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Case Reports in Orthopedics

Yoohak Kim, Fumiaki Inori, Kiyotaka Yamanaka, Shouichi Murakami, Eri Narita, Kazumasa Yamamura, Hiroyuki Yasuda, Makoto Fukuda, Sadahiko Konishi, Yukihide Minoda
Calcaneal osteomyelitis (CO) is considered to be difficult to cure when it turned into a chronic phase. We report one case of calcaneal osteomyelitis which arises after the operation of calcaneal fracture. Remission was obtained by performing curettage of the infected cancellous bone of the calcaneal body and filling antibiotic-containing calcium phosphate cements (CPC) within its bone defect. This one-stage surgery is useful to treat calcaneal osteomyelitis.
2018: Case Reports in Orthopedics
Hironori Ochi, Katsuaki Taira, Naho Nemoto, Noboru Oikawa, Soya Nagao, Tadamasa Takano, Kazuo Kaneko
Osteomyelitis caused by Mycobacterium species may be difficult to diagnose and treat. We report a case of treatment for osteomyelitis caused by Mycobacterium species in the epiphysis of the right proximal tibia. A 28-month-old boy presented to a hospital with symptoms of fever and right knee pain. He had been vaccinated with Mycobacterium bovis Bacille Calmette-Guérin (BCG) at five months of age. The epiphyseal radiolucent lesion had increased in size and extended to the metaphysis through the physis on a plain radiograph of the right proximal tibia...
2018: Case Reports in Orthopedics
Alexander J Hron, Benjamin C Noonan
Soft tissue injuries are prevalent after traumatic anterior shoulder dislocation. However, bony fractures, often referred to as bony Bankart injuries, are less common. The authors describe the case of a 16-year-old male who displayed a bony Bankart with a unique, everted presentation. The patient presented with left shoulder pain, restricted range of motion, and crepitus. Two weeks prior to physical examination, he sustained a traumatic anterior glenohumeral dislocation after a bicycle accident, which reduced spontaneously...
2018: Case Reports in Orthopedics
Ryan Sefcik, Kyle Andrews, Jacob Stirton, Justin Lea, Mina Tanios, Martin Skie
Isolated dislocations of the scaphoid are extremely uncommon injuries and are often associated with significant ligamentous failures. Since scaphoid dislocations typically present with associated carpal fractures, few cases of isolated dislocations of the scaphoid exist in the literature. The proposed treatment options in the literature range from closed reduction and casting to open reduction and internal fixation. We present the case of a 41-year-old male with an isolated scaphoid dislocation in whom open reduction and internal fixation was performed with K-wires...
2018: Case Reports in Orthopedics
Garrett L Chapman, Nirav H Amin
We report a patient who developed persistent knee pain with mechanical symptoms after an uncomplicated patellofemoral arthroplasty. The etiology of his knee pain remained inconclusive following magnetic resonance imaging due to metallic artifact image distortion. With the use of an in-office needle arthroscopy, an immediate and definitive diagnosis was obtained, preventing an unnecessary surgery for a diagnostic arthroscopy. We discovered a lateral meniscus tear, an anterior cruciate ligament tear, and a medial femoral condyle chondral defect for which the patient underwent arthroscopic partial meniscectomy, ligament reconstruction, and osteochondral allograft transplantation, with resolution of his knee pain...
2018: Case Reports in Orthopedics
Kenneth Herring, Seth Mathern, Morteza Khodaee
Bursitis is a relatively common occurrence that may be caused by traumatic, inflammatory, or infectious processes. Septic bursitis most commonly affects the olecranon and prepatellar bursae. Staphylococcus aureus accounts for 80% of all septic bursitis, and most cases affect men and are associated with preceding trauma. We present a case of an 86-year-old female with an atypical septic bursitis involving the infrapatellar bursa. Not only are there very few reported cases of septic infrapatellar bursitis, but also this patient's case is particularly unusual in that she is a female with no preceding trauma who had Pseudomonas aeruginosa on aspirate...
