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Applied Radiology     Full-text available via subscription   (Followers: 10, SJR: 0.128, CiteScore: 0)
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Applied Radiology
Journal Prestige (SJR): 0.128
Number of Followers: 10  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0160-9963
Published by Anderson Publishing, Ltd Homepage  [1 journal]
  • Parsonage-Turner Syndrome: Antecedents May Not Be Causes

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      Authors: Bauer; Thomas W.; Resnick, Lloyd
      Abstract: imageNo abstract available
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Reconstruction of Ipsilateral Femoral and Tibial Bone Defect by 3D Printed
           Porous Scaffold Without Bone Graft: A Case Report

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      Authors: Hou; Guojin; Liu, Bingchuan; Tian, Yun; Liu, Zhongjun; Zhou, Fang
      Abstract: imageCase: This study reported the case of a 42-year-old woman with traumatic ipsilateral critical bone defect of right femur and tibia after a motor accident. Three-dimensional (3D) printed porous titanium scaffolds were innovatively used to reconstruct this challenging situation. The initial stability was safe enough for early exercise and partial weight bearing. The 26-month follow-up showed osseous integration of the prosthesis-bone interface with short-term satisfactory clinical result.Conclusion: The custom-designed 3D-printed porous scaffold has the potential to become an effective option for reconstructing the segmental irregular-shaped bone defect.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Jones Fracture: A Late Sequelae of Undercorrected or Recurrent Congenital
           Talipes Equinovarus: A Report of 2 Cases

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      Authors: Schoenfeldt; Theodore L; Altiok, Haluk
      Abstract: imageCase: We present 2 cases in which patients previously treated for congenital talipes equinovarus (CTEV) presented with residual cavovarus deformity and lateral foot pain and were found to have Jones fractures. Both patients were indicated for surgical correction of their residual cavovarus deformity, although neither elected to proceed. These 2 patients were treated conservatively for their fractures with cast immobilization. At the final follow-up, both were clinically and radiographically healed.Conclusion: Residual cavovarus foot deformities after the treatment of CTEV are at risk for proximal fifth metatarsal or Jones fractures. Although conservative management may lead to healing of these fractures, the underlying stresses persist after conservative management increasing the risk for recurrent fracture. Correction of the residual deformity should be the main goal.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Atraumatic Index Finger Flexor Tendon Rupture as a Presenting Sign of
           Capitate Osteonecrosis: A Report of 2 Cases

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      Authors: Serra López; Viviana M.; Koressel, Joseph; Liu, Stephen Y.; Steinberg, David
      Abstract: imageCase: We present 2 cases of spontaneous index finger (IF) flexor tendon ruptures because of previously undiagnosed osteonecrosis (OA) of the capitate. Imaging revealed fragmentation of the capitate, and patients were treated with excision or fixation of the bony fragments with tendon repair. At the final follow-up, both patients had functional digital range of motion.Conclusions: OA of the capitate is relatively rare and may present as atraumatic (IF) flexor tendon ruptures because of attritional wear when associated with bony fragmentation.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • A Novel Insertional Achilles Tendon Rupture Repair After Heel Spur
           Debridement: A Case Report

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      Authors: Casciato; Dominick; Mendicino, Robert; Steginsky, Brian
      Abstract: imageCase: We report a case of a 46-year-old woman who suffered an insertional Achilles tendon rupture secondary to a fall after undergoing retrocalcaneal and Achilles tendon debridements with flexor tendon transfer. Examination revealed posterior ankle pain with insertional Achilles tendon retraction. Treatment options included continued immobilization vs. surgical repair. She underwent Achilles tendon tenodesis to the calcaneus using a combined gastrocsoleus recession and Krackow suture technique.Conclusion: At the 1-year follow-up, examination revealed pain-free return to normal function. In the presence of a ruptured Achilles tendon with retraction, this repair provided sufficient lengthening and fixation of the Achilles tendon complex.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Bilateral Unstable Severe Valgus Slipped Capital Femoral Epiphysis: A Case
           Report

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      Authors: Venkatadass; K.; Durga Prasad, V.; Jain, Deepak; Rajasekaran, S.
      Abstract: imageCase: Bilateral valgus slipped capital femoral epiphysis (SCFE) is a rare condition with few cases reported in the literature. However, there are no reports of bilateral unstable valgus SCFE. We report a unique case of bilateral acute-on-chronic unstable valgus SCFE with severe coxa valga in a 9-year-old girl. She was treated with bilateral capital realignment procedure along with subtrochanteric osteotomy and had a good clinical outcome.Conclusion: We hitherto report a rare case of bilateral unstable valgus SCFE which was successfully managed. This report also highlights the importance of the need for additional osteotomies to address the deformity.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Complex Total Hip Arthroplasty in a Patient with Klippel-Trénaunay
           Syndrome: A Case Report

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      Authors: Morrison; Todd A.; Streufert, Benjamin D.; Engel, Corey C.; Bernasek, Thomas L.; Gill, Meera
      Abstract: imageCase: Klippel-Trénaunay syndrome (KTS) carries manifestations including skeletal dysplasia and prominent vascular malformations. This report details a case of hip dysplasia in the setting of KTS treated with total hip arthroplasty (THA) requiring preoperative embolization, intraoperative angiography for placement of an iliac artery occlusive balloon, and modular hip arthroplasty components for femoral and acetabular dysplasia. Perioperatively, the patient rehabilitated well and was walking painlessly and unassisted at 3 and 12 months postoperatively.Conclusion: Successful THA for dysplasia and degenerative changes associated with KTS is possible but requires a complex multidisciplinary perioperative approach.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Traumatic Transposition of the Ulnar Nerve Through the Distal Radioulnar
           Joint: A Case Report

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      Authors: Pientka; William II; Hoelscher, Skyler; Bates, Christopher; Pipkin, William
      Abstract: imageCase: A 27-year-old woman sustained a left open distal radius fracture with dislocation of the distal radioulnar joint (DRUJ). Postoperatively after initial temporizing treatment, the patient reported numbness in an ulnar distribution and was noted to have intrinsic hand weakness. At the time of conversion to internal fixation, the ulnar nerve was found to be translocated through the DRUJ and was narrowed and felt to benefit from resection and grafting.Conclusion: The combination of ulnar nerve palsy and wide displacement of the distal radius with DRUJ dislocation should raise the possibility of translocation of the ulnar nerve through the DRUJ.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Recurrent Hemarthrosis Secondary to Erosive Patellofemoral Arthritis
           Treated with Arthroplasty: A Report of 3 Cases

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      Authors: Turner; Rachael A.; Duke, Justin N.; Murray, Trevor G.; Foran, Jared R.H.
      Abstract: imageCase: Three patients presented with recurrent hemarthrosis secondary to erosive patellofemoral arthritis. Recurrent hemarthrosis from the eroded patellofemoral subchondral bone has not been well described. Each patient presented with symptoms secondary to painful effusions that were identified by aspiration. Each patient was successfully treated with patellofemoral or total knee arthroplastyConclusion: Spontaneous or recurrent effusions in the setting of erosive patellofemoral arthritis should prompt orthopaedic surgeons to consider hemarthrosis as the cause of such effusions. Patellofemoral or total knee arthroplasty is effective in resolving the hemarthroses, resolving pain, and restoring function in these patients.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Staged Corrective Surgery for a Patient With Sagittal Malalignment Related
           to Noonan Syndrome: A Case Report

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      Authors: Iwamae; Masayoshi; Matsumura, Akira; Namikawa, Takashi; Hoshino, Masatoshi; Hori, Yusuke; Nakamura, Hiroaki
      Abstract: imageCase: A 20-year-old man with Noonan syndrome had rigid cervical kyphosis caused by cervical myelopathy and thoracic lordosis caused by pulmonary disfunction. Two-staged corrective surgery, which involved initial posterior spinal fusion (PSF) in T2-L2 followed by PSF in C3-T2, had been performed without any complications. The radiographs before surgery and 2 years after surgery showed that cervical lordosis (C2-7) changed form −56° to −29°, and thoracic kyphosis (T5-12) improved from −49° to 10°.Conclusion: Initial realignment surgery in the caudal lesion should be better for improving global spinal alignment in patients with rigid spinal deformities at different locations.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Stand-Alone Interbody Cage to Treat Cervical Facet Dislocation: A Case
           Report

