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Case Reports in Orthopedics

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https://www.readbyqxmd.com/read/28929003/fatal-cobalt-toxicity-after-a-non-metal-on-metal-total-hip-arthroplasty
#1
Rinne M Peters, Pax Willemse, Paul C Rijk, Mels Hoogendoorn, Wierd P Zijlstra
This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year postoperatively, X-rays and MARS-MRI showed a fixed reversed hybrid THA, with periarticular densities, flattening of the femoral head component, and a pattern of periarticular metal wear debris and pseudotumor formation...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28894615/chronic-osteomyelitis-of-the-distal-femur-treated-with-resection-and-delayed-endoprosthetic-reconstruction-a-report-of-three-cases
#2
Sean Ryan, William Eward, Brian Brigman, Robert Zura
Chronic osteomyelitis involving the distal femur often results in amputation or arthrodesis. This article presents three cases of chronic osteomyelitis treated with a staged approach culminating in endoprosthetic reconstruction. Stage one involved resection of infected bone and placement of an intramedullary nail spanning the bony defect between proximal femur and tibia, with antibiotic cement packed around the nail. Patients were then placed on long-term IV +/- oral antibiotics to clear the infection. A "cooldown" period was then used between stages where patients were off antibiotics and inflammatory markers were monitored for signs of remaining infection...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28875045/the-training-effect-of-early-intervention-with-a-hybrid-assistive-limb-after-total-knee-arthroplasty
#3
Takashi Fukaya, Hirotaka Mutsuzaki, Kenichi Yoshikawa, Ayumu Sano, Masafumi Mizukami, Masashi Yamazaki
After total knee arthroplasty (TKA), it is important for patients to show early improvements in knee joint function and walking to regain independence in performing the activities of daily life. We conducted for 4 weeks an intervention one week after TKA using a hybrid assistive limb (HAL: unilateral leg type) as an exoskeleton robotic device to facilitate knee joint function and walking. The intervention improved the range of knee extension movement safely and without pain compared to preoperation. In addition, we found that training with the HAL improved walking ability, speed, and rate, as well as the time taken to perform the timed up and go (TUG) test compared to preoperation...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28856026/acute-traumatic-patellar-tendon-rupture-at-the-tibial-tuberosity-attachment-without-avulsion-fracture
#4
Shuichi Miyamoto, Makoto Otsuka, Fumio Hasue, Takayuki Fujiyoshi, Koushirou Kamiya, Hitoshi Kiuchi, Ken Ohara, Atsushi Yunde, Yasunori Toki, Tadashi Tanaka, Junichi Nakamura, Seiji Ohtori
Patellar tendon rupture in children is especially rare. The fact that the area of traumatic rupture has wide variations makes surgical treatment difficult. We present an 11-year-old boy with acute traumatic patellar tendon rupture at the tibial tuberosity attachment without avulsion fracture. Primary end-to-end repair and reinforcement using 1.5 mm stainless steel wires as a surgical strategy were undertaken. Early range of motion began with a functional knee brace and the reinforced stainless wire was removed 3 months after surgery...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28840049/recalcitrant-lateral-premalleolar-bursitis-of-the-ankle-associated-with-lateral-ankle-instability
#5
Masashi Naito, Takumi Matsumoto, Song Ho Chang, Masachika Ikegami, Jun Hirose, Sakae Tanaka
Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between the bursa and articular cavity of the ankle joint via the sheath of the extensor digitorum longus tendon, which was considered to act as a check valve leading to a large and recalcitrant bursitis...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28835861/vertebral-artery-caught-in-the-fracture-gap-after-traumatic-c2-3-spondylolisthesis
#6
Ralf Henkelmann, Christoph Josten, Stefan Glasmacher, Christoph-Eckhard Heyde, Ulrich Josef Albert Spiegl
BACKGROUND CONTEXT: Patient with a C2 fracture and entrapment of the right vertebral artery in the fracture gap. PURPOSE: Presentation of a case with follow-up until end of treatment. STUDY DESIGN: Case report. METHODS: A 25-year-old woman was brought into our emergency room after falling while riding a horse. She complained of pain in the cervical spine. Clinical examinations showed local tenderness at the upper cervical spine and painful impairment of the mobility of the neck, with no signs of neurological impairment...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28811949/surgical-hip-dislocation-for-management-of-acetabular-osteochondroma-in-an-adult
#7
Alexandre H Nehme, Georges F Haidamous, Hicham G Abdelnour, Jad N BouMounsif, Joseph W Wehbe, Ramzi C Moucharafieh
The purpose of this study is to report a rare case of acetabular osteochondroma with a unique clinical presentation occurring in an adult with normally developed hips. The distinctive size and location of the lesion required an open approach with surgical dislocation of the hip for complete resection.
