Current Issue : July - September Volume : 2020 Issue Number : 3 Articles : 8 Articles
We present a rare case of neglected hip dislocation in a 3-year-old boy. Hip dislocations in childhood represent less than 6% of all\ninjuries. The boy presented to the ED with ongoing hip pain after his leg got stuck in a carousel. The physical and radiologic\nexamination revealed a posterior right hip dislocation. The closed reduction failed, so open reduction during surgery was\nperformed. The postoperative protocol included 3 days of immobilization with early mobilization and pain-adapted weight\nbearing. No signs of femoral head malperfusion occurred 2 months after the injury. The patient did not complain of any\nlimitations such as weight bearing problems or loss of range of motion. In comparison to adults, there are several specialties\nsuch as the fact that minor trauma can lead to hip dislocations due to the laxity of the ligaments, and due to the limited direct\nanamnestic options, neglected hip dislocations can occur. The treatment should focus on immediate proper reduction. The main\ncomplications after traumatic hip dislocation are avascular necrosis of the femoral head, redislocation, and early osteoarthritis....
Intraneural ganglion cysts are benign soft-tissue masses located in the epineurium of peripheral nerves. They originate from nearby\njoint connections via articular branches. Traumatic events seem to play a role in their pathogenesis as well. Clinical manifestations\ninclude pain over the area of the cyst, palpable tender mass, hypoesthesia, and muscle weakness depending on the affected nerve.\nOur case highlights an uncommon clinical manifestation of this entity with acute foot drop, as the primary symptom, without any\nprevious traumatic event, enriching by this way the current diagnostic thinking process of clinical physicians. We report a case of a\n42-year-old military officer who presented to our emergency department with acute foot drop that appeared during a march.\nInitially, the common peroneal palsy was misdiagnosed as L5-S1 disc herniation, but investigation with lumbar MRI scan led to\nrejection of our primary diagnosis. After performing EMG of the lower extremity and knee MRI, an intraneural ganglion cyst of\nthe common peroneal nerve was diagnosed. Patient was treated with surgical decompression of the cyst, followed by ligation\nand complete resection of the articular branch, as well as disarticulation of the superior tibiofibular joint. At a twelve-month\nfollow-up, the patient showed significant functional recovery. This is, to the best of our knowledge, the first case of intraneural\nganglion cyst manifested with an acute complete foot drop without a clear prior traumatic event. We underline the need for a\nhigh index of suspicion when dealing with cases of acute peroneal palsy without any accompanying symptoms...
We report an unusual case of basic bilateral fracture of fifth metatarsals in a\n48 years old post-menopausal woman. She had previously been treated for\narterial high blood pressure, parathyroidectomy and rheumatoid arthritis by a\nlong corticotherapy treatment. The lesion was caused by an indirect mechanism\nin an overweight context. The diagnosis of a pseudarthrosis of the base of\nthe fifth metatarsals was maintained after 7-month treatment. The patient received\na treatment of both pseudarthrosis. The post-operative periods were\nsimple. After a 9-month follow-up, the treatment allowed consolidation with\npainless feet allowing her to resume work....
Background. While Corynebacterium striatum and other Corynebacterium species were historically considered contaminants, they\nare recently being identified as pathogens with increasing frequency. Case Summary. We report the case of a 78-year-old gentleman\nwith a three-year history of knee pain and established diagnosis of osteoarthritis referred for consideration for total knee\narthroplasty. He had no knee pain with passive range-of-motion. Plain films demonstrated bony erosions atypical for\nosteoarthritis. Joint aspiration white blood cell count was 30,548/mm3, but multiple cultures were positive for C. striatum. The\ninfection was successfully treated with open irrigation and debridement, complete synovectomy, and six weeks of intravenous\ndaptomycin. Conclusion. To our knowledge, this is the first report of chronic C. striatum septic arthritis of a native joint and\nonly the third case of C. striatum septic arthritis of the knee....
Introduction. Carpal tunnel syndrome (CTS) is caused by the compression of the median nerves in the wrist. Patients have pain\nand numbness in the hands. According to the records of Songklanagarind Hospital from 2015 to 2018, of 800 patients, 196 or\n24.5% were treated with surgery. The novel tool of minimally invasive surgery for carpal tunnel syndrome (MIS-CTS) was\ndeveloped to improve effectiveness and safety. Purpose. This study was performed to the effectiveness of visualization during\nsurgery and the complete release of the transverse carpal ligament (TCL) and also the safety of using the MIS-CTS kits. Methods.\nTwenty fresh cadaveric forearms had surgery. Surgical techniques were (1) incision 15â??18mmat palmar hand; (2) the scissors and\nthe navigator were inserted to create working space underneath the palmar aponeurosis; (3) the visual enhancer was inserted. The\nvisual enhancer improves the visual field by shielding the soft tissue around the operative field; (4) the TCL was cut at the distal\nTCL by surgery scalpel, and then a flexible freer was used to detach the fibrous tissue from the median nerve and the TCL; and (5)\nthe TCL cutting blade was pushed straight to cut the TCL completely from distal to proximal. TCL length was observed until the\ncomplete release. The median nerve and the recurrent branch of the median nerve were observed. Results. All TCL were cut\ncompletely. All median nerves, recurrent branches of the median nerve, and superficial palmar arches could be observed during\nthe operation, and none were injured. This technique showed effectiveness and safety for minimally invasive carpal tunnel surgery.\nConclusions. The study found that the new device, MIS-CTS kits, along with this technique is effective for CTS release in terms of\nminimally invasive open carpal tunnel surgery....
Case. We present a 23-year-old male with 7 episodes of left elbow dislocation during a two-year period. He had a positive pivot shift\ntest with engaging. The original treatment plan included lateral ulnar collateral ligament reconstruction and eventually bone defect\ngrafting and osteosynthesis. However, a bone graft was not performed. After 2 years of follow-up, the DASH score was 3.3. The\nMayo Score was 90. Conclusion. Posterolateral instability associated with an engaging bone defect, in every elbow extension and\npivot shift test, was not found in the literature. The capitellum defects are associated with PLRI and make it worse. Bone\nreconstruction may not be indicated....
Avulsion fracture of the tibial tuberosity is an infrequent injury in adolescents and an extremely rare occurrence in adults. We\ndescribe the case of an 86-year-old gentleman presenting after a fall, sustaining injury to the left knee. Radiographs of the left\nknee showed avulsion fracture of the tibial tuberosity. The purpose of this study was to present a rare case of tibial tuberosity\navulsion fracture in an adult, the treatment performed, and the challenges faced. The case is discussed with the review of the\nliterature....
We report a case of volar fourth and fifth carpometacarpal (CMC) joint dislocation complicated by a hamate hook fracture. The\nCMC joint was reduced in a closed fashion and temporally fixed with Kirschner wires. Using intraoperative computed\ntomography, the displaced fracture of the hamate hook was reduced by open reduction and internal fixation and fixed with a\nscrew. We suggest that this rare injury was caused by the over contraction of the flexor carpi ulnaris and avulsion force from the\nligamentous structure around the pisiform, hamate, and metacarpal bones....
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