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      Authors: Buontempo; Michael G.; Imam, Nareena; Koerner, John
      Abstract: imageCase: We present a 36-year-old man who sustained a traumatic C5-6 unilateral facet dislocation without neurological deficit. The patient was treated with anterior diskectomy and fusion using a stand-alone interbody cage.Conclusion: Current treatment of cervical facet dislocations (CFDs) in patients undergoing an anterior cervical diskectomy and fusion commonly makes use of plates with screw fixation and interbody grafts or cages to achieve spinal fusion after the diskectomy is performed. This report documents the successful treatment of a CFD with a stand-alone interbody cage.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Tubercle-Sparing Proximal Tibial Reconstruction in Patients with Primary
           and Metastatic Bone Disease: A Case Report

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      Authors: Fourman; Mitchell S.; Ramsey, Duncan C.; Newman, Erik T.; Heng, Marilyn; Raskin, Kevin A.; Lozano-Calderon, Santiago A.
      Abstract: imageCase: Two patients with cancer involving their proximal tibia required proximal tibial replacement (PTR). One had a soft-tissue sarcoma that involved her posterior cortex, and the other had extensive metaphyseal destruction from metastatic breast cancer. Their anterolateral cortex and tibial tubercle were uninvolved, permitting tubercle-sparing PTR. A plate was applied to the bone bridge in the latter patient in anticipation of radiotherapy. Both healed uneventfully and had minimal extensor lag 2 weeks postoperatively.Conclusion: Tubercle-sparing PTR preserves extensor mechanism function with minimal lag. It should be considered in patients with cancer when sparing the anterolateral cortex is oncologically safe.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • A 180° Spin of the Femoral Component in Unicompartmental Knee
           Arthroplasty: A Report of 2 Cases

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      Authors: Bouché; Pierre-Alban; Ehkirch, François-Paul
      Abstract: imageCase: We report 2 cases of undescribed lateral unicompartmental knee arthroplasty failure: a 180° rotation of the femoral component. The patients experienced a locking event several years after arthroplasty, and radiographs revealed a perfect 180° rotation of the implant. Each patient underwent revision surgery to a total knee arthroplasty. At the 13-year follow-up, the first patient had no pain and a range of motion of 140°. The second patient, at 3 months, could walk without crutches with a flexion at 145°.Conclusion: Excessive laxity, coronal or sagittal, might be associated with this complication.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Pelvic Ring Disruption During Childbirth: A Case Report

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      Authors: Hoehmann; Christopher L.; Doss, William; DeTore, Saila
      Abstract: imageCase: We present the management of a peripartum pelvic ring disruption. Initial conservative treatment failed; ultimately, open reduction with internal fixation was required. Four years later, the patient gave birth to another child by elective cesarean delivery.Conclusion: Pelvic ring fracture is a rare occurrence during childbirth. The mechanism involves hormonally mediated ligamentous laxity of the pelvis combined with the forceful movement of the fetal head. This case highlights the continuum of care from injury to treatment, and follow-up, demonstrates proper management of pregnancy-related pelvic ring injury, and explores the role of previous pelvic ring injury in a pregnant patient.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Osteopenia in Scaphoid Fracture: An Indicator of Good Prognosis or Is it
           Cause for Concern': A Case Report

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      Authors: Singh; Chander Mohan; Prasad, Manish; Thakur, Kamparsh; Vig, Varun
      Abstract: imageCase: A 32-year-old man sustained a scaphoid waist fracture and was managed nonoperatively in a short-arm cast. Radiographic follow-up at 6 weeks showed marked loss of radiodensity of the whole scaphoid, although the fracture was clinically united. Patchy ossification at 3 months was followed by the complete restoration of radiodensity and trabecular pattern by 20 weeks. The patient had an uneventful and full functional recovery.Conclusion: This, perhaps unreported, finding seems to be an indicator of preserved vascularity in scaphoid fractures. Further research/reporting of this radiological pattern in these fractures will help improve their understanding and management.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Neurophysiological Intraoperative Monitoring in Patients with Cochlear
           Implant Undergoing Posterior Spinal Fusion: A Case Report

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      Authors: Pan; Tommy; Adeyemo, Adeshina; Armstrong, Douglas G.; Petfield, Joseph L.
      Abstract: imageCase: Transcranial electric stimulation motor-evoked potentials (tcMEPs) are the most sensitive technique in multimodality intraoperative neuromonitoring (IONM) for posterior spinal fusion (PSF). The presence of a cochlear implant (CI) is considered a contraindication to IONM because of theoretical risk of implant device and local tissue damage from voltages induced by tcMEPs. We present the case of a 10-year-old girl with CI who underwent successful PSF with tcMEP and monopolar electrocautery (MoEC) without perioperative complications or CI damage.Conclusion: With proper precautions, such as MoEC usage at a minimal voltage, motor-evoked potential monitoring can be safely performed in pediatric patients with CI undergoing PSF.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Spectacular Accidental Distraction Arthroplasty in Dupuytren Contracture
           with Good Outcome: A Case Report

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      Authors: Degreef; Ilse; Van Hoecke, Emanuel; Van Nuffel, Maarten
      Abstract: imageCase: An exceptional event occurred during gradual extension with an external fixator for recurrent small finger Dupuytren flexion deformity. A massive proximal interphalangeal joint distraction arose, possibly because of the center of rotation misalignment and a hasty patient-controlled correction. The device was removed, and a plaster splint protected the finger for 5 days to prevent dislocation of the unstable joint. It relocated with an acceptable clinical result.Conclusion: Gradual extension of Dupuytren contractures with an external fixator may induce severe joint distraction by eccentric placement of the device. On the other hand, the good outcome of this case report may inspire further research on controlled joint distraction in hooked deformity.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Anterior Compartment Neurovascular Bundle Entrapment in a Minimally
           Displaced Distal Tibial Fracture: A Case Report

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      Authors: Lachance; Andrew D.; Shields, Margaret V.; Ryan, Scott P.
      Abstract: imageCase: A 29-year-old woman presented with a low-energy, minimally displaced pilon fracture with progressive pain and paresthesias in the affected foot, ultimately requiring open reduction and internal fixation. Intraoperatively, the deep peroneal nerve and anterior tibial artery and vein were entrapped within the fracture. After freeing the bundle and fixing the fracture, the paresthesias improved and ultimately resolved.Conclusion: Injury to the anterior leg compartment neurovascular structures should be considered in low-energy, minimally displaced pilon fractures. In this instance, progressive neurologic symptoms not consistent with the radiographic findings indicated the patient for surgical exploration and fixation.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Aortic Injury After Shoulder Reduction in a Patient with Multiple Rib
           Fractures: A Case Report

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      Authors: Lim; Eic-Ju; Kim, Se-Heon; Shon, Hyun-Chul; Yang, Jae-Young
      Abstract: imageCase: A 74-year-old woman presented with multiple rib fractures, hemothorax, spleen rupture, and right shoulder dislocation. Shoulder joint reduction was performed using the traction-countertraction method. An injury to the descending aorta, caused by the seventh rib, was confirmed.Conclusion: The authors encountered an aortic injury, a rare complication of shoulder joint reduction, in a patient with a posterior rib fracture. When managing patients with posterior fractures of the fourth to ninth ribs on the left side, the reduction method should be carefully selected depending on the status of the patient to avoid aortic injuries.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Two Single-Level Nonadjacent Corpectomies With Expandable Vertebral Body
           Replacements for Spinal Metastasis: A Case Report

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      Authors: Trojner; Teodor; Rečnik, Gregor
      Abstract: imageCase: The case describes a 59-year-old male patient who suffered from a solitary metastasis of unknown origin in the L1 vertebra. Owing to the instability, a corpectomy and posterior fixation with the expandable cage implantation was performed. However, the disease progressed, which required additional nonadjacent corpectomy and cranial elongation of the construct with implantation of the additional expandable cage at the level Th11.Conclusion: In such complex pathology, two single-level nonadjacent corpectomies and expandable cage implantations present a surgical solution that may provide a satisfactory outcome.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Anterior Column Reconstruction with Vascularized Rib After Thoracic
           Spondylectomy: A Case Report

