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Case Reports in Orthopedics

Hironari Tamiya, Hiroki Hagizawa, Takaaki Nakai, Yoshinori Imura, Takaaki Tanaka, Kazuya Oshima, Toshikazu Ito, Norifumi Naka, Shigeyuki Kuratsu
Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority...
2018: Case Reports in Orthopedics
Bahtiyar Haberal, Duygu Turkbey Simsek, Ekin Kaya Simsek
Schwannomas (also called neurilemmomas) are slow-growing nerve sheath tumors derived from Schwann cells. However, intraosseous schwannoma is a rare entity with an incidence of only 0.2% in overall primary bone tumors. The purpose of this case report is to present a case of an intraosseous schwannoma of the calcaneus. A 35-year-old woman was admitted to our outpatients' clinics with a complaint of long-time right heel pain (for approximately eight months). After a suspicious cystic lesion was observed on the patient's plain radiograph examination, a magnetic resonance imaging (MRI) was performed...
2018: Case Reports in Orthopedics
C Siebenmann, F Ramadani, G Barbier, E Gautier, P Vial
Physeal fractures of the medial clavicle with posterior displacement of the metaphysis are very rare injuries, but additional injuries can be life-threatening. Due to the specific clavicular ossification process, skeletally immature patients present usually not true sternoclavicular joint (SCJ) dislocations accordingly to adults but rather displaced physeal fractures. There is no consensus in the current literature on the best treatment of this lesion. Conservative treatment is not resulting in good outcome; closed reduction is often not successful, and open reduction with internal fixation is finally required...
2018: Case Reports in Orthopedics
Pingal Desai, Vivek Sharma, Karanvir Prakash
Total knee arthroplasty is mostly done to relieve pain and disability from a severe and degenerated knee. Deformities in the coronal and sagittal plane could be corrected with the help of cuts made in tibia and femur during total knee replacement as well as with ligament release. However, large deformities in the lower extremity particularly in the diaphysis region need correction prior to the total knee replacement. It helps to limit the amount of bone that will be cut and helps the ligament release. Several extra articular and intra-articular methods for the correction of diaphyseal deformity have been described...
2018: Case Reports in Orthopedics
Kira Vande Voorde, Jan Dauwe, Jan Van Oost
Introduction: Hip fractures are one of the most common osteoporotic fractures, and the incidence is expected to increase in the future. Vascular injury of the femoral vessels, although uncommon, is an intermittently reported complication in the treatment of proximal femoral fractures. This may be iatrogenic or less frequently as a result of the fracture itself. The profunda femoris artery is most commonly involved, probably because of its close relationship to the femur in the subtrochanteric region...
2018: Case Reports in Orthopedics
Akira Ikumi, Yuki Hara, Eriko Okano, Sho Kohyama, Norihito Arai, Yu Taniguchi, Hisashi Sugaya, Tomokazu Yoshioka, Akihiro Kanamori, Masashi Yamazaki
The digital nerves are important for normal hand function. In addition to conventional therapies such as neurolysis, direct repair, and auto/allografts, new treatments administering growth factors and cells for promoting nerve regeneration exist. Platelet-rich plasma (PRP), an autologous product with proven therapeutic effects for musculoskeletal disorders, is a new treatment option for peripheral nerve injury. We hypothesized that PRP could stimulate healing of digital nerve injuries. In the current case report, intraoperative local administration of PRP was performed during neurolysis surgery for a healthy 28-year-old woman with digital nerve crush injury...
2018: Case Reports in Orthopedics
Ryan K Dahlberg, Mary Elizabeth Lyvers, Thomas K Dahlberg
Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture...
2018: Case Reports in Orthopedics
N Bouguennec, P Colombet
Chronic rupture of the patellar tendon is a severe injury that leads to dramatic functional consequences including lack of extension and walking difficulty. Surgery is the gold standard to treat this type of injury, but revision reconstructions are problematic because an ipsilateral graft was often harvested for the initial surgery. Because fibrotic tissues on the patellar tendon need to be debrided, another graft must be added to reinforce the tendon. We reported the case of a former semiprofessional handball player, a 29-year-old man who presented an iterative rupture with the fracture of the transverse patellar tunnel 6 months after reconstruction using a semitendinosus graft and suture repair...
2018: Case Reports in Orthopedics
Matt Blue, Christian Douthit, Joel Dennison, Cyrus Caroom, Mark Jenkins
A rare complication from computer-navigated total knee arthroplasty is a fracture through the insertion site of a tracking pin. These pins are inserted across the femoral and tibial shafts either bicortically, transcortically, or unicortically and have a reported fracture incidence of 1.38%, with all published cases occurring after bicortical pin placement. In this case, a 60-year-old female suffered a femoral shaft fracture through a unicortically inserted computer navigation tracking pin 6 weeks after total knee arthroplasty...