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28811948/the-dorsoulnar-artery-perforator-adipofascial-flap-in-the-treatment-of-distal-radioulnar-synostosis
#8
Alessia Pagnotta, Giorgio Antonietti, Iakov Molayem
Posttraumatic radioulnar synostosis (RUS) is a rare event following forearm fractures. Consequences are disabling for patients who suffer from functional limitation in forearm pronosupination. Distal RUS are even more rare and more difficult to treat because of high recurrence rates. The patient we describe in this paper came to our attention with a double distal RUS recurrence and a Darrach procedure already performed. We performed a radical excision of RUS and interposition with a vascularized dorsoulnar artery (DUA) adipofascial perforator flap...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28808593/combined-bone-transportation-and-lengthening-techniques-for-the-treatment-of-septic-nonunion-of-the-forearm-followed-by-tendon-transfer
#9
Konstantinos Ditsios, Eirini Iosifidou, Lazaros Kostretzis, Panagiotis Konstantinou, Iosafat Pinto, Ioannis Theodoroudis, Ippokratis Hatzokos
Infected nonunion of a forearm fracture complicated by a considerable skin-muscle defect poses a great challenge to orthopaedic surgeons. The treatment strategy comprises eradication of the infection, ensuring bony union and soft tissue coverage along with functional restoration. We report a case of a 23-year-old man with an open Gustilo-Anderson IIIb fracture complicated by infected nonunion after internal fixation. After thorough surgical debridement, a considerable soft tissue defect, extensor muscle loss, and posterior interosseous nerve laceration had to be addressed...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28798878/treatment-of-knee-osteochondral-lesions-using-a-novel-clot-of-autologous-plasma-rich-in-growth-factors-mixed-with-healthy-hyaline-cartilage-chips-and-intra-articular-injection-of-prgf
#10
Ramón Cugat, Eduard Alentorn-Geli, Gilbert Steinbacher, Pedro Álvarez-Díaz, Xavier Cuscó, Roberto Seijas, David Barastegui, Jordi Navarro, Patricia Laiz, Montserrat García-Balletbó
Knee cartilage or osteochondral lesions are common and challenging injuries. To date, most symptomatic lesions warrant surgical treatment. We present two cases of patients with knee osteochondral defects treated with a one-step surgical procedure consisting of an autologous-based matrix composed of healthy hyaline cartilage chips, mixed plasma poor-rich in platelets clot, and plasma rich in growth factors (PRGF). Both patients returned to playing soccer at the preinjury activity level and demonstrated excellent defect filling in both magnetic resonance imaging and second-look arthroscopy (in one of them)...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28785499/subclinical-partial-attritional-rupture-of-the-flexor-digitorum-profundus-as-an-etiology-of-atraumatic-trigger-finger
#11
D Anthony Bastian, Nicholas Kusnezov, John C Dunn, Justin S Mitchell, Miguel Pirela-Cruz
BACKGROUND: Trigger finger is a relatively common clinical entity. The etiology is most often attributable to stenosing tenosynovitis though traumatic cases have been described. When trigger finger is associated with an underlying flexor tendon rupture, previous cases have reported a clear association with overt laceration or previous trauma. METHODS: We present the case of a 23-year-old male active duty military service member who presented with a characteristic history and clinical exam consistent with trigger finger...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28761771/lateral-subtalar-dislocation-with-tarsometatarsal-dislocation-a-case-report-of-a-rare-injury
#12
Samik Banerjee, Mostafa M Abousayed, Douglas J Vanderbrook, Kaushik Bagchi
Dislocation of the fourth and fifth tarsometatarsal joints in conjunction with lateral subtalar dislocation is a rare occurrence. Little is known about the mechanism of injury, the appropriate treatment for this condition, and its ultimate prognosis. In this report, we describe this atypical presentation in a middle aged, otherwise healthy male who sustained a trivial twisting injury to the ankle when he slipped and fell on ice. Open reduction and K-wire fixation were necessary to affix the lateral tarsometatarsal and talonavicular joints...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28751995/-monocept-a-brief-report-of-congenital-absence-of-the-long-head-of-the-biceps-tendon-and-literature-review
#13
Benjamin A Winston, Katlyn Robinson, Dennis Crawford
The long head of the biceps tendon plays an important role in shoulder stability and its functional absence has been shown to contribute to glenohumeral instability. Congenital absence of the long head to the biceps tendon is rare, although described in the literature. We report the case of an 18-year-old recreational athlete with recurrent shoulder instability and congenital absence of the long head of the biceps tendon (which we term "monocept") and mild ipsilateral upper extremity hemimelia. The patient was treated surgically with posterior capsular shift with anterior Bankart repair without complication...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28740742/radical-surgery-of-only-the-anterior-elements-of-the-spine-at-the-posterior-element-fusion-level-due-to-metastatic-thyroid-cancer
#14