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      Authors: Tobert; Daniel G.; Yeung, Caleb M.; Morse, Christopher R.; Lee, Sang-Gil; Schwab, Joseph H.
      Abstract: imageCase: A 35-year-old man with a chondrosarcoma of the thoracic spine was treated with neoadjuvant proton radiotherapy (RT), total en bloc spondylectomy (TES), and adjuvant RT. Multiple vertebrae were removed to ensure negative margins, which created a sizable midthoracic defect. A vascularized rib autograft was harvested and intussuscepted within a femoral allograft for reconstruction of the anterior column and supplemented with posterior and lateral instrumentation.Conclusion: This report demonstrates the feasibility of using a rib autograft within a femoral allograft sleeve to achieve immediate robust biomechanical support and eventual osseous union after thoracic TES for malignant tumors.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Rapidly Progressive Paraplegia Resulting from Latent Cervical Dural
           Arteriovenous Fistula After Lumbar Surgery: A Case Report

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      Authors: Han; Zhenchuan; Ren, Bowen; Liu, Yang; Liu, Jianheng; Wang, Zheng; Mao, Keya
      Abstract: imageCase: A 68-year-old woman developed symptoms of acute paraplegia due to an occult cervical dural arteriovenous fistula (DAVF) after a minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). She was subsequently diagnosed by angiography and treated with vascular embolization. A 2-year follow-up showed that the patient's upper limb muscle strength returned to normal, and the lower limb muscle strength partially improved with remnant motor dysfunction.Conclusion: For patients with symptoms of nerve injury inconsistent with the spinal surgery site, a possibility of DAVF should be considered, and related investigations should be performed. Once diagnosed, active treatment is required.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Acute Carpal Tunnel Syndrome After Radial Artery Cannulation: A Case
           Report

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      Authors: Garríguez-Pérez; Daniel; Serrano-Mateo, Laura; Donadeu-Sánchez, Susana; Gimeno, María Dolores; Marco, Fernando
      Abstract: imageCase: A 20-year-old postpartum woman developed paresthesias and intolerable pain over the volar aspect of the first through fourth fingers, after radial artery cannulation (RAC) during cesarean section. Ultrasonography did not show any hematoma in the forearm. Urgent carpal tunnel release and median nerve decompression were performed, resulting in complete disappearance of symptoms.Conclusion: Acute median nerve compression is a rare injury in its own, but it is even rarer as a complication of RAC. Urgent decompression should be performed as soon as possible to avoid future neurological deficits.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Elbow Osteochondral Allograft Transplantation and Lateral Ulnar Collateral
           Ligament Repair with Internal Brace: A Case Report

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      Authors: Lee; Steven J.; Bedford, Benjamin B.; Kim, Andrew H.; Rahman, Omar F.; Zbeda, Robert M.
      Abstract: imageCase: A 23-year-old woman with an Osborne-Cotterill lesion and posterolateral rotatory instability (PLRI) of the elbow was treated with osteochondral allograft transplantation (OCA) and lateral ulnar collateral ligament (LUCL) repair with internal brace. Two years after surgery, she reported resolution of pain and returned to all recreational activities. She reported no mechanical symptoms and no episodes of postoperative instability.Conclusion: PLRI can present with an Osborne-Cotterill lesion in addition to LUCL injury. The purpose of this case report was to describe the use of OCA to manage bony defects in the capitellum in addition to LUCL repair for patients with PLRI.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Nonoperative Management of Chronically Subluxated Bilateral Cervical
           Facets with Bony Fusion: A Case Report

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      Authors: Humphrey; Tyler; Song, Junho; Zhang, Andrew; Czerwein, John; Chao, Simon
      Abstract: imageCase: We describe a case of a 65-year-old woman with bilateral chronically subluxated C6 to 7 facets with facet fusion, who presented for care for the first time 1 year after a motor vehicle accident. The patient was minimally symptomatic at the time of her evaluation; thus, nonoperative treatment was provided. At 3-year follow-up, our patient remained minimally symptomatic with no progression of neurologic deficits.Conclusion: Consistent with previous reports, conservative management was used rather than surgical fusion in a patient with stable osseous fusion complexes and minimal neurologic symptoms.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • A Two-Stage Diabetic Foot Salvage Using Synthetic Bone Void Filler and
           Lesser Toe Fillet Flap: A Case Report

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      Authors: Lee; Jong Min; Del Balso, Christopher; Gupta, Sanjay; Tay, Sherilyn; Daniels, Timothy R.; Halai, Mansur
      Abstract: imageCase: A 54-year-old type 2 diabetic man with a diabetic forefoot ulcer and osteomyelitis successfully underwent a staged reconstruction to salvage his foot. An antibiotic-carrying bone void filler was used to decrease the infection burden after initial debridement. The fifth toe fillet flap was performed to cover the large soft-tissue defect. The patient returned to baseline ambulation at the 1-year follow-up with a well-incorporated flap.Conclusion: This case highlights the utility of combining an antibiotic-carrying bone void filler and a toe fillet flap in a two-stage approach to salvage complex diabetic foot ulcers.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Severe Hip Dysplasia in Wiedemann-Steiner Syndrome Treated with Bilateral
           Bernese Periacetabular Osteotomy: A Case Report

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      Authors: Evans; David C.; Novais, Eduardo N.
      Abstract: imageCase: Wiedemann-Steiner syndrome (WDSTS) is a rare autosomal dominant disorder with many phenotypic characteristics, including multiple orthopaedic manifestations. Of these, symptomatic significant hip dysplasia has been variably noted. Nonetheless, few reports detail surgical treatment for these patients, including hip preservation for those with hip dysplasia.Conclusion: Periacetabular osteotomy allows for the correction of severe hip dysplasia in patients with WDSTS. With proper recognition and timely intervention, adequate care may be provided for these patients.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Repair of Osteochondritis Dissecans of the Lateral Femoral Condyle by a
           Trochlea Osteochondral Autograft: A Case Report

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      Authors: Ogawa; Hiroyasu; Matsumoto, Kazu; Akiyama, Haruhiko
      Abstract: imageCase: A 17-year-old adolescent boy with large deep osteochondritis dissecans (OCD) of the right lateral femoral condyle was treated with ipsilateral trochlea osteochondral autograft transplantation combined with iliac cancellous bone grafting to the donor site of the lateral trochlea. Both autografts were fused 3 months after surgery. It was radiographically confirmed that the OCD lesion was successfully reconstructed.Conclusion: This procedure is an alternative surgical option for large and deep OCDs. It offers sufficient loading strength to the joint and adequate reconstruction of the congruent joint surface and can be performed at any regular facility.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Multidisciplinary Approach to Multiple Multiresistant Agent Infection of
           Instrumented Spine Surgery: A Case Report

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      Authors: Xará-Leite; Francisco; Ribau, Ana; Lopes Guerra, Mário Diogo; Abreu, Miguel Araújo; Rodrigues-Pinto, Ricardo
      Abstract: imageCase: We report the case of a patient with consecutive infections with several multidrug-resistant agents—including carbapenem-resistant strains of Klebsiella pneumoniae among others—from a surgical wound infection after lumbar spine fusion, only successfully treated after the resort to novel antibiotics (ceftazidime-avibactam) in combination therapy.Conclusions: Multidrug resistance has become a major challenge in today’s medicine. Care should be taken to avoid their emergence, but when present, a multidisciplinary approach is mandatory to ensure clinically up-to-date treatment choices. Multimodal antibiotic schemes tend to show the most promising results, with which successful infection resolution can still be achieved.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Chronic Popliteus Tendon Avulsion Fracture with Chronic Knee Pain and
           Locking: A Case Report

