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Journal of Orthopaedic Case Reports

Kunal Shah, Gaurang Atodaria, Milind Patwardhan, Abhay Nene
Introduction: Non-tuberculous mycobacteria (NTM) are slow-growing organisms affecting both immunocompromised and immunocompetent patients. As compared to tuberculosis, they pose formidable challenge in successful management beginning with diagnosis extending through its treatment. Case Report: Our case highlights unusual spinal presentation of NTM, intricacies in diagnosis, and successful management. Conclusion: As the prevalence of NTM is rising, it is important as clinicians to understand unique aspects which differ from tuberculosis for appropriate and successful treatment...
November 2017: Journal of Orthopaedic Case Reports
Nathan M Krebs, Ryan C Krebs, Amjad M Yaish
Introduction: Hematogenous osteomyelitis of long bones in immunocompetent adults is extremely rare and uncommonly presents as a pathological fracture. Case Report: A 53-year-old Caucasian male presented with an atraumatic mid-shaft femur fracture secondary to hematogenous osteomyelitis. The organism was found to be Streptococcus anginosus. The patient required multiple surgical debridements and was treated with an antibiotic-impregnated cement rod and external fixator along with IV Rocephin...
November 2017: Journal of Orthopaedic Case Reports
Skand Sinha, Durgashankar Meena, Ananta K Naik, M Selvamari, Rajendra K Arya
Introduction: Tibial spine avulsion fracture is more frequent in children than adults. Various methods of fixation have been mentioned, but concern remains about crossing the tibial physis. We present a technique of arthroscopic fixation with non-absorbable suture. Case Report: A total of 10 skeletally immature patients with tibial spine avulsion of Meyers and McKeever Type 2 and 3 were included in the study. The knee was arthroscopically cleared of hematoma. The avulsed tibial insertion of anterior cruciate ligament was reduced and held in place with tibial guide...
November 2017: Journal of Orthopaedic Case Reports
Raju Vaishya, Vipul Vijay, Abhishek Vaish, Amit K Agarwal, Nitin P Ghonge
Introduction: Double posterior cruciate ligament (PCL) sign is a sign on magnetic resonance imaging (MRI) which is suggestive of a bucket- handle tear (BHT) of the meniscus. We undertook this study to assess the presence of a double PCL sign and its correlation with arthroscopic findings. We also discussed the various mimics and variants of the double PCL sign. Case Report: All the patients with a double PCL sign on the MRI and who underwent knee arthroscopy between January 2012 and December 2016 (total of 5 cases, 4 males and one female) were included in the study...
November 2017: Journal of Orthopaedic Case Reports
Ayush Sharma, Prashant Chandrakant Kamble, Vijay Singh
Introduction: Neurothekeomas are uncommon benign soft tissue tumors of the peripheral nerves. It is commonly found in the upper extremities and in the head and the neck region as a small, asymptomatic, and superficial nodule. Case Report: We report a rare case of intraneural neurothekeoma (2.8 χ 2.4 x 1.8 cm) of the median nerve at the wrist in a 56-year-old female, which presented with clinical features of carpal tunnel syndrome. Conclusion: Carpal tunnel syndrome caused by intraneural neurothekeoma has been rarely reported...
November 2017: Journal of Orthopaedic Case Reports
Coulibaly Ndeye Fatou, B A Amadou, Gueye Alioune Badara, Dembele Badara, Daffe Mohamedi, Dieme Charles Bertini
Introduction: Tuberculous tenosynovitis localization is rare. This unusual presentation, often misunderstood, results in frequent misdiagnosis. We report 4 cases of patients which represent the 3 anatomo-clinical forms described by Kanavel. The knowledge of its different manifestations will make it possible to recognize and to suspect the tuberculous origin. Case Report: This was a retrospective study from January 2006 to May 2017 which involved all patients received and treated with tuberculous tenosynovitis...
