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tment helped us in this patient's complete recovery without cognitive impairment.

We must always suspect isolated cerebral FES as a diagnosis in polytrauma patients even when the classical findings are not present. Selleckchem Vismodegib MRI compatible implants have to be used as far as possible as MRI may be required to confirm the diagnosis of CFE. The early total care with definitive fixation and supportive treatment helped us in this patient's complete recovery without cognitive impairment.

Modified tension band wiring (MTBW) using two cannulated cancellous screws which also achieve a horizontal figure of eight patterns of tension band is established as a superior fixation to using Kirschner wires for type 34-C1 fracture of the patella. We are describing a case where this method was used for failed MTBW using two Kirschner wires where an impending failure in the early post-operative period proceeded to complete bony union without any implant failure or functional deficit following a period of conservative management.

We are describing a 67-year-old man with type 34-C1 fracture of patella treated by MTBW using Kirschner wires and a stainless steel (SS) wire, with fixation failure after around 6 weeks, which was revised by MTBW using two vertically placed cannulated partially threaded cancellous screws and SS wire as a tension band. In the early post-operative period, a routine X-ray of the operated part showed fracture fragment separation with a slight sack in the tension band wire without any signs of implant failure. To our surprise, the fracture proceeded to complete bony union while continuing gradually increased active knee range of motion exercises.

This case report presents how an impending failure proceeded to complete fracture healing because of dynamic compression of the fracture provided by the tension band construct.

This case report presents how an impending failure proceeded to complete fracture healing because of dynamic compression of the fracture provided by the tension band construct.

Stable fixation with a wide-foot-plate expandable cage and lateral lumbar interbody fusion (LLIF) cage has been reported as the ideal treatment for vertebral pseudarthrosis or deformity after an osteoporotic vertebral fracture. (OVF). The procedure requires anterior surgery, which may be associated with unique complications. Therefore, we performed a novel procedure consisting of posterior vertebral column resection (PVCR) using a lateral lumbar interbody fusion LLIF cage.

In 2020, we prospectively studied three patients (one male and two female patients; mean age, 75.1 years) who underwent posterior insertion of a lateral lumbar interbody fusion LLIF cage for kyphotic deformity due to osteoporotic vertebral fractures. OVFs. The affected levels were L1, T12, and T11 in patients one, two, and three, respectively. The cage trajectory was confirmed by simulating the procedure using PowerPoint® software. Radiological outcomes were assessed using the angle of local kyphosis pre-preoperatively and postoperatively, and the clinical outcomes and neurological complications were reviewed. We inserted the cage smoothly and optimally in all three patients without sacrificing the nerve root, consistent with our pre-operative simulations. The mean operation time was 405 min (range, 368-433 min), and the mean blood loss was 845 mL (range, 800-865 mL). The mean local kyphotic angle was 46.3° preoperatively and 16.3° two2 weeks postoperatively. The pre-operative low back pain disappeared in all the patients. Post-operative neurological complications occurred in two of the patients, but did not interfere with walking rehabilitation.

The present study is the first to demonstrate that posterior insertion of a lateral lumbar interbody fusionLLIF cage is feasible in patients undergoing posterior vertebral column resection.PVCR.

The present study is the first to demonstrate that posterior insertion of a lateral lumbar interbody fusionLLIF cage is feasible in patients undergoing posterior vertebral column resection.PVCR.

Monostotic fibrous dysplasia is a rare genetic non-inherited orthopedic condition presenting at any age with variable presentation. Proximal femur being the most common site, the mechanical factor predisposes it to increased chances of pathological fracture, which makes it challenging to choose an appropriate treatment modality and implant selection in children.

In this retrospective case series, six children aged 7-12 years with monostotic fibrous dysplasia with or without fracture were treated with different treatment modalities from 2015 to 2020. Extended curettage and bone grafting and stabilization were done with extramedullary implants such as locking plates and DHS. Autograft alone or combination with allograft was chosen according to size of lesion. Patients without fracture were treated with curettage and artificial bone graft substitute with hip spica. Patients were followed up to 12 months. Revised Musculoskeletal Tumor Society (MSTS) score at each follow-up and Toronto Extremity Salvage Score ity should be chosen wisely after analyzing pre-operative radiograph, lesion size, presence of pathological fracture, and each patient profile. Extramedullary fixation devices can be an alternate choice of implant in children and adolescents for monostotic fibrous dysplasia. Long duration follow-up and patient counseling should be done for recurrence of lesion and deformities.

Among the benign primary bone tumors, Giant cell tumor (GCT) accounts for about 3% to -5%. It is a locally aggressive tumor with maximum incidence between 20 to and 40 years of age. The sites where GCT is most commonly seen are distal femur, and proximal tibia followed by distal end radius. Distal end of ulna is a rare site with an incidence of only 0.45% to -3.2%.