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      Authors: Blackwell; Christopher; Selley, Ryan; Taber, Caroline E.; Benitez, Carlos L.; Marx, Robert G.
      Abstract: imageCase: A 31-year-old man who had a chronic popliteus avulsion fracture 18 years earlier treated with physical therapy presented with new onset left knee locking after exercising at the gym. Magnetic resonance imaging demonstrated a chronic popliteus avulsion fracture of the lateral femoral condyle. Surgical excision of the nonunited bone fragment was performed.Conclusion: Isolated popliteus avulsion fractures are extremely rare injuries that occur primarily in a skeletally immature patient population and for which treatment options are not well understood. Treatment options include conservative management and early surgical intervention, both of which have inherent risks and benefits. We recommend prompt imaging with computed tomography (CT) to better characterize the degree of injury and follow-up CT imaging in patients who do not undergo early surgical intervention.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Bilateral Extensor Mechanism Allograft Reconstruction in Native Knees: A
           Case Report

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      Authors: DePalma; Brian J.; Costales, Timothy G.; Schneider, Matheus B.; Henn, R. Frank III
      Abstract: imageCase: A 66-year-old man presented with chronic bilateral extensor mechanism dysfunction and profound patella baja after failed revision surgery for bilateral quadriceps tendon ruptures. Staged bilateral reconstruction with complete extensor mechanism allograft resulted in excellent two-year satisfaction and clinical outcomes.Conclusion: Complete extensor mechanism reconstruction can be a successful treatment for chronic quadriceps tendon rupture with profound patella baja.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Midfoot Derotational Osteotomy for Ankylosing Inversion Deformity in
           Patients with Rheumatoid Arthritis: A Report of 3 Cases

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      Authors: Etani; Yuki; Hirao, Makoto; Ebina, Kosuke; Kunugiza, Yasuo; Noguchi, Takaaki; Tsuboi, Hideki; Tsuji, Shigeyoshi; Okada, Seiji; Hashimoto, Jun
      Abstract: imageCase: Ankylosing midfoot inversion deformities in 3 patients with rheumatoid arthritis (RA) treated by midfoot derotational osteotomy to remove the pain due to excessive loading of the fifth metatarsal base and to obtain the plantigrade position are presented. All cases achieved sufficient correction and good clinical and radiographic improvement.Conclusion: Midfoot derotational osteotomy seems useful and has the possibility to be a definitive surgical procedure for ankylosing inversion deformity in patients with RA. Osteotomy should be performed from both medial and lateral sides, and careful retraction of soft tissues should always be kept in mind.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Management of Postoperative Infection After Fixation of a Delbet Type III
           Pediatric Femoral Neck Fracture: A Case Report

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      Authors: Trynz; Samantha; McCaskey, Meghan; Warnick, Drew
      Abstract: imageCase: A pediatric male patient sustained a postoperative infection of the femoral neck after open anatomic reduction and internal fixation (ORIF) of a Delbet type III femoral neck fracture. Treatment included surgical intervention with antibiotic Steinmann pins incorporated into an external fixator to provide stability to the femoral neck. At the 27-month follow-up, films showed complete healing with a 1.67-cm leg length discrepancy, treated with a 1-cm shoe lift.Conclusion: There is insufficient literature for the treatment of postoperative infection after ORIF in a pediatric patient. We present a successful treatment method for treating an infection while sustaining the stability of the femoral neck.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Delayed Postoperative Spinal Cord Injury with Complete Paralysis After
           Adolescent Idiopathic Surgery: A Case Report

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      Authors: Kia; Cameron; Stelzer, John W.; Lee, Mark C.
      Abstract: imageCase: We report a 14-year-old girl with adolescent idiopathic scoliosis who experienced bilateral lower extremity paralysis related to postoperative hypotension 10 hours after posterior spinal fusion. She returned to the operating room for spinal cord decompression and hardware removal. Six weeks later, reinstrumentation was performed, and complete neurologic recovery was achieved.Conclusion: Delayed presentation of neurologic injury after scoliosis surgery is particularly uncommon. Close postoperative monitoring, with an emphasis on hypotensive etiologies and a low threshold to remove the instrumentation, is essential to rapidly diagnose and treat these catastrophic events.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Direct On-Lay Repair of Isolated Pediatric Lateral Collateral Ligament
           Knee Injury with Biceps Femoris Tendon Rotation Graft Augmentation: A Case
           Report

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      Authors: Perry; Samuel; Matelic, Thomas; Beyer, Sean
      Abstract: imageCase: A 13-year-old male American football player sustained an isolated grade III lateral collateral ligament (LCL) rupture and underwent direct repair with biceps femoris rotation graft augmentation after failure of nonoperative management. The procedure was performed without any complications or graft site morbidity and achieved complete functional resolution.Conclusion: Isolated LCL injuries in the pediatric population are an extremely rare finding, with no evidence of rotation graft in the literature to date. Most of these cases involve multiligamentous knee injuries in the adult population, and therefore, there is no consensus regarding pediatric repair vs. reconstruction in this presentation.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Management of a Retained Rare Earth Magnetic Finger Mass Sustained from a
           Semiconductor Explosion Injury: A Case Report

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      Authors: Cavanaugh; Priscilla K.; Inniss, Susan A.; Wang, Mark L.
      Abstract: imageCase: We present a case of a 51-year-old man with a retained supercharged rare earth magnetic finger mass sustained from an explosion injury at a semiconductor processing facility. The patient underwent excision of the rare metal mass, subsequently maintaining digital function without mass recurrence.Conclusion: Common to the semiconductor industry, neodymium is a rare earth metal and powerful magnet. Particulates are highly combustible, representing a potential explosive biohazard. To date, its toxicity and bioreactivity within the hand have not been thoroughly investigated. This is the first report of the successful surgical treatment of a retained rare earth neodymium magnetic hand mass.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Imaging Follow-up of Pediatric Transphyseal Anterior Cruciate Ligament
           Reconstruction: A Case Report

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      Authors: Maupoint; Estelle; Vial, Julie; Simon, Sophie; Gauthier, Léa; Accadbled, Franck
      Abstract: imageCase: We are reporting on the x-ray and magnetic resonance imaging (MRI) follow-up of an 8-year-old boy who underwent transphyseal anterior cruciate ligament reconstruction with a 4-strand semitendinosus tendon graft. His graft was followed for 5 years by MRI, demonstrating a satisfactory but slow and gradual ligamentization process.Conclusion: The long-term MRI follow-up demonstrated the satisfactory outcome of the transphyseal reconstruction, although with a slower and more progressive ligamentization process than in adult patients.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Radial Forearm Vascularized Osteomuscular Flap for Proximal Ulnar
           Deficiency After Revision Total Elbow Arthroplasty: A Case Report

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      Authors: Hill; J. Ryan; Boyer, Martin I.; Chamberlain, Aaron M.
      Abstract: imageCase: A 61-year-old woman presented with a failed proximal ulna allograft-prosthetic composite after revision total elbow arthroplasty (TEA). The ulnar deficiency was addressed using an osteomuscular flap from the distal radius pedicled on the radial artery. At final follow-up, she had minimal pain and a flexion-extension arc of 0° to 130°. Radiographs demonstrated graft incorporation and a stable TEA construct.Conclusion: This demonstrates utilization of a vascularized osteomuscular flap from the radius for treatment of proximal ulnar deficiency in the setting of revision TEA. This technique offers an alternative option for the challenge of a failed TEA with ulnar bone loss.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Compartment Syndrome Secondary to Intraosseous Access Abutting Tibial Stem
           Cement Mantle of a Total Knee Arthroplasty: A Case Report

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      Authors: Chughtai; Morad; Pang, Aaron; Khan, Taiba; Cantrell, William C.; Mesko, Nathan W.; Kamath, Atul F.
      Abstract: imageCase: A 79-year-old man 6 days status-post left total knee arthroplasty (TKA) presented to our institution from an outside hospital (OSH) after a suspected STEMI and ventricular fibrillation arrest. At the OSH, intraosseous (IO) access was placed in his right tibia. Orthopaedics was consulted for compartment syndrome at the IO access site. X-rays demonstrated this was secondary to the IO access abutting the cement mantle of a stemmed tibial component of a remote TKA, for which the patient required emergent fasciotomies.Conclusions: Healthcare providers should be cognizant of potential orthopaedic hardware that can impede proper introduction of IO access.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Spondylolysis of the Thoracic Spine with Instability: A Rare Cause for
           Myelopathy