2018: Case Reports in Orthopedics
Giuseppe Rollo, Giuseppe Rinonapoli, Paolo Pichierri, Michele Bisaccia, Auro Caraffa, Luigi Meccariello
Introduction: Trochanteric fractures of the femur are common in elderly individuals with osteoporosis. The use of cephalomedullary nails is increasing, and they are now the most commonly used fixation devices, especially for the treatment of unstable trochanteric fractures. The nail breakage is not the most common complication of intramedullary nailing. Many scientific papers report nail breakage in a specific location: through the lag screw hole, the nail shaft, or the distal locking hole...
2018: Case Reports in Orthopedics
M O Abrego, F L De Cicco, N E Gimenez, M O Marquesini, P Sotelano, M N Carrasco, M G Santini Araujo
Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve within the tarsal tunnel that lies beneath the retinaculum on the medial side of the ankle. It is often underdiagnosed. Talus bipartitus is a rare anatomical variant; only a few cases have been described in medical literature. We report a case of a 36-year-old female with tarsal tunnel syndrome secondary to a talus bipartitus undergoing surgical treatment with good clinical outcome. To our knowledge, talus bipartitus presenting as tarsal tunnel syndrome has no previous reports...
2018: Case Reports in Orthopedics
Takumi Matsumoto, Song Ho Chang, Ryutaro Takeda, Sakae Tanaka, Takuo Juji
Adult-acquired flatfoot deformity is a progressive flattening of the arch of the foot that results from posterior tibial tendon insufficiency with a predilection for middle-aged women. A lateralized force vector associated with hindfoot valgus in adult-acquired flatfoot produces lateral ankle pain due to impingement at the lateral hindfoot, which can even lead to stress fractures of the distal fibula. Here, we present the rare case of a 73-year-old woman who presented with stress fractures of the bilateral taluses and unilateral distal fibula accompanied by severe adult-acquired flatfoot deformities...
2018: Case Reports in Orthopedics
Rohan Bhimani, Preeti Singh, Fardeen Bhimani
Introduction: Nonunion patella with quadriceps contracture is an unusual orthopaedic finding. Very few cases have been recorded in the past with this complication. We present a case of a 40-year-old male with nonunion patella with quadriceps contracture secondary to trauma . Case Report. A 40-year-old male with posttraumatic nonunion patella with quadriceps contracture since 6 months presented with complaints of defect in the left knee with restriction of movements. X-ray of the left knee confirmed our findings...
2018: Case Reports in Orthopedics
Keizo Wada, Tomohiro Goto, Tomoya Takasago, Takahiko Tsutsui, Koichi Sairyo
Case: A 79-year-old woman with an extreme bone defect after failed cementless total hip arthroplasty underwent revision arthroplasty with a novel technique that involved cutting the anterior iliac bone and sliding it distally to reconstruct the anterior acetabular wall. A three-dimensional printed bone model enabled understanding the details of the bone defect. The clinical outcome at 3 years after surgery was favorable. Conclusion: The advantages of this technique are twofold, namely, stable fixation of the cup sandwiched between the anterior and posterior walls and reconstruction of the anterior wall using living bone, which allows bone ingrowth into the cup...
2018: Case Reports in Orthopedics
Mohammad Jawad H Rahal, Karam M Karam, Selim M Nasser, Jihad A Daher, Hicham G Abdel Nour, Alexandre H Nehme, Ramzi C Moucharafieh
We report the case of a sixty-eight-year-old female patient who presented for left ankle pain; X-rays and MRI showed a benign calcaneal cyst, found to be delayed distant metastasis from primary papillary thyroid carcinoma. Patient required surgical excision of the cyst. Results of histological examination showed metastatic papillary thyroid carcinoma. The patient underwent total thyroidectomy 12 years prior to presentation, with the same pathology. Postoperatively, she was treated with radioactive iodine. At 10-year follow-up post calcaneal mass excision, she was found to have a right proximal tibial mass and found to be recurrent with the same pathology...
2018: Case Reports in Orthopedics
Amalie Erwood, Jacob M Wilson, Andrew M Schwartz, Mara L Schenker, Thomas Moore
The sport of motocross entails off-road motorcycle racing and is associated with a high incidence of traumatic injury. While prophylactic knee braces are routinely worn, there has been anecdotal concern that brace use is linked to femoral shaft fractures. While this risk remains unreported in the medical literature, preventing this complication has played a role in new commercial knee brace designs. We present two cases in which two motocross riders sustained transverse femoral shaft fractures at the proximal portion of each respective knee brace...
2018: 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
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