IFI syndrome. To the best of our knowledge, this is the first such case reported in the literature.
A 15-year-old girl reported persisting hip pain for a month following increased physical activity. The symptoms had started a couple of days following a weekend of increased activity due to her participating in a dancing contest. Physical examination and imaging studies (standard anterior pelvis radiograph and MRI-scan) failed to reveal any pathology apart from an area of diffused edema in the IF space. Standard hematology and biochemistry laboratory tests were all within normal range. Conservative treatment for 6 monn to be successful in the hereby described case.
IFI is a rather uncommon condition in the developing skeleton. As in adults, in adolescents as well, MRI is the study of choice in cases of IFI, since it shows QF pathology and allows measurement of the IF and QF spaces, assisting physicians in establishing the right diagnosis. However, the coexistence of a QF hematoma and/or edema, may temper with the initial MRI measurements and render the diagnosis of the primary condition rather difficult. Conservative treatment (with local infiltration of the QF) was proven to be successful in the hereby described case.
Posterior glenohumeral joint dislocations with associated bony lesions are challenging to treat; namely, reverse Hill-Sachs's lesions increase humeral head excursion predisposing to recurrent dislocations. To add to the complexity of management, posterior shoulder dislocations are often missed on plain radiographs, leading to chronicity in presentation.
We describe here our technique in our case series of three patients. Case I, 32 years, gentleman, presented 3 days after injury. He had a locked posterior dislocation of shoulder which he sustained while he fell asleep and hit a glass table. Shoulder was not reducible in emergency department. Reverse Hill- Sachs's lesion involved 40% of humeral head. Case II, a 54- years- old gentleman, a keen gym trainer . Following sudden withdrawal of diazepam, he woke up lying on the floor and started experiencing shoulder pain. He presented a week following the injury. The dislocated shoulder could not be reduced in emergency department. Bony defect involved 50% of hution with osteochondral allograft is a promising technique to help shoulder surgeons achieve good outcomes for these patients. We propose a novel technique for fashioning allograft to anatomically fill the defects from bone loss, aiming to restores the native sphericity of the humeral head.
Reconstruction with osteochondral allograft is a promising technique to help shoulder surgeons achieve good outcomes for these patients. We propose a novel technique for fashioning allograft to anatomically fill the defects from bone loss, aiming to restores the native sphericity of the humeral head.
Primary subacute pyogenic osteomyelitis, or Brodie's abscess was initially documented by Sir Benjamin Brodie in 1832. We present a case report with a 6-months follow-up period, demonstrating the successful diagnosis and surgical treatment of a focal lesion of the proximal metaphysis of the right humerus in a 21-years-old female. The pathology of hematologic osteomyelitis and its role in the development of a subacute abscess along with a review of literature and an in detail description of the pathogenesis of Brodie's abscess is discussed and submitted.
A 21- years -old healthy female with a history of fall sustaining injury to the right shoulder one 1 year back followed by which she presented to the outpatient clinic with a swelling over her right shoulder. The patient was managed conservatively with analgesics and was relieved of pain over a course of one 1 week of medications, the patient now presents with pain and swelling in the right shoulder joint on and off since the episode of fall one 1 year backt and aggressive antibiotic cover, a near 100% success rate is observed in the treatment of Brodie's abscess with no residual deformities in the affected bones or restrictions in the range of movements in the neighboring joints.
Type II distal clavicle fractures are associated with significant displacement and high rates of nonunion. Due to the risk of nonunion, these fractures are most often managed operatively soon after the injury.
We present an 84-year-old male who sustained a Type II closed distal clavicle fracture that converted to an open fracture 1 month following initial injury. The patient underwent surgical repair with open reduction internal fixation and coracoclavicular ligament reconstruction. Following surgery, the patient experienced hardware failure with nonunion. He did not have any residual soft-tissue problems.
Delaying surgical treatment of significantly displaced Type II distal clavicle fractures may pose a risk of conversion to open fracture. Surgeons should counsel their patients on this potential complication when discussing the risks and benefits of operative versus nonoperative treatment.
Delaying surgical treatment of significantly displaced Type II distal clavicle fractures may pose a risk of conversion to open fracture. Surgeons should counsel their patients on this potential complication when discussing the risks and benefits of operative versus nonoperative treatment.
Tissue engineered reconstruction is a minimally invasive approach for healing major complex wounds successfully. It combines accurate, conservative debridement with a specially adapted suction method, platelet-rich plasma (PRP) injections, and biomaterial application to salvage injured tissues and grows new soft tissues over wounds.
A healthy young man in his early 30s presented to our emergency department with complex knee-thigh injuries following a high-velocity automobile accident. Degloved anterolateral thigh, severe thigh muscle injuries, and ruptured extensor patellar mechanism were observed. Accurate conservative (as opposed to radical) debridement and PRP injections salvaged the injured muscles and tendons. Specially carved reticulated foam wrapped around the injured ischemic muscles, followed by low negative, short intermittent, cyclical suction therapy. Wound exploration 4 days apart revealed progressive improvements with considerable vascularization of the injured soft tissues within 2 weeks. Thereafter, meticulous reconstruction of the salvaged muscles and tendons restored anatomical congruity.