2018: Case Reports in Orthopedics
Kamal Patel, Emma Spowart, Dana Sochorova, Nadia Diego, Georgios Mamarelis, Mohammad Zain Sohail
Subscapular abscess is an uncommon condition which requires early recognition followed by prompt surgical intervention. We present a case of spontaneous subscapular abscess following blunt trauma to the shoulder in a patient with a history of recurrent superficial soft tissue infections, in which Panton-Valentine leukocidin-producing S. aureus was identified as the infectious agent. This strain due to its virulence can lead to fatal infections in otherwise healthy individuals; therefore, a high index of suspicion is needed to investigate with an MRI to rule out abscess formation in a patient with acute shoulder girdle pain and negative joint aspirate...
2018: Case Reports in Orthopedics
Naohisa Miyakoshi, Shigeto Maekawa, Masakazu Urayama, Yoichi Shimada
Spinal flexion-distraction injuries (FDIs) are unstable fractures, commonly located at the thoracolumbar junction. Management of FDIs often necessitates the use of posterior instrumentation and fusion, but long-segment instrumentation surgery decreases postoperative spinal mobility and increases the risk of junctional kyphosis and fracture. We report the case of a patient with FDI showing an L2 vertebral fracture, unilateral L2 pedicle fracture, and disruptions of the posterior ligamentous complex between L1 and L2...
2018: Case Reports in Orthopedics
Yiyang Zhang, Jason Old
Acromioclavicular cysts are an uncommon manifestation secondary to a massive rotator cuff tear and/or a degenerative osteoarthritic AC joint. We present a case of an 80-year-old female with a symptomatic acromioclavicular cyst that extended intramuscularly into the trapezius. She did not complain of symptoms associated with a massive rotator cuff tear; however, the cyst has been increasing in size and she was interested in having it removed. Intraoperatively, the mass extended into the trapezius muscle and was removed en bloc after dissecting it down to the stalk...
2018: Case Reports in Orthopedics
Gilber Kask, Toni-Karri Pakarinen, Jyrki Parkkinen, Hannu Kuokkanen, Jyrki Nieminen, Minna K Laitinen
This case study describes a total tibia resection and reconstruction with a custom-made endoprosthetic replacement (EPR) and a long-term, 8-year follow-up. The patient underwent a total tibia adamantinoma resection in 2009. Reconstruction was performed with a custom-made total tibia EPR, where both the knee joint and ankle joint were reconstructed. Two muscle flaps, latissimus dorsi free flap and a pedicled medial gastrocnemius flap, were used for soft tissue reconstruction. The patient returned to normal life as a kindergarten teacher, without complications for eight years...
2018: Case Reports in Orthopedics
Mohammad O Alawad, Saleh Alharthi, Jameel Mahmoud, Basam Alanazi, Saad Surur
Open acromial fractures are a rare set of fractures. We report a case of Gustilo IIIA open acromial fracture (14A2 as per OTA scapular fracture classification) that was isolated from any other injury. Our patient had a good recovery and showed excellent clinical outcome after irrigation and screw fixation of the acromial fracture. We also reviewed the literature for other cases of open acromial fracture.
2018: Case Reports in Orthopedics
Graeme Matthewson, Samuel Larrivee, Tod Clark
Perilunate fracture dislocations are a rare but devastating injury, which is often missed on initial presentation leading to significant delays in treatment. With the delay in treatment and a high energy mechanism of injury, patients are at increased risk of developing complex regional pain syndrome following trauma. In this report, we review the case of a 57-year-old left-hand dominant female who presented to a clinic with a five-and-a-half-week-old transtriquetral, perilunate fracture dislocation with comminution of the scaphoid facet...
2018: Case Reports in Orthopedics
Shigeki Kubota, Tadashi Kubo, Hiromi Kameda, Yoshiyasu Itoh
The modified Steindler procedure-a reconstructive surgery used to restore elbow flexion following upper brachial plexus injuries-involves shifting the origins of the muscle groups responsible for wrist flexion and forearm pronation originating from the medial epicondyle to the proximal direction to be used as flexors of the elbow. In the postoperative rehabilitation, we focused on strengthening not only the transferred muscle but also the wrist extensor muscles as antagonist muscles. After reconstruction surgery for elbow flexion via the modified Steindler procedure for traumatic brachial plexus injury, we performed long-term rehabilitation to strengthen the antagonist muscles...
