This previously unobserved knee injury triad was successfully treated arthroscopically, dispensing with the need for a posterior surgical approach. Aggressive range of motion exercises, combined with early post-operative weight-bearing, played a crucial role in the speedy recovery and positive outcome.
There can be significant complications associated with the intramedullary nail's incarceration. Many documented nail removal strategies exist, yet when these fail to achieve the desired outcome, it can be challenging to determine the optimal procedure. A proximal femoral episiotomy demonstrates remarkable efficacy in this context.
Arthritis of the hip was diagnosed in a 64-year-old male. The patient's existing antegrade femoral nail, implanted 22 years before, needed removal due to the planned hip arthroplasty. Good results and a positive patient outcome were achieved through a proximal femoral approach, assisted by episiotomy.
Trauma surgeons should readily recognize and utilize the multitude of meticulously described techniques for assisting with the removal of an embedded nail. A proximal femoral episiotomy, a technique beneficial in various situations, should be mastered by all surgeons.
The extraction of incarcerated nails relies on several thoroughly described techniques, each of which every trauma surgeon should understand. The implementation of proximal femoral episiotomy, a valuable technique, is crucial for any surgeon's comprehensive skill set.
Ochronosis, a rare syndrome, is characterized by the abnormal accumulation of homogentisic acid in connective tissues, brought about by a deficiency of homogentisic acid oxidase. Sclera, ear cartilage, and joint synovium, displaying blue-black pigmentation, are indicative of connective tissue damage, causing destruction of joint cartilage and early arthritis onset. With extended stillness, the color of urine deepens to a dark shade. Heart valve deposits of homogentisic acid can trigger uncommon cardiac problems in certain patients.
A 56-year-old female patient, having experienced a fall at home, was admitted with a fractured neck of the femur. The patient consistently experienced the debilitating effects of chronic backache and knee pain. Severe arthritic modifications were apparent on the plain radiographs of the knee and spine. Exposure to the surgical site was impeded by the hard and brittle tendons and joint capsule. The femur head and acetabulum cartilage displayed a dark brown appearance. During the postoperative clinical assessment, the sclera and hands displayed a dark brown pigmentation.
Early osteoarthritis and spondylosis in patients with ochronosis warrant a careful differential diagnosis from other early arthritis conditions, such as rheumatoid arthritis and seronegative arthritis. Pathological fracture is a consequence of the breakdown of joint cartilage and the weakening of subchondral bone. A substantial obstacle to surgical exposure arises from the rigidity of soft tissues situated around the joint.
Differentiating early osteoarthritis and spondylosis, which commonly occur in ochronosis patients, from other early arthritis causes, including rheumatoid and seronegative arthritis, is crucial. A cascade of events, starting with joint cartilage destruction and progressing to subchondral bone weakening, causes pathological fractures. The demanding aspect of surgical exposure arises from the firmness of the tissues surrounding the joint.
Shoulder instability, directly linked to the impaction of the humeral head, can lead to a coracoid fracture. The frequency of coracoid fracture in conjunction with shoulder dislocation is low, somewhere between 0.8 and 2 percent of affected individuals. We were confronted with a unique clinical presentation involving both shoulder instability and a coracoid fracture. The treatment of this issue is detailed in this technical note.
A 23-year-old male, experiencing repeated shoulder dislocations, suffered a coracoid fracture. A 25% glenoid defect was identified in the subsequent evaluation. The magnetic resonance imaging procedure revealed a lesion on the track of the humeral head, incorporating a 9mm Hill-Sachs lesion and an anterior labral tear, with no associated rotator cuff tear. Using an open Latarjet technique, a fractured coracoid fragment was grafted to the conjoint tendon in the patient's management.
This technical note describes a strategy for managing coracoid fractures and instability during a single operative session, capitalizing on the fractured coracoid fragment as an advantageous graft option in acute cases. Restrictions on the graft's dimensional characteristics and shape are among the practical considerations, which the operating surgeon must account for during the procedure.
This technical note aims to offer a solution for simultaneously addressing instability and coracoid fractures during a single procedure, highlighting the coracoid fragment's suitability as an excellent graft in acute cases. Despite this, certain constraints, including the graft's dimensional and morphological appropriateness, must be recognized by the operating surgeon.