November 2017: Journal of Orthopaedic Case Reports
Ying-Cheng Huang, Shan-Wei Yang, Chun-Yu Chen, Jenn-Huei Renn
Introduction: Chondrolipomas are rare benign mesenchymal tumors primarily occurring in the shoulder region. To the best of our knowledge, only one case of chondrolipoma arising from the shoulder has been reported. We herein report an intramuscular chondrolipoma located in an unusual area of the scapula. Our case is interesting because magnetic resonance imaging (MRI) that shows lipomatous tumor masses with cartilaginous nodules may mislead surgeons into not considering the possibility of chondrolipomas...
November 2017: Journal of Orthopaedic Case Reports
Masafumi Kashii, Kenta Masuhara, Takashi Kaito, Motoki Iwasaki
Introduction: The relationship between the morphometry of atlantoaxial joint and chronic atlantoaxial rotatory fixation (AARF) is well known, but disorders in the atlanto-occipital joint in chronic AARF are not fully elucidated. The authors report two rare cases of secondary deformities in the atlanto-occipital joint in chronic AARF. Case Reports: Two patients with chronic AARF were treated with closed manipulation, skull traction and halo-vest immobilization. Clinical outcomes and radiographs were reviewed retrospectively, focusing on pathological changes in the atlanto-occipital joint using multiplanar reconstruction computed tomography and three-dimensional computed tomography images...
November 2017: Journal of Orthopaedic Case Reports
Matthew Gaines, Mike Grant, Simon Robinson, Helene Stevenson
Introduction: Phlegmasia cerulea dolens (PCD) is a rare pathology with a very high morbidity and mortality rate, which usually occurs in the lower limb. There is very little literature available to aid management. Case Report: We present a case of upper limb PCD in a 67-year-old female secondary to heparin-induced thrombocytopenia caused by warfarin bridging. She presented to the orthopedic team with upper limb compartment syndrome from a bleed around a peripherally inserted central catheter, for which she was urgently taken to the theater for fasciotomies...
November 2017: Journal of Orthopaedic Case Reports
Wesley Ng, Cheuk Hang Sin, Chong Hing Wong, Wing Fat Chiu, On Ming Chung
Introduction: Gouty spondyloarthropathy is generally believed to be uncommon. Together with the fact that it can mimic a variety of disease entities, it imposes significant diagnostic challenge in our clinical practice. In this article, we report two patients diagnosed with spinal gout, and both were initially suspected to have a pyogenic infection. Case Reports: The first patient, a 66-year-old man, was admitted for fever and a short history of bilateral upper limb weakness...
November 2017: Journal of Orthopaedic Case Reports
Milind V Pimprikar, Madhu Geddam, Hitendra G Patii
Introduction: The main objective of this case report is to demonstrate endoscopic calcaneoplasty (ECP) using two lateral portals. Case Report: The patient is middle-aged male aged 40 years, with higher basal metabolic index (BMI) and was diagnosed having a Haglund's bump and was on conservative treatment for a period of over 6 months, with minimal relief. We did ECP with the patient in lateral decubitus position using two lateral portals instead of using one medial and one lateral portal, his American Orthopaedic Foot and Ankle Society score has improved from 64 to 98, and his Fowler-Philip angle is reduced from 71° to 45°...
November 2017: Journal of Orthopaedic Case Reports
Juan Pablo Zícaro, Agustín Rubén Molina Rómolil, Carlos Heraldo Yacuzzi, Matías Costa Paz
Introduction: Anterior cruciate ligament (ACL) reconstruction is a "daily" surgery. Nevertheless, pretibial cyst formation is a very rare complication and may appear years after the reconstruction. Even more infrequent is the recurrence of this complication. Case Report: We present a patient who developed a pretibial cyst 44 months after an ACL reconstruction and who underwent three open surgeries due to recurrence. Up to date, there are no symptoms or signals of cyst recurrence after 18 months of follow-up...
November 2017: Journal of Orthopaedic Case Reports
Gaurav Garg, Rajat Malot
Introduction: Proximal femur is the common site for localization of benign bone lesions, and the diagnosis is often delayed and potentially challenging due to their atypical presentations. Early diagnosis is difficult as intra-articular lesions often present with clinical and radiological features of inflammatory synovitis in the joint. Case Report: Two patients of intra-articular osteoid osteoma in proximal femoral presented with atypical features limb lengthening, minimal reactive bone sclerosis, and multifocal nidus...