We report a case of a 32- year- old male with (GCT) giant cell tumor of the left distal ulna. We managed the patient with en bloc resection of distal ulna along with reconstruction of distal radio ulnar joint (DRUJ) and triangular fibro cartilage complex (TFCC) using proximal fibula graft and palmaris longus graft. DRUJ was stabiliszed with a k- wire.

After 1 year of follow- up, patient showed good results in terms of range of movements of the wrist joint with no evidence of recurrence.

After 1 year of follow- up, patient showed good results in terms of range of movements of the wrist joint with no evidence of recurrence.

The Exeter stem by Stryker is a polished, double wedge, tapered,and stainless steel cemented implant that is known to have high mechanical strength, and therefore can carry a significant load.

Due to the rare nature of fractures of this type of implant, its success and effectiveness within hip arthroplasty, the Exeter stem has become one of the most commonly used surgical treatment regimens for hip fractures. At present, there are only a handful of published papers detailing a fracture through an Exeter stem implant.

The current case report documents a rare case of a fractured Exeter V40 stem and its subsequent treatment.

The current case report documents a rare case of a fractured Exeter V40 stem and its subsequent treatment.

Fracture neck of femur in pediatric age group occurs due to high energy trauma and is an uncommon entity with high complication rate. No uniform guidelines are present to manage these fractures, especially in delayed presentation of fracture neck of femur as a smaller number of such cases were reported.

Eight children (nine hips), five boys and three girls of age <15 years, were operated on. The mean delay in surgery time was 8.6 days (range 5-22 days). The mean union time was 13.44 weeks. The mean follow-up was 20.88 months (range 12-36 months). All the cases were managed with closed or open reduction followed by internal fixation with or without hip spica application and resulted in satisfactory outcomes in most of the cases.

Anatomical reduction (open or closed) and fixation reduce the risk of complications even in delayed presentation if the orthopedic surgeon is familiar with the management.

Anatomical reduction (open or closed) and fixation reduce the risk of complications even in delayed presentation if the orthopedic surgeon is familiar with the management.

Cardiovascular diseases are the most common non-obstetric cause of maternal death. These cases became more common thanks to the improvement in cardiovascular therapies. A multidisciplinary team is necessary to manage these pregnancies.

A 32 years old women at the 25

week of gestation for acute heart failure in pre-existing left ventricular dysfunction induced by radio-chemotherapy admitted to the Coronary Unit of IRCCS Policlinico Universitario Agostino Gemelli for worsening of dyspneic symptoms and anuria not responding to diuretic therapy. At the echocardiogram ejection fraction 30%, enlarged left atrium, systolic pulmonary arterial pressure 38 mmHg, bilateral pleural effusion, bilateral diffused pulmonary B lines. A multidisciplinary team composed by cardiologists, gynecologists, anesthesiologists, cardiac surgeons, neonatologists and bioethicists decided for an elective cesarean delivery at the 27

week of gestation in the hybrid cardio-thoracic operating theater. Anesthesia was provided by combinected in the spinal needle at a 0.1 mcg/kg/minute through a central line and was continued until the end of surgery. Fluid management consisted of a total of 200 ml of crystalloids. HPI values never reached alarm values (maximum value =10). The patient was discharged home on the 5th day after delivery with good hemodynamic compensation. The baby was intubated at birth and then gradually weaned from mechanical ventilation, then discharged.

Transplanted patients receiving immunosuppressive agents are at a higher risk of Coronavirus-disease-2019 (COVID-19), and their polypharmacy state makes the choice of treatment challenging. This study aimed to assess the drug-related problems (DRP) and clinical pharmacists' interventions to manage transplanted patients and candidates for transplantation with COVID-19.

This cross-sectional study was conducted in the COVID-19 intensive care unit of Shiraz Organ Transplantation Center (Iran), from March 2020 to April 2021. Patients were admitted to the COVID-19 intensive care unit based on clinical symptoms or positive polymerase chain reaction (PCR) tests. The clinical pharmacist reviewed all medications and physicians' orders on a daily basis and evaluated DRPs in accordance with the pharmaceutical care network of Europe (PCNE) classification (V 8.01). The treatment team was informed of the DRPs, and the acceptance or rejection of the intervention was also documented. Data were analyzed using SPSS (Version 25.0). In order to determine the proportion and determinants of drug-related problems, descriptive statistics and logistic regression were applied, respectively.

A clinical pharmacist reviewed 631 individuals with 11770 medication orders, and 639 DRPs were found in 69% of them with an average of 1.01±1 per patient. The most commonly reported DRPs were treatment efficacy issues followed by adverse drug reactions (ADRs). A total of 982 interventions were provided at prescriber, patient, and drug levels, of which 801 were accepted, and 659 (82.27%) were fully implemented.

There have been considerable drug-related issues in managing transplanted patients with COVID-19. DRPs are more common in people with polypharmacy, more than three comorbidities, and hydroxychloroquine regimens.

There have been considerable drug-related issues in managing transplanted patients with COVID-19. DRPs are more common in people with polypharmacy, more than three comorbidities, and hydroxychloroquine regimens.