Ryuto Tsuchiya, Kazuki Fujimoto, Kazuhide Inage, Sumihisa Orita, Yasuhiro Shiga, Hiroto Kamoda, Kazuyo Yamauchi, Miyako Suzuki, Jun Sato, Koki Abe, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Masaki Norimoto, Tomotaka Umimura, Masao Koda, Takeo Furuya, Junichi Nakamura, Kazuhisa Takahashi, Seiji Ohtori
Spinal metastasis of differentiated thyroid cancer can have a favorable prognosis if radical surgery is performed. We encountered a case of spinal metastasis involving three anterior vertebral bodies at the posterior element fusion level and successfully achieved adequate stability by radical surgery involving only the anterior elements. A 67-year-old woman who had numbness and muscle weakness in the lower limbs caused by metastatic spinal tumor at the posterior element fusion level of L1-L3 vertebrae was treated with radical surgery of only the anterior element to gain stability...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28713606/autologous-concentrated-bone-marrow-grafting-for-the-treatment-of-osteonecrosis-of-the-humeral-head-a-report-of-five-shoulders-in-four-cases
#15
Takeshi Makihara, Tomokazu Yoshioka, Hisashi Sugaya, Masashi Yamazaki, Hajime Mishima
Five shoulders in four patients affected by advanced osteonecrosis of the humeral head were treated with autologous concentrated bone marrow grafting. Bone marrow sample was aspirated from the iliac crests, concentrated by a centrifugation technique, and injected into the necrotic site. The shoulders were evaluated radiologically with X-ray scoring and clinically with measurement of range of motion and pain score (visual analogue scale, VAS). The mean follow-up period was 49.4 (range, 24-73) months. The concentration ratio of nucleated cells was calculated and the number of transplanted mesenchymal stem cells (MSC) was estimated by a colony-forming assay...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28698814/a-patient-matched-entire-first-metacarpal-prosthesis-in-treatment-of-giant-cell-tumor-of-bone
#16
Thipachart Punyaratabandhu, Boonrat Lohwongwatana, Chedtha Puncreobutr, Arkaphat Kosiyatrakul, Puwadon Veerapan, Suriya Luenam
Giant cell tumor of the bones occurring in the first metacarpals frequently requires entire metacarpal resection due to the aggressive nature and high rate of recurrence. Bone reconstruction can be performed with autogenous bone grafts. Here we describe a new technique of reconstruction using a patient-matched three-dimensional printed titanium first metacarpal prosthesis. This prosthesis has a special design for ligament reconstruction in the proximal and distal portions. Good hand function and aesthetic appearance were maintained at a 24-month follow-up visit...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28656116/a-large-rice-body-containing-cyst-mimicking-infection-following-total-hip-arthroplasty-a-case-report
#17
Wael Bayoud, Maroun Rizkallah, Samuel Georges, Tonine Younan, Gaby Haykal
INTRODUCTION: Soft tissue mass following total hip arthroplasty raises several differential diagnoses not limited to infection, hematoma, wear debris, malignancy, and bursitis. Rice body formation in the hip region is an uncommon process denoting a chronic inflammation. We report here the second case of its kind in the medical literature of a wide symptomatic rice-like body cyst complicating a total hip arthroplasty. CASE PRESENTATION: This is the case of an 82-year-old white female, presenting with a warm, red, and inflated groin five years after revision of right total hip arthroplasty...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28638670/arthroscopic-treatment-of-2-consecutive-cases-of-dysplasia-epiphysealis-hemimelica-of-the-ankle-a-5-year-follow-up-report
#18
Cosma Calderaro, Carlo Iorio, Francesco Turturro, Federico Morelli, Luca Labianca, Antonello Montanaro, Andrea Ferretti
The dysplasia epiphysealis hemimelica (DEH) is a rare disease of unknown etiology consisting in an abnormal osteocartilaginous growth at the epiphysis, usually hemimelic with histological findings similar to benign osteochondroma. In this case series, we described the results of the arthroscopic treatment of 2 consecutive cases of intra-articular ankle localization of DEH in 2 patients aged 9 and 10 years. The good result obtained, persistent at the 5-year follow-up, leads us to consider the arthroscopic approach as a reliable treatment in patient affected by intra-articular ankle DEH...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28634562/a-simple-bone-cyst-in-cervical-vertebrae-of-an-adolescent-patient
#19
Adriana Bruges Boude, Lina González Vásquez, Fernando Alvarado-Gomez, María Constanza Bedoya, Andrés Rodríguez-Múnera, Luis Carlos Morales-Saenz
INTRODUCTION: Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature. CASE PRESENTATION: Incidental Magnetic Resonance Imaging (MRI) finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28634561/custom-made-alumina-ceramic-total-talar-prosthesis-for-idiopathic-aseptic-necrosis-of-the-talus-report-of-two-cases
#20
Ichiro Tonogai, Daisuke Hamada, Yuhei Yamasaki, Keizo Wada, Tomoya Takasago, Takahiko Tsutsui, Tomohiro Goto, Koichi Sairyo
Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina ceramic total talar prosthesis. Immobilization of the ankle in a short-leg cast for 3 weeks was followed by early rehabilitation. One year and 6 months after surgery, both women were able to walk without pain...
2017: Case Reports in Orthopedics
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