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      Authors: Ramachandran; Karthik; Viswanathan, Vibhu Krishnan; Kavishwar, Rohit Akshay; Shetty, Ajoy Prasad; Shanmuganathan, Rajasekaran
      Abstract: imageCase: A 51-year-old lady with multiple comorbidities presented with T11 spondylolysis in association with thoracic stenosis and myelopathy. Our patient underwent T11-T12 laminectomy, T10-L1 posterior instrumented stabilization, and T11-T12 transforaminal interbody fusion. She had a good neurological recovery, and the radiographs at 1-year follow-up showed good fusion and implant position.Conclusion: Spondylolysis is an anatomical defect or stress fracture of the pars interarticularis and usually reported in the lumbar region. This case of T11 spondylolysis in association with thoracic stenosis, spinal instability, and myelopathy is highlighted for its rarity and to reiterate the need for high index of suspicion among surgeons for the timely diagnosis.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • High Median Nerve Entrapment by Fracture Callus in Surgically Treated
           Pediatric Supracondylar Humeral Fracture: A Case Report

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      Authors: Yano; Koichi; Ishiko, Megumi; Iida, Ken; Sasaki, Kosuke; Kojima, Takahito; Kaneshiro, Yasunori; Sakanaka, Hideki
      Abstract: imageCase: We describe a patient with incomplete high median nerve palsy after surgical treatment of pediatric supracondylar humeral fracture (SCHF). Preoperative images after 11 months after the surgical treatment of the SCHF showed rotational deformity and an isolated median nerve entrapped between the proximal humerus anteriorly and callus posteriorly in the bony tunnel of the distal humerus. Two years after neurolysis, he showed clinical recovery. Four cases similar to our case were reported previously.Conclusion: Common pediatric fractures may cause unusual neuropathy. Rotational deformity of fracture might be an important factor for isolated median nerve entrapment after SCHF.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Unusual Presentation of a Clavicle Fracture Locked Under the First Rib
           with Global Brachial Plexus Injury: A Case Report

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      Authors: Babu; T. Shanmukha; Devendra, Agraharam; Venkatramani, Hari; Bharadwaj, Praveen; Dheenadhayalan, Jayaramaraju; Rajasekaran, Shanmuganathan
      Abstract: imageCase: Thoracic penetration of the medial half of clavicle fracture is rare and can be life-threatening and limb-threatening because of its proximity to the pleura and neurovascular structures. We report an unusual presentation of the medial portion of clavicle fracture locked under the first rib associated with the pneumothorax and global brachial plexus palsy successfully reduced by gentle manipulation. Partial injury to the subclavian vein was repaired. Nerve transfer was performed for brachial plexus palsy. The patient showed good functional recovery.Conclusion: Reduction of locked intrathoracic clavicle fracture was performed safely by gentle manipulation. Subsequent appropriate interventions for the brachial plexus palsy led to a good outcome.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Acute Cauda Equina Syndrome Due to Spondylolisthesis in the Midst of a
           Pandemic: A Case Report

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      Authors: Isakov; Aleksandr; Yanamadala, Vijay; Yassari, Reza; Udemba, Adaobi; Shaparin, Naum; Hascalovici, Jacob R.
      Abstract: imageCase: A 54-year-old woman with chronic lumbar radiculopathy due to grade II spondylolisthesis at lumbar 4 to 5 developed acute cauda equina syndrome (CES) after an elective lumbar decompression, and fusion was delayed because of statewide bans on elective procedures during the pandemic. The diagnosis was made largely through telehealth consultation and eventually prompted urgent neurosurgical intervention.Conclusion: This case report illustrates a rare presentation of acute CES and highlights some of the challenges of practicing clinical medicine in the midst of a pandemic.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Bilateral Quadriceps Tendon Rupture and Femoral Neck Fracture After
           Generalized Tonic-Clonic Seizures: A Case Report

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      Authors: Örgel; Dr. Marcus; Ranker, Dr. Alexander; Wirries, Dr. Nils; Krettek, Professor Dr. Christian; Clausen, Dr. Jan-Dierk; Mommsen, Professor Dr. Philipp
      Abstract: imageCase: We report on a 19-year-old male renal transplant patient with multiple medical issues who sustained simultaneous bilateral quadriceps tendon ruptures and bilateral femoral neck fractures after 2 generalized tonic-clonic seizures. The quadriceps tendon ruptures were detected early surgically repaired; the femoral neck fractures were not detected and managed with bilateral total hip arthroplasty for almost 2 weeks.Conclusion: Tonic-clonic seizures can be associated with unique and complex acute orthopaedic injuries that can be initially missed. Physicians should be cognizant of the need for a thorough medical history and physical examination to avoid orthopaedic postseizure missed diagnoses.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Post-traumatic Radioulnar Synostosis in Distal Forearm Fractures in
           Children: A Report of 2 Cases

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      Authors: Gounot; Alexandre; Simon, Anne-Laure; Dizin, Frédérique; Chinnappa, Jason; Mas, Virginie; Jehanno, Pascal
      Abstract: imageCases: Two pediatric cases of post-traumatic distal radioulnar synostosis are reported, accompanied by a literature review summarizing evidence on the management of these conditions. Radioulnar synostosis is a rare complication of distal forearm fractures, which impairs upper-extremity function. The numerous surgical procedures that have been described to treat this condition in adults typically involve synostosis resection and an interposition graft to reduce recurrence. The optimal treatment in children has not been established.Conclusions: Post-traumatic radioulnar synostoses are rare conditions in pediatric patients who can be successfully treated with surgical excision of the synostoses and without the use of interposition grafting.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Open Reduction and Internal Fixation of Pediatric Scapula Fractures: A
           Report of 2 Cases

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      Authors: Schultz; Blake J.; Davis, Elizabeth P.; Chang, Gerard; Ward, Norman H.; Berkes, Marschall; Choo, Andrew M.
      Abstract: imageCase: Two pediatric patients with displaced, extra-articular scapula fractures who underwent surgery because of concerns for persistent deformity and decreased function with continued nonoperative management.Conclusion: We advocate careful consideration of all patient factors and treatment options when addressing pediatric scapula fractures. Specific fracture patterns with altered shoulder girdle mechanics may warrant surgical intervention to restore anatomic alignment and stability.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Spinal Epidural Hematoma Producing Neural Compression After Bilateral Rod
           Fractures in Failed Long-Construct Fusion: A Case Report

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      Authors: Xu; Amy L.; Mo, Kevin C.; Babu, Jacob M.; Neuman, Brian J.
      Abstract: imageCase: A 75-year-old woman with remote history of T10-S1 spinal fusion with pelvic fixation presented with radicular back pain and numbness in the right lower extremity. Imaging showed bilateral rod fractures at L4-5 and a dorsal spinal epidural hematoma (SEH) with associated severe canal narrowing and cauda equina compression. The patient underwent bilateral L4-5 laminectomies, hematoma evacuation, reinforcement of multilevel nonunion, and implant replacement. Her symptoms resolved after the procedure.Conclusion: SEH is a rare complication that may occur secondary to failed spinal fusion and must be considered in the differential diagnosis of new or progressive neurological symptoms.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Paralysis: A Rare Presentation of Lemierre's Syndrome: A Case Report

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      Authors: McGovern; Madeline; Fried, Tristan Blase; Mangan, John; Hilibrand, Alan S.
      Abstract: imageCase: A patient presented with acute paralysis in the setting of undiagnosed Lemierre's syndrome. Streptococcus pyogenes was the causative organism leading to internal jugular vein thrombosis, sternocleidomastoid abscess, vertebral osteomyelitis, and epidural phlegmon. The patient was treated both surgically, with abscess evacuation, hemicorpectomy, and fusion, and medically, with antibiotics and anticoagulation. Postoperatively, the patient regained upper extremity strength and lower extremity sensation, but the paraplegia remained.Conclusion: Lemierre's syndrome is a rare complication of oropharyngeal infection with a constellation of findings including jugular thrombophlebitis, metastatic abscesses, and frequent involvement of anaerobic pathogens that may present acutely with paralysis.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Synchronous Primary Multifocal Skeletal Chondrosarcoma of Extremity: A
           Report of 2 Cases