2018: Case Reports in Orthopedics
Daisuke Tateiwa, Ryoji Yamasaki, Rinsei Tei, Yasushi Shin, Kenta Ariga, Kenji Hayashida, Eiji Wada
Intradural disk herniation (IDH) is a rare condition, occurring more often at the L4-5 level. We examined a case of an IDH at the L1-2 level mimicking an intradural spinal tumor. A 71-year-old woman with a long history of backache and pain radiating down the left leg was admitted to our hospital with the worsening of these symptoms. Magnetic resonance imaging and computed tomographic myelography demonstrated an intradural mass at the L1-2 level. Given the radiologic findings and the location of the mass, the preoperative differential diagnosis centered on intradural spinal tumors...
2018: Case Reports in Orthopedics
Nick N Patel, Robert W Bruce
Anterior elbow dislocations in the pediatric population represent rare and sometimes difficult injuries to manage. Associated olecranon fractures are even more uncommon with limited literature existing on the topic. We present the case of a six-year-old male with a traumatic transolecranon anterior elbow fracture dislocation in whom closed reduction was prevented by buttonholing of the proximal ulna through the anterior joint capsule. This case of pediatric anterior elbow fracture dislocation provides insight into an uncommon and challenging injury complex...
2018: Case Reports in Orthopedics
M Prod'homme, S Pour Jafar, P Zogakis, P Stutz
Treatment of displaced intra-articular fractures of the calcaneus remains a challenge for the orthopaedic surgeon. Conservative therapy is known to produce functional impairment. Surgical approach is plagued by soft-tissue complications and insufficient fracture reduction. We describe a minimally invasive technique that will hopefully improve these issues. We want to present our first experience through two cases. The first was a 46-year-old man who presented with a Sanders type IIBC calcaneal fracture, and the second was a 86-year-old woman with a type IIIBC calcaneal fracture...
2018: Case Reports in Orthopedics
Hiroaki Tagomori, Nobuhiro Kaku, Tomonori Tabata, Hiroshi Tsumura
We report a case of bilateral spontaneous greater trochanteric fracture after bilateral simultaneous total hip arthroplasty (THA) performed via the posterolateral approach during the early postoperative phase. A 75-year-old woman underwent bilateral simultaneous THA (BS-THA) for severe osteoarthritis with developmental dysplasia of the hip; she also presented a limited range of adduction. BS-THA was successful without any intraoperative complications. Rehabilitation with full weight-bearing exercises was initiated the day after the surgery...
2018: Case Reports in Orthopedics
Ichiro Tonogai, Koichi Sairyo
Patients with conversion disorder (CD) present with weakness or unexplained movement disorder that may evolve from inciting psychological events, but presentation with rigid deformity is rare. Only one case of CD presenting as foot deformity with atraumatic rigid psychogenic equinovarus has been reported previously. Here we describe a rare case of psychogenic equinovarus in a physically healthy 10-year-old boy. He had noticed left equinovarus deformity upon waking abruptly but had no history of preceding trauma and no relevant medical history...
2018: Case Reports in Orthopedics
Catherine Kilmartin, Katharine D Harper, Chirag Mehta, Joseph Thoder, Andrew Newman
Reconstructive flaps have revolutionized the ability of surgeons to restore function and cosmesis for patients. While reconstructive flaps have been used to bridge large defects due to oncologic or congenital maladies necessitating large debridements, few cases have observed salvage flaps in traumas which provide additional challenges secondary to an injury trajectory. This case report details use of an osteofasciocutaneous fibular free flap and radial head prosthesis to restore forearm function in a 64-year-old female with a comminuted fracture of the proximal radius...
2018: Case Reports in Orthopedics
Giuseppe Rollo, Roberto Rotini, Denise Eygendaal, Paolo Pichierri, Ante Prkic, Michele Bisaccia, Riccardo Maria Lanzetti, Domenico Lupariello, Luigi Meccariello
Introduction: The elbow interposition arthroplasty is a very common procedure performed mainly on active young patients who need great functionality and for whom total joint replacement is contraindicated and arthrodesis is noncompliant. We are going to demonstrate a case of a 34-year-old male suffering from malunion of the distal humerus, elbow stiffness, and manifest signs of arthrosis of the dominant limb, treated with the IA Grika technique at a 5-year follow-up. Patients and Methods: The chosen criteria to evaluate the injured side and the uninjured side during the clinical and radiological follow-up were the objective function and related quality of life, measured by the Mayo Elbow Performance Score (MEPS), and postoperative complications...
2018: Case Reports in Orthopedics
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