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Case Reports in Orthopedics

Kenichi Mishima, Hiroshi Kitoh, Masaki Matsushita, Tadashi Nagata, Yasunari Kamiya, Naoki Ishiguro
Localized scleroderma, also known as morphea, is a rare condition characterized by progressive sclerosis of the skin and associated atrophy of the underlying tissues. The linear type of localized scleroderma is the most frequent form in childhood, usually affecting unilateral extremities. Fibrosclerosis of the fasciae and muscles can spread across joints and impair the range of motion of the joint. Dysplastic and/or atrophic bones of the affected lower extremity can lead to clinically significant leg length discrepancy (LLD)...
2018: Case Reports in Orthopedics
Kyohei Takase, Sang Yang Lee, Takahiro Waki, Tomoaki Fukui, Keisuke Oe, Tomoyuki Matsumoto, Takehiko Matsushita, Kotaro Nishida, Ryosuke Kuroda, Takahiro Niikura
Rotational malreduction is a potential complication of intramedullary nailing for tibial shaft fractures. We experienced a symptomatic case of a 24° externally rotated malunion that we treated with minimally invasive corrective osteotomy. A 49-year-old man sustained a tibial shaft spiral fracture with a fibula fracture. He had been initially treated elsewhere with a reamed statically locked intramedullary nail. Bone union had been obtained, but he complained of asymmetry of his legs, difficulty walking and running, and the inability to ride a bicycle...
2018: Case Reports in Orthopedics
Saif Shamshoon, Patrick Thornley, Justin de Beer
We describe a case of aseptic failure with profound femoral stem trunnion wear and femoral head dissociation nine years after initial primary total hip arthroplasty (THA) with the Stryker Accolade total hip arthroplasty system. Current guidelines for postoperative care and follow-up after THAs as potential intervention points for early detection of prosthetic joint failure are also reviewed.
2018: Case Reports in Orthopedics
Takashi Sono, Mitsuru Takemoto, Koh Shinohara, Yasuhiro Tsuchido
An 81-year-old man presented with severe back pain. Magnetic resonance imaging detected L5/S discitis without signs of epidural abscess. Punctures of the disc revealed that the causative organism was Gemella morbillorum (G. morbillorum) , which is part of the normal flora of the oral cavity and an uncommon causative pathogen of spondylodiscitis. The E-test method was useful for rapid susceptibility testing. Intravenous penicillin G treatment was effective, and the patient recovered without surgery.
2018: Case Reports in Orthopedics
Samuel Larrivée, Graeme Matthewson, Laurie Barron
There is scarce literature describing treatment of volar dislocation of the distal radio-ulnar joint (DRUJ). Irreducible dislocation is usually treated surgically. We present the case of a 37-year-old male with acute right wrist pain and loss of pronation. A diagnosis of volar DRUJ dislocation was made. Reduction using conventional technique was unsuccessful. A second attempt was successful by applying pressure over the interosseous membrane of the forearm and manipulating the ulnar head. At three weeks, the patient had minimal pain, a stable DRUJ, and near complete range of motion...
2018: Case Reports in Orthopedics
Juan Martín Patiño, Alejandro Rullan Corna, Alejandro Michelini, Ignacio Abdon, Alejandro José Ramos Vertiz
A malunion as a complication of distal humerus fractures has been frequently linked with aesthetic problems but less frequently with posterolateral rotatory instability. We report 2 cases of childhood posttraumatic cubitus varus with subsequent posterolateral rotatory instability and their treatment with a minimum of 2 years of follow-up. The etiology of the so-called posterolateral rotatory instability of the elbow is mostly traumatic, but iatrogenic causes have also been described such as the treatment of tennis elbow and less frequently and chronically due to overuse and overload because of distal humerus malunion...