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      Authors: Paul; Manu; Sugath, Bhaskar Subin; P, Shivanesan; NP, Prakash; Nair, Sreejith G.; Rajasekharan, Rani
      Abstract: imageCase: Multifocal synchronous primary skeletal chondrosarcomas of an extremity are rarely reported. In this study, we report 2 such cases. The first case is a 32-year-old woman who presented with extensive right femoral and tibial diaphysis lesions. The second case is a 36-year-old woman with lesions in the left proximal humerus, the coracoid process of scapula and sternum. Both patients underwent limb salvage surgery and were disease-free at the 38- and 20-month follow-up.Conclusion: Athough rare, the possibility of multifocal chondrosarcoma should be kept in mind during the workup of a patient with chondrosarcoma.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • A Displaced Double-Layered Meniscus in a Caucasian Patient: A Case Report

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      Authors: Fraticelli; Nicole C.; Prough, Haley A.; Wilcox, C. Luke
      Abstract: imageCase: Double-layered menisci are a rare anatomical variant, with cases identified predominantly in Asian populations. We present a case of Caucasian woman with a double-layered lateral meniscus, in which the accessory lateral meniscus had displaced into the intercondylar notch causing feelings of instability within the right knee. The accessory lateral meniscus was removed through arthroscopic surgery, and the patient had complete resolution of her symptoms postoperatively.Conclusion: Double-layered menisci can present similar to bucket-handled meniscus tears if the accessory meniscus displaces into the intercondylar notch. Arthroscopic debridement can be effective at improving clinical symptoms for these patients.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Delayed Presentation of Sciatic Nerve Injury with Gap: A Case Report with
           a Unique Solution from the Past

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      Authors: Acharya; Ashwath M; Bhat, Anil K; Jyothish, Gayathri; Mukadam, Aditya
      Abstract: imageCase: A 35-year-old farmer presented with a foot ulcer on his left flail foot because of a sciatic nerve injury of 1-year duration. A gap of 11 cm was observed in the sciatic nerve for which he underwent 2-staged pedicled peroneal nerve grafting and posterior bone block procedure for the ankle. He had S3 grade sensation at 5-year follow-up without any recurrence of ulcer and a stable foot without external support for walking.Conclusion: Staged pedicled peroneal nerve grafting with a posterior bone block procedure is a viable solution for very large sciatic nerve defect with predictable results.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Subacute Posttraumatic Ascending Myelopathy: A Rare Complication After
           Thoracolumbar Spinal Cord Injury: A Case Report

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      Authors: Basu; Saumyajit; Gohil, Kushal; Sarangi, Trinanjan
      Abstract: imageCase: A 45-year-old man presented with posttraumatic fracture-dislocation of T11/12 with neurological level T8 AIS A. Sensory level progressed to T4 in the next day morning. He underwent T10, T11, T12, and L1 percutaneous pedicle screw-rod fixation. Postoperatively, there was rapid worsening of his neurology and within 48 hours, he became tetraplegic with neurological level C2 with respiratory paralysis requiring mechanical ventilation. He died on the 14th postoperative day. Clinicoradiological findings were consistent with subacute posttraumatic ascending myelopathy (SPAM).Conclusion: Surgeons must be vigilant in days and weeks after spinal cord injury for early recognition and management of SPAM. Treatment guidelines are uncertain and yet to be developed.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Radial Wrist Extensor Tendon Entrapment in Volarly Displaced Distal Radius
           Fracture: A Report of 2 Cases

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      Authors: Amemiya; Tsuyoshi; Okazaki, Masato; Kato, Tomoyuki; Tazaki, Kenichi
      Abstract: imageCase: We experienced 2 cases of these entrapments. In the first case, the entrapment was identified immediately and treated successfully. In the second case, the entrapment was diagnosed after union when the disturbance of wrist flexion became apparent.Conclusion: When there is a longitudinal fracture line at the vicinity of the second compartment, the entrapment of extensors should be suspected even when acceptable overall alignment is accomplished.Entrapment of extensor pollicis longus, indicis proprius, and digitorum communis tendons in volarly displaced distal radius fracture has been previously reported. However, to the best of our knowledge, the entrapment of extensor carpi radialis brevis and longus tendons has not been reported.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Transverse Rectus Abdominis Muscle Flow-Through to Free Fibula Flap for
           Lumbar Spinal Reconstruction in a Pediatric Patient: A Case Report

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      Authors: Moores; Neal G.; Luo, Jessica; Pires, Giovanna; Moss, Whitney; Short, Scott; Bollo, Robert J.; Randall, R. Lor; Agarwal, Jayant P.
      Abstract: imageCase: A 7-week-old girl presented with a recurrent primitive myxoid mesenchymal tumor of infancy requiring extensive resection of lower back musculature, L3–S2 vertebral bodies, and left L5 nerve root. Reconstruction consisted of transverse rectus abdominis muscle (TRAM) flow-through to free fibular flap to reconstruct the bony defect and fill the soft-tissue void. One-year postoperative imaging revealed a well-incorporated fibula graft. At the 30-month follow-up, the patient can bear weight on the autograft while sitting upright, allowing for efficient ambulation with a wheelchair.Conclusion: TRAM flow-through to free fibular flap is an efficacious reconstructive method for a multilevel vertebral spinal defect in a pediatric patient.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Osteonecrosis with Concomitant Bacterial Osteomyelitis of Both Hips and a
           Knee in a Post–COVID-19 Patient: A Case Report

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      Authors: Jain; Sanjeev; Sawant, Tushar
      Abstract: imageCase: We report the case of a coronavirus disease 2019 (COVID-19)-recovered, 42-year-old man with osteonecrosis and concomitant acute bacterial osteomyelitis of both hips and his left knee. The patient underwent total hip replacement for both hips and arthroscopic decompression and synovectomy of the knee joint. On follow-up, he has complete and painless range of motion with resolving osteomyelitis and no signs of active infection.Conclusion: Corticosteroid therapy and COVID-19–associated thrombotic microangiopathy might have caused osteonecrosis in our patient. However, concomitant osteomyelitis is extremely rare and might be overlooked because of elevated inflammatory markers after recovery from COVID-19 infection.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Diffuse Idiopathic Skeletal Hyperostosis Combined with Thoracic Spinal
           Stenosis Treated by Endoscopic Surgery: A Case Report

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      Authors: Liu; Guang-pu; Wang, Zhen-fei; Han, Meng; Zhang, Jian-wei; Liu, Lei; Xu, Qiang; Ma, Chao; Liu, Guang-wang
      Abstract: imageCase: A 48-year-old man presented to our facility with debilitating motor and sensory symptoms due to advanced T10-11 thoracic spinal stenosis secondary to diffuse idiopathic skeletal hyperostosis (DISH). The patient's condition was addressed with endoscopic spine surgery through a yet-to-be-reported interlaminar approach, and at the 12-month follow-up, his neurologic function was significantly improved.Conclusion: Select patients with symptomatic thoracic spinal stenosis secondary to DISH can be effectively managed with endoscopic spine surgery through an interlaminar approach by clinicians with extensive endoscopic spine experience.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • “Floating Hip” and “Floating Knee” Associated with Hip
           Dislocation, Sciatic Nerve Palsy, and Patella Fracture: A Case Report

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      Authors: Saini; Mukesh Kumar
      Abstract: imageCase: We report a very rare case of simultaneous ipsilateral floating hip and floating knee (SIFHFK) injury with the neck of the femur and patella fracture and hip dislocation associated with sciatic nerve injury in a 45-year-old man after a road traffic accident. We adopted a staged approach for surgical fixation of the fractures after stabilization. At the latest 2 years follow-up, the patient was asymptomatic with satisfactory clinical outcome.Conclusion: SIFHFK injuries present a challenging and emergent clinical scenario and require extensive clinical experience, careful planning, and multidisciplinary teamwork because of the paucity of specific treatment protocols for the treatment of this complex injury.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Treatment of Subchondral Bone Marrow Edema with Intralesional Viscous Bone
           Cement in a Young, Active Patient: A Case Report