November 2017: Journal of Orthopaedic Case Reports
Ferdinando Da Rin De Lorenzo
Introduction: Non-unions at forearms are usually challenging and difficult to treat. If additionally, an infection is present, reconstructive surgery should be planned only after full debridement, antibiotic treatment, and confirmation, based on clinical observation and laboratory tests that the infection has subsided. Bone grafting may be required for reconstruction. The use of autogenous bone calls for a second surgical site with an increased risk of morbidity. Using bone substitutes may reduce the need for autogenous bone...
November 2017: Journal of Orthopaedic Case Reports
Farzam Vazifehdan, Vasilios G Karantzoulis, Robert Ebner, Vasilios G Igoumenou
Introduction: Scheie syndrome is an extremely rare systematic disease that represents the most attenuated form of mucopolysaccharidosis Type I disorder. Although associated with a variety of manifestations, Scheie syndrome leading to the development of cervical myelopathyis yet to be reported. Our purpose was to present a unique case of a Scheie syndrome patient, who underwent surgery due to cervical myelopathy, and to discuss the clinical and imaging findings, as well as the challenges and outcomes of surgical treatment...
November 2017: Journal of Orthopaedic Case Reports
Waqar Saadat, Puneet Monga
Introduction: Posteriorly dislocated humeral head fracture has a great implication, as it is associated with high risk of avascular necrosis, limited access through the deltopectoral approach, and posterior approach to the posteriorly dislocated humeral fracture increases the risk to the remaining blood supply. Technical Tip: Posteriorly dislocated humeral fracture is approached through deltopectoral approach. Schanz pin is inserted into the humeral head to achieve purchase in the humeral head...
November 2017: Journal of Orthopaedic Case Reports
Vanlommel Jan, Vanderschot Paul
Introduction: Hip fractures in the elderly pose an increasing problem in society. In the elderly, a bipolar hemiarthroplasty (HA) remains the treatment of choice in case of hip fractures related to osteoporosis. However, due to an ongoing osteoporosis in this age group, a periprosthetic femoral fracture and a fracture of the unresurfaced acetabulum are increasingly noticed.In the literature, no information can be found regarding the treatment options for this kind of periprosthetic acetabular fracture...
November 2017: Journal of Orthopaedic Case Reports
Prasoon Kumar, Saurabh Agarwal, Rajesh Kumar Rajnish, Vishal Kumar, Karan Jindal
Introduction: Avulsion fractures of lesser trochanter (LT) of femur are generally seen following trauma with intertrochanteric or sub trochanteric fractures. Non-traumatic fractures of LT could oc-cur due to sudden violent contraction of the iliopsoas muscle that inserts on the LT; during vigorous exercise, or sudden pull involving flexion of hip. These are seen commonly in adolescents where the physis has not fused yet. Such a scenario in an adult patient most often or not leads to a diagnosis of an underlying malignancy or metastatic lesion...
November 2017: Journal of Orthopaedic Case Reports
Anantha Krishnan Raghupathi, Avinash Joshi
Introduction: Septic arthritis of the hip is a rare entity in acute presentation of hip pain in adults. Even though hip is the second most commonly affected joint, adult patients with septic arthritis not related to a surgical procedure represent <0.00001% of total acute admissions. Case Report: We present a 32-year-old female intravenous drug abuser, positive for Hepatitis B and C who had started to inject her femoral veins 2 years ago. She presented with a 10 weeks history of radiating pain in the leg which was full, constant and diffuse in nature with hip stiffness...
November 2017: Journal of Orthopaedic Case Reports
Mourad Zaraa, Heithem Sahli, Imene Yeddes, Sabri Mahjoub, Mondher Mbarek
Introduction: The stress fracture of the femoral head rarely occurs; but, it is generally encountered in case of bone insufficiency, and it is exceptional in younger individuals. The main differential diagnosis may include several diseases, namely, slipped upper femoral epiphysis, septic arthritis, osteomyelitis, and Perthes' disease. Bone scintigraphy is very sensitive but lacks specificity. Nowadays, the magnetic resonance imaging (MRI) is the gold standard for an accurate diagnosis...
November 2017: Journal of Orthopaedic Case Reports
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