Ipsenbowers2462

We also conclude that particular attention should be given to elderly people with poor bony quality who have high chances of implant failure, along with attention to proper cage size, screw position and proper locking of the screw to further lessen the chances of implant failure.Arterial haemorrhage is a potentially life threatening complication in severe pelvic ring injuries such as "open book" fractures. These injuries mostly implicate the posterior branches of the internal iliac artery. However, we report an unusual case wherein the source of bleeding was identified to be the internal pudendal artery and its branches. Patient was a 27-year-old male who presented to the emergency following an alleged history of road traffic accident and was diagnosed as a case of pelvic fracture (Young and Burgess Antero-Posterior Compression II) with sacral fracture (Denis type 2) with suspected urethral injury. Computerised Tomography (CT) angiogram revealed contrast extravasation from the right internal pudendal artery. However, digital subtraction angiography (DSA) was normal indicating spontaneous closure of the arterial bleeder. Surgical stabilisation of the fracture was carried out and subsequently, patient was discharged. This report serves to highlight that although uncommon, internal pudendal artery can be injured in hemodynamically unstable "open book" pelvic fractures and hence, must be always ruled out.Isolated apophyseal avulsion of the greater trochanter is a rare condition in the paediatric population, frequently related to avascular necrosis of the femoral head. Since there are few cases in the literature, there is no consensus regarding the best treatment of this injury. Our study describes the case of a 9-year-old patient with an avulsion of the right greater trochanter. A minimally invasive osteosynthesis was performed, achieving complete clinical and radiographic healing of the patient and no long-term complications after four years.Hoffa fractures are rare and difficult fractures to manage. Hoffa fracture involves a coronal plane fracture of posterior femoral condyle. Non-union in Hoffa fracture is further difficult to manage. The surgical management for such nonunion includes open reduction with recon/LCP plate or screw fixation with bone grafting. The problem with plates is the difficulty in contouring the plates according to the shape of posterior femoral condyles. We describe a new technique with 2 L shaped neutralisation plates placed in a circular fashion. This technique provides a more rigid construct and gives better holding strength of screws in Hoffa fragment. This enhances union and mobilisation can be started early.Delayed post-operative spinal epidural haematoma (DPSEH) is diagnosed when the onset of symptoms is more than three days from the index surgery. DPSEH is a rare but serious complication of spinal surgery. Missed diagnosis will result in irreversible neurological deficit which may lead to permanent disabilities. We report two cases of DPSEH who presented with worsening neurological deficit four days after the index surgery. Magnetic resonance imaging (MRI) showed the presence of an epidural haematoma compressing the spinal cord. Surgical evacuation of haematoma were performed for both patients. Both patients experienced neurological improvement. Surgeons should have high index of suspicion to identify delayed onset of spinal epidural haematoma (SEH) and timely intervention should be taken to avoid irreversible neurological damage.This is a case report of a Gustilo-Anderson Type IIIB comminuted open right tibial fracture with massive bone loss, complicated by methicillin-resistant Staphylococus aureus (MRSA) infection. Non-viable and contaminated bony fragments were removed and infected bone resected. BAY-3827 Soft tissue coverage and antibiotics were effective against the MRSA infection. A unifocal bone transport with the Ilizarov method regenerated 13cm of the missing tibia. Autologous peripheral blood stem cells (PBSC) injections into the osteogenesis site boosted bone regeneration and consolidation with a shortened Bone Healing index (BHI) of 23 days/cm.

The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg's infraction.

Twenty patients with Freiburg's infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal.

The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r's = -0.85, P < .001).

The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.

The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.

Doxycycline is a commonly used antibiotic that is also a potent inhibitor of matrix metalloproteinase (MMPs). The use of doxycycline in repairing tendon lesions has been previously investigated and conflicting findings have been reported on its effectiveness. In this study, we sought to evaluate the effects of exposure to doxycycline on Achilles tendon repair.

Twenty healthy rats of the same breed and gender were randomly assigned to two groups of sham, and Doxycycline group therapy. The rats underwent a surgical intervention in which a 2mm incision was performed on the lateral sides of the right Achilles tendons. The treatment group received oral gavage administrations of 50mg/kg/day of doxycycline for 30 days. After this duration, tissue samples were taken from the site of the injuries, which were then histologically evaluated for alignment of the collagen fibres, inflammation reaction, cellular density, and fibroblastic activity.

The histological assessment of the tissue samples, revealed significant changes in the repaired tissues of the treatment group in comparison to the sham group; namely more irregularity in the alignment of the collagen fibres, increased cellular density, and increased fibroblastic activity.