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      Authors: Vander Molen; Jonathan; Berlinberg, Elyse J.; Forsythe, Brian
      Abstract: imageCase: A 23-year-old male patient presented with symptomatic, high-grade medial tibial plateau bone marrow edema unresponsive to conservative treatment. After the injection of intralesional viscous bone cement, the patient had resolution of his symptoms and returned to running.Conclusion: The use of intralesional viscous bone cement has grown in popularity for the treatment of bone marrow edema in individuals older than 40 years but is uncommon in younger individuals. This case demonstrates that intralesional viscous bone cement may be considered in the treatment of high-grade bone marrow edema in young, active patients who are unresponsive to extensive conservative management.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Bilateral Pseudoarthrodesis: A Case Report of Complex Bilateral Total Knee
           Replacement for a Severe Hemophilia A Patient with Inhibitors

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      Authors: Assi; Hussein; Massé, Vincent; Saint-Yves, Hugo; Barry, Janie; St-Louis, Jean; Isler, Marc
      Abstract: imageCase: We present a severe hemophilia A patient with high titers of inhibitors presenting stage IV knee arthropathy with functional bilateral arthrodesis. On presentation, his mode of ambulation was to project himself forward without the benefit of any significant ankle motion. Total knee arthroplasty was performed on both knees and allowed significant improvement in the range of motion of both knees from 5° to 100°.Conclusion: Although hemophilic patients with inhibitors can represent complex cases, successful outcomes can be achieved in a multidisciplinary team setting. However, we would recommend performing this type of surgery at an earlier stage when less extensive muscle and tendon release is required.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Two-Staged Total Knee Arthroplasty in Juvenile Rheumatoid Arthritis with
           Severe Flexion Deformity: A Case Report

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      Authors: Vecham; Ratnakar; Annapareddy, Adarsh; Hippalgaonkar, Kushal; Bhushan, Chandra; Pawar, Sawankumar; Reddy, A.V. Gurava
      Abstract: imageCase: Juvenile rheumatoid arthritis (JRA) is associated with severe flexion contracture of the knees disabling a patient's ability to walk. Although various treatment modalities are available in the literature, we report a 2-stage procedure in a case of a 22-year-old female JRA patient with bilateral severe flexion deformity of the knee: stage 1—correction of the flexion contracture deformity by ring fixators and stage 2—total knee arthroplasty (TKA) for arthritis. To the best of our knowledge, no such approach has been reported previously.Conclusions: An Ilizarov ring fixator is a safe technique for gradual correction of a severe flexion deformity. Subsequent TKA can be performed as a standard procedure.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Pediatric Lyme Disease Presenting as a Ruptured Popliteal Cyst: A Report
           of 3 Cases

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      Authors: Sager; Alora F.; Carolan, Patrick L.; Georgiadis, Andrew G.; Laine, Jennifer C.
      Abstract: imageCases: This case report describes 3 pediatric patients presenting with acute calf or knee pain, calf swelling, and a ruptured popliteal cyst diagnosed by magnetic resonance imaging. Lyme disease was serologically confirmed in each case. In all instances, treatment was delayed because of atypical presentation. All patients responded favorably after antibiotic therapy.Conclusion: The differential diagnosis of Lyme disease should be considered in the context of children presenting with atraumatic unilateral calf pain and a ruptured popliteal cyst. Otherwise, this unusual presentation could delay diagnosis or result in unnecessary surgical intervention, particularly in pediatric patients.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Intraoperative Anaphylaxis to the Bovine Flowable Gelatin Matrix: A Report
           of 2 Cases

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      Authors: Coury; Josephine R.; Skaggs, Kira F.; Marciano, Gerard F.; Pinyavat, Teeda; Naseef, Mervat; Roye, Benjamin D.; Vitale, Michael G.
      Abstract: imageCase: We present 2 cases of life-threatening intraoperative anaphylaxis to the bovine flowable gelatin matrix during pediatric spinal deformity surgery for kyphoscoliosis. Both patients had no known bovine or gelatin allergies. Anaphylaxis occurred shortly after pressurized injection into the first cannulated pedicle tract and was successfully treated with epinephrine, diphenhydramine, and methylprednisolone infusion. The allergic reaction was confirmed with tryptase levels and serum-specific immunoglobulin E for beef, pork, bovine collagen, and porcine collagen.Conclusion: In patients with beef, pork, or gelatin intolerance, a significant atopic history or childhood vaccine reaction, preoperative allergy consultation, and testing should be performed to prevent this life-threatening complication.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Adolescent Quadriceps Tendon Rupture, an Early Complication After ACL
           Reconstruction: A Case Report

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      Authors: Gawel; Richard J.; Kemler, Bryson R.; Rao, Somnath; Otlans, Peters T.; Salvo, John P.
      Abstract: imageCase: A healthy adolescent male patient initially presented with complete rupture of the anterior cruciate ligament (ACL) after a plant-twist injury during a high school football game. Four weeks after ACL reconstruction with autograft bone-patella tendon-bone, the patient slipped and fell, sustaining hyperflexion of the knee, resulting in rupture of the ipsilateral quadriceps tendon.Conclusion: Although this rare complication has previously been reported in the adult population, to the best of our knowledge, this is the first known report of an adolescent patient sustaining a quadriceps tendon rupture after ACL reconstruction.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Acute Well-Leg Compartment Syndrome After Meniscal Allograft
           Transplantation and Revision ACL Reconstruction: A Case Report

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      Authors: Markus; Danielle H.; Mojica, Edward S.; Blaeser, Anna M.; Avila, Amanda; Strauss, Eric J.
      Abstract: imageCase: A 17-year-old adolescent boy presented with continued knee pain, swelling, and mechanical symptoms after anterior cruciate ligament (ACL) reconstruction with partial meniscectomy. The patient eventually underwent ACL revision surgery that was without complications. Postoperatively, the well leg grew firm with associated neurological deficits, and physical examination confirmed compartment syndrome of the lower leg compartments that resolved with emergency fasciotomy. The patient proceeded on normal postoperative course.Conclusion: Compartment syndrome of the well leg is a rare complication in the field of sports medicine, owing to the relatively healthy and young demographic, but providers should nonetheless be vigilant to prevent disastrous sequalae.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Traumatic Fibular Loss Managed with a Free Vascularized Fibular Graft: A
           Case Report

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      Authors: Hartnett; Davis A.; Milner, John D.; Salameh, Motasem; Got, Christopher J.; Blankenhorn, Brad D.
      Abstract: imageCase: A 25-year-old man involved in a jet skiing accident experienced a traumatic excision of his distal fibula in conjunction with other lower extremity injuries. He subsequently underwent a reconstruction of his lateral malleolus using an ipsilateral free vascularized fibular graft (FVFG) from his proximal fibular shaft, resulting in a preserved and stabilized ankle joint at 1 year.Conclusion: Traumatic distal fibular excision is a rare injury that can be successfully managed using an FVFG, with fusion of the distal syndesmosis and a symmetric ankle mortise observed at the 1-year follow-up.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Bone Block Grafting for Posterior Instability After Anatomical Total
           Shoulder Arthroplasty: A Case Report

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      Authors: Matsumoto; Ryo; Matsumura, Noboru; Furuhata, Ryogo; Kimura, Hiroo; Suzuki, Taku; Iwamoto, Takuji; Matsumoto, Morio; Nakamura, Masaya
      Abstract: imageCase: A 60-year-old woman with avascular necrosis of the right humeral head underwent anatomical total shoulder arthroplasty (TSA); however, recurrent posterior dislocation occurred 13 months postoperatively. We performed bone block grafting of an autologous iliac crest to the posterior glenoid and posterior capsular plication, after which satisfactory postoperative shoulder function without residual joint instability was achieved.Conclusion: The presented case had recurrent posterior dislocation after TSA without any abnormal findings in the prosthetic components. Posterior bone block grafting with capsular plication should be considered a viable option for posterior instability after anatomical TSA.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Arthroscopy and Micronized Allogenic Cartilage Matrix Grafting for a
           Missed Talus Nonunion: A Case Report