2018: Case Reports in Orthopedics
Avinesh Agarwalla, Richard Puzzitiello, Austin V Stone, Brian Forsythe
Tibial tubercle avulsion fractures are an uncommon injury occurring due to strong contraction of the quadriceps femoris muscle during leg extension, ultimately causing failure of the physis at the patellar tendon insertion. This injury has been previously reported with various concomitant injuries, such as compartment syndrome from bleeding into the anterior compartment, vascular injury, patellar tendon avulsion, and meniscal injury-exhibited only with fracture types that extend intra-articularly. We report the case of a 14-year-old healthy adolescent male basketball player who sustained this injury as a result of a collision with another player...
2018: Case Reports in Orthopedics
Jessica R Dowling, Thomas J Dowling
Acute motor and sensory axonal neuropathy (AMSAN) is a rare axonal variant of Guillain-Barré syndrome. AMSAN is considered the most severe form of GBS, known for its rapid onset of severe symptoms, and often leading to quadriparesis within 7 days of initial symptom onset. We present a case of a middle-aged Caucasian female who developed AMSAN 2 weeks following an elective spinal surgery. Although rare, GBS has been reported as a complication of surgery. GBS classically presents as ascending motor weakness starting in the lower extremities following a gastrointestinal or upper respiratory tract infection...
2018: Case Reports in Orthopedics
Kevin Moerenhout, Georgios Gkagkalis, Benoit Benoit, Georges Yves Laflamme
Introduction: Quadriceps tendon ruptures (QTR) frequently occur in patients with end-stage renal failure, while triceps brachii tendon ruptures (TTR) are less common. This is the first properly documented report of a simultaneous ipsilateral traumatic rupture of both of these tendons. Case Report: A 50-year-old patient, on hemodialysis for end-stage renal failure, fell on his right side. He presented with sudden right knee and elbow pain, with functional impairment of both joints...
2018: Case Reports in Orthopedics
Raja Bhaskara Rajasekaran, Rajasekaran Shanmuganathan
Schwannoma is a benign, noninvasive tumour of the peripheral nerve sheath with rare occurrence in the extremities. We present a case of a schwannoma in the posterior tibial nerve which presented with symptoms suggestive of tarsal tunnel syndrome. The patient was managed with surgical excision of the tumour under microscope, and the diagnosis was confirmed by histopathology. Such a presentation is rare, and our case report adds light regarding the management of such cases.
2018: Case Reports in Orthopedics
Bedri Karaismailoglu, Turgut Nedim Karaismailoglu
Background: Cerclage wires or cables are commonly being used in hip reconstruction procedures like primary (especially in patients with developmental hip dysplasia) or revision arthroplasty. Local or distant migration of a broken cable or wire is a complication that might lead to devastating situations depending on the route of migration. Case Presentation: We report a case of a 40-year-old female who underwent bilateral total hip arthroplasty surgery due to bilateral developmental hip dysplasia...
2018: Case Reports in Orthopedics
Song Ho Chang, Takumi Matsumoto, Koichi Okajima, Masashi Naito, Jun Hirose, Sakae Tanaka
Heterotopic ossification (HO) is an ectopic formation of the lamellar bone in the soft tissues. Some authors have previously reported HO or calcific tendinitis of the peroneus longus tendon at the level of the cuboid bone, while the HO of the peroneus longus tendon in the retromalleolar portion has not been reported. The purpose of this report is to describe clinical, radiological, and histological features of this rare ossification and its treatment. To the best of our knowledge, this is the first report presenting a case of HO of the peroneus longus tendon, which developed in the retromalleolar portion...
2018: Case Reports in Orthopedics
Richard N Puzzitiello, Avinesh Agarwalla, Austin Stone, Brian Forsythe
Presented in this report is a complex revision case of a patellar tendon repair preceded by excess tendon excision to correct for recurrent patella alta deformity, in a workers' compensation patient. The goal of this procedure was to alleviate this patient's pain, to preserve his ability to function in his activities of daily living, and to allow him to return to work at some capacity. On postoperative radiographs, the revision procedure appeared to have successfully corrected this patient's patella alta deformity...