A coronal plane fracture of the femoral condyles, known as a Hoffa fracture, is a relatively rare occurrence. The coronal fracture pattern creates difficulties in clinic-radiological assessment.
A 42-year-old male patient's right knee swelled and throbbed in pain after a mishap involving a two-wheeler. His general practitioner, failing to identify the Hoffa fracture on plain radiographs, responded with conservative treatment using analgesics, following his consultation. rhuMab VEGF Unable to find relief, he visited our emergency department, where a CT scan showed a Hoffa fracture of the lateral condyle. An open surgical procedure was performed on him, during which a lateral condylar fracture was repaired. Remarkably, an undisplaced medial condylar Hoffa fracture of the ipsilateral femur was concurrently discovered. The fracture went undetected in the initial CT scan image. Both fractures were stabilized by means of internal fixation, after which the patient was placed in a rehabilitation program. The patient's knee achieved a full range of motion at the conclusion of the six-month follow-up period.
Thorough CT scans, meticulously examining for fractures beyond the Hoffa area, are crucial to avoid overlooking any accompanying bone injuries. The surgeon undertaking open or arthroscopic fixation of a Hoffa's fracture has a responsibility to thoroughly investigate the possibility of additional bone trauma.
For comprehensive assessment, CT scans must meticulously examine for fractures, especially those not confined to the Hoffa region, thereby ensuring no associated bone injuries are missed. The treating surgeon, during either open or arthroscopic fixation of a Hoffa's fracture, should actively look for any other bony injuries.
Knee injuries, specifically anterior cruciate ligament (ACL) tears, are prevalent in contact sports due to the inherent risks. ACL reconstruction procedures recommend multiple techniques, coupled with a range of graft materials. Using hamstring tendon grafts, this study seeks to evaluate the functional results of arthroscopic single-bundle ACL reconstruction in adult patients with anterior cruciate ligament deficiency.
A prospective study, conducted at Thanjavur Medical College from 2014 to 2017, examined 10 patients presenting with anterior cruciate ligament deficiency. Employing the Lysholm, Gillquist, and IKDC-2000 scores, a preoperative evaluation was conducted for every patient. rhuMab VEGF All patients had arthroscopic single bundle ACL reconstruction using hamstring tendon grafts. Femoral fixation was accomplished via an endo-button CL fixation system and tibial fixation with an interference screw. A standard rehabilitation procedure was recommended to them. Employing the same assessment scales, all patients were evaluated post-surgically at 6 weeks, 3 months, 6 months, and one year.
For a period encompassing six months to two years, ten patients were eligible for follow-up care. The average period of follow-up was determined to be 105 months. Evaluating their knee function post-operatively versus their pre-operative assessments, it was determined that a clear improvement existed. Of the patients evaluated, 80% demonstrated results that were good to excellent, 10% had fair outcomes, and 10% experienced poor results.
Acceptable outcomes are achievable with arthroscopic single bundle reconstruction procedures for young, active individuals. Patients can benefit from arthroscopic methods to address their post-operative challenges. To evaluate the presence of any degeneration that might happen between the injury and ligament reconstruction, a substantial long-term follow-up of these instances is needed.
Young, active adults can experience favorable results with single-bundle arthroscopic reconstruction procedures. Arthroscopic procedures can resolve problems arising after surgery. It is vital to undertake a protracted follow-up of these cases to examine the development of any degeneration between the moment of injury and the ligament reconstruction procedure.
Childhood agricultural polytrauma injuries are infrequent. Rotavator blades' rotational force can lead to devastating and debilitating harm.
A 11-year-old male child presented with severe facial avulsion injuries, a degloving injury to the left lower limb, a grade IIIB compound fracture of the left tibia shaft with a substantial butterfly fragment, and a closed fracture of the right tibia shaft. Through tracheostomy intubation, the patient received general anesthesia. Under the skilled hands of a team of specialists, simultaneous surgeries were performed on the patient's face and limbs. Following debridement, the facial injury was repaired. rhuMab VEGF With the debridement complete, the compound fracture of the left tibia was stabilized using two interfragmentary screws and an external fixator spanning the ankle. A closed fracture of the right tibia's shaft was addressed using a closed, elastic intramedullary nail. Both thighs underwent simultaneous degloving injury debridement, followed by wound closure.