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      Authors: Mathew; Justin; Mahjoub, Adel; Freeland, Erik
      Abstract: imageCase: A 33-year-old man who had experienced polytraumatic injury from a motorcycle collision 5 months previously presented to the clinic with right ankle pain. On physical examination, anterior ankle tenderness was present, and imaging revealed a previously unrecognized nondisplaced talar body fracture with a chondral defect. The patient underwent arthroscopy of the right ankle, which influenced the senior author to perform a medial malleolar osteotomy and subsequent open reduction internal fixation with micronized allogenic cartilage matrix.Conclusion: Arthroscopy provides valuable information for the surgical planning of talar nonunions, and allogenic cartilage matrix graft may provide benefit with associated chondral defects.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Nonabsorbable Suture of a PCL Allograft Resulting in a Squeaking Knee
           After PCL Reconstruction: A Case Report

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      Authors: Amin; Omar A.; Alzahrani, Khalid H.; Basaqr, Abdulaziz A.; Tayeb, Mazen M.
      Abstract: imageCase: This case report describes the occurrence of a squeaking knee joint on active flexion-extension in a 35-year-old man who had previously undergone posterior cruciate ligament (PCL) reconstruction surgery. The patient suffered from psychosocial distress because of the noise and complained of persistent left knee pain. After nonsurgical treatment failed to resolve the noise, arthroscopic surgery was performed to debride the interposed nonabsorbable suture located on the intra-articular surface, resulting in squeaking sound elimination.Conclusion: Surgery was necessary to alleviate a squeaking knee joint caused by interposed nonabsorbable sutures after PCL reconstruction in this patient.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Necrotizing Fasciitis of the Hand After a Prolonged Endodontic Procedure:
           A Case Report

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      Authors: Bradley; Eric; Werntz, Ryan; Cappelleti, Giacomo; Hoffler, Charles Edward II
      Abstract: imageCase: In this article, we present a case report of a patient with limited medical history and without apparent local injury, who developed left hand Group A Streptococcus-induced necrotizing fasciitis after undergoing a prolonged endodontic procedure.Conclusion: In addition to host factors, perhaps, the virulence of the bacteria present in the oropharynx and the expected bacterial load based on the length and complexity of a dental procedure need to be considered when deciding on whether or not to administer prophylactic antibiotics to patients undergoing dental procedures.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Iliopsoas Hematoma After Total Hip Arthroplasty Using a Minimally Invasive
           Modified Direct Anterior Approach: A Case Report

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      Authors: Fernández Palomo; Luis Justino; González Pola, Ramón; Castillo Vázquez, Francisco Guillermo
      Abstract: imageCase: The modified direct anterior approach (MDAA) is a recently popular surgical technique for total hip arthroplasty (THA), with well-documented challenges. Characterized as acute hip and back pain, we present the case of a 78-year-old woman who developed an iliopsoas hematoma after an MDAA THA and discuss the management of this incident.Conclusions: Iliopsoas hematoma after THA poses a unique challenge and should be considered in patients with acute hip and back pain, with loss of strength on the affected limb after an MDAA THA.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Effect of Denosumab on Bone Health in Adult Patients with Duchenne/Becker
           Muscular Dystrophy: A Report of 2 Cases

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      Authors: Hung; Chermaine; Mathews, Katherine D.; Shibli-Rahhal, Amal
      Abstract: imageCase: Duchenne/Becker muscular dystrophy (DMD/BeMD) is caused by a loss of dystrophin leading to muscular weakness. Glucocorticoids are used to delay loss of muscle strength but frequently result in osteoporosis and fractures. Bisphosphonates are the drug of choice, and there are limited data on the efficacy of denosumab. We describe 2 patients who were treated with denosumab and had stable to improved bone density with no side effects.Conclusion: Denosumab can be considered for the treatment of osteoporosis in adults with DMD/BeMD, especially when the response to bisphosphonates is not satisfactory.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Congenital Elbow Dislocation: A Case Report

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      Authors: Agrawal; Alok Chandra; Inamdar, Anupam Pradip; Garg, Ankit Kumar; Choudhary, Ranjeet
      Abstract: imageCase: We present a case of a 12-day-old male baby who presented with right elbow deformity and inability to flex the elbow. Radiographs and computed tomography scan of the elbow revealed loss of humeroulnar alignment, superior migration of olecranon, and posteromedial displacement, suggesting an elbow dislocation. The child was successfully managed with open reduction and Kirschner wire fixation of the elbow joint. At 1-year follow-up, the child has a well-reduced and stable elbow joint with a functional range of movements.Conclusion: Congenital dislocation of the ulnohumeral joint can occur because of hypoplasia of the skeletal components or tissue interposition within the joint articulation.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Double Level Osteotomy in an Overcorrected Distal Femoral Varisation
           Osteotomy: A Case Report

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      Authors: N; Nizaj; N, Sukesh A.; Jacob, Bobby; George, Bibu; Kandathil, Julio C.; Theruvil, Bipin
      Abstract: imageCase: We report a patient who was diagnosed with idiopathic genu valgum at the age of 11 years and underwent bilateral distal femur osteotomies. At age 30 years, she presented with pain around her right knee with a varus deformity. Although the corrective osteotomy was at the distal femur, she was noticed to have a bifocal deformity in both femur and tibia. She was managed with single-stage osteotomies at the distal femur and proximal tibia.Conclusion: This case report highlights the importance of preoperative analysis to identify the site of deformity. In bifocal pathology, a 2-level osteotomy is required to prevent an oblique joint line.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • High-Grade B-Cell Lymphoma of the Sciatic Nerve That Mimicked a
           Schwannoma: A Case Report

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      Authors: Richards; Alexandra R.; Lee, Linus; Gusho, Charles; Blank, Alan T.
      Abstract: imageCase: A 41-year-old woman with a history of high-grade B-cell lymphoma status-post chemotherapy was evaluated for a painful left posterior thigh mass and significant weakness with sensory changes. Imaging revealed a benign-appearing mass consistent with schwannoma; however, intraoperative frozen section suggested high-grade B-cell lymphoma. Subsequent restaging studies revealed metastatic disease.Conclusion: A history of lymphoma warrants careful investigation of a posterior thigh mass, despite imaging findings consistent with nerve sheath tumor. Surgical removal of lymphomas of the nerve often proves futile, so these lesions are usually managed with medical treatment or radiation.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Patellar Stress Fracture After Suture Anchor Patellar Tendon Repair in an
           Active Duty Military Member: A Case Report

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      Authors: Murphy; Timothy P.; Mescher, Patrick K.; Tucker, Christopher J.
      Abstract: imageCase: A 31-year-old US service member presented with a patellar tendon tear that was repaired acutely with 2 biocomposite suture anchors. He presented more than 2 years later with a stress fracture through a suture anchor drill hole and was treated with partially threaded screw fixation.Conclusion: Stress fracture through a suture anchor drill hole after patellar tendon repair is a previously unreported complication. Surgeons should have a high index of suspicion and low threshold to obtain advanced imaging in cases of unexplained pain after patellar tendon repair.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Profound Hypercalcemia Associated with Acute Toxic-Metabolic
           Encephalopathy After Calcium Sulfate Bead Use: A Case Report

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      Authors: Sabharwal; Samir; Schmerler, Jessica; Thakkar, Savyasachi C.
      Abstract: imageCase: We present the case of an 81-year-old woman who developed profound hypercalcemia requiring admission to the intensive care unit after calcium sulfate bead use during revision hip arthroplasty. The patient's serum calcium level peaked at 21.0 mg/dL and was associated with acute encephalopathy. After treatment with calcitonin and bisphosphonates, her serum calcium level normalized and her mentation improved.Conclusion: The risk of clinically significant hypercalcemia should be considered when using calcium sulfate during orthopaedic surgery.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
  • Novel Technique for Percutaneous Reduction of Displaced LCII Pelvic Ring
           Injury: A Case Report

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      Authors: Chen; Michael J.; Kleweno, Connor P.; Firoozabadi, Reza
      Abstract: imageCase: We present a case report of an elderly patient with a displaced lateral compression type II pelvic ring injury and describe a novel technique for maintaining a percutaneously obtained reduction during percutaneous fixation using a supra-acetabular Schantz pin attached to a mechanical limb positioner.Conclusion: The mechanical limb positioner used allows the surgeon to hold a multidirectionally obtained reduction of the hemipelvis with ease.
      PubDate: Sat, 01 Jan 2022 00:00:00 GMT-
       
 
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