2018: Case Reports in Orthopedics
Lucas Korcek, Benjamin Hoch, Dustin Richter
Fibroma of the tendon sheath most often presents around small joints and involves the tendon and tendon sheaths of the fingers, hands, and wrist. In rare instances, it presents as an intra-articular mass. It has never been described in the hip joint. In the current case presentation, this benign tumor was found to be the source of a patient's atypical severe hip pain. Arthroscopic resection of this tumor alleviated the patient's pain.
2018: Case Reports in Orthopedics
Konstantinos Anagnostakos, Andreas Thiery, Christof Meyer, Octavian Tapos
We present a case of a 70-year-old male patient with an untypical gout infiltration of the peroneal tendons mimicking synovial sarcoma. The patient had a negative history of gout at initial presentation in our department. Magnetic resonance imaging of the region revealed a finding highly suspicious for synovial sarcoma of the peroneal tendons. Open biopsy was performed. Histopathological examination of the tissue samples demonstrated the presence of gout with no signs of malignancy. The gout infiltration was excised in a subsequent surgery...
2018: Case Reports in Orthopedics
Hideyuki Kinoshita, Masayuki Hashimoto, Jiro Hirayama, Kouji Fujita, Yoshio Takeuchi, Junichi Iwasaki, Hironori Yamasaki, Mitsuhiro Kitamura, Seiji Ohtori, Tsuguo Morikawa
Pseudoaneurysm is one of the most serious complications of femoral trochanteric fracture surgery. Since the rupture of pseudoaneurysm may lead to death, early detection is important. We report the case of an 80-year-old male who developed pain in the proximal thigh and severe swelling after internal fixation of a femoral trochanteric fracture with a hip nail. Angiography revealed a pseudoaneurysm of a branch of the deep femoral artery near the interlocking screw. The vascular lesion was immediately treated by transcatheter embolization, and the vascular leakage was completely resolved with catheter embolization...
2018: Case Reports in Orthopedics
Koichi Yano, Yasunori Kaneshiro, Hideki Sakanaka
A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension -75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed...
2018: Case Reports in Orthopedics
Chaiwat Kraiwattanapong, Vanlapa Arnuntasupakul, Rungthiwa Kantawan, Gun Keorochana, Thamrong Lertudomphonwanit, Pakkanut Sirijaturaporn, Methawut Thonginta
Introduction: Minimally invasive oblique lumbar interbody fusion is one of the novel lateral lumbar interbody fusion techniques for which the successful early results have been reported. However, new complications were increasingly reported from ongoing studies. Case Presentation: We report a case of an unusual complication of minimally invasive oblique lumbar interbody fusion associated with contralateral nerve root compression due to deep and posterior position of polyetheretherketone cage and discussion of the operating technique for repositioning polyetheretherketone cage...
2018: Case Reports in Orthopedics
Emmanuel Bukara, Alex M Buteera, Robert Karakire, Felix Manirakiza, Samuel Muhumuza, Emmanuel Rudakemwa, Lynnette Kyokunda
Introduction: Multiple hereditary exostoses (MHE) is a rare autosomal dominant disorder characterized by the presence of multiple skeletal deformities. They are painless slow-growing lesions. Malignant transformation tends to occur later in adulthood and has only been seen in 1-5% of patients. Objective: We describe the clinical, radiological, and pathological characteristics of a child with MHE who developed osteoblastic osteosarcoma beneath an osteochondroma. Case Presentation: An 11-year-old male Rwandan presented to our hospital with a two-week history of a dull persistent pain in his left distal femur and loss of weight and appetite...
2018: Case Reports in Orthopedics
Yoann Durand, Clémence Bruyère, Marco Saglini, Aurélien Michel-Traverso
We report the case of a 15-year-old boy brought to the emergency department after a bike accident, complaining of an isolated left hip pain. The X-rays showed an obturator hip dislocation treated by closed reduction under general anaesthesia, followed by 6 weeks of discharge. The follow-up MRI performed 6 weeks after the trauma showed an avascular femoral head necrosis, for which we performed multiple retrograde femoral head drilling, completed by the injection of autologue stem cells from the iliaq crest. One year later, the patient has no hip pain, no joint limitation, and can practice BMX at a high level again...
2018: Case Reports in Orthopedics
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