Journal of Orthopedics & Bone Disorders最新文献

{"title":"Reactivation of Dormant Tibial Methicillin- Resistant Staphylococcus aureus Osteomyelitis after 17 Years: A Case Report and Literature Review","authors":"C. Fryer","doi":"10.23880/jobd-16000223","DOIUrl":"https://doi.org/10.23880/jobd-16000223","url":null,"abstract":"Introduction: Staphylococcus aureus is the most common cause of osteomyelitis with significant morbidity and mortality outcomes. Methicillin-susceptible Staphylococcus aureus osteomyelitis reactivation years after the primary episode are a well-known phenomenon. However, there are few case reports documenting dormant Methicillin-Resistant Staphylococcus aureus osteomyelitis recurrence years later. Our case report of dormant Methicillin-Resistant Staphylococcus aureus tibial osteomyelitis reactivation after 17-years, represents one of the longest documented recurrence intervals from initial bout of Methicillin-Resistant Staphylococcus aureus , as well as, the diagnostic and therapeutic challenges involved. Case report: A 55-year-old male reports suffering a Gustilo & Anderson grade 1 open left tibial plafond fracture in 2004 that was managed with wound debridement and Taylor Spatial Frame. Initial management was with debridement and primary closure of the wound and application of a Taylor spatial frame (TSF) as definitive management of the fracture. One month following application of the frame, the patient reports he suffered a pin site infection. This was found to be infected osteomyelitis MRSA. The wound underwent surgical debridement and once the fracture was consolidated enough at three months, removal of external frame and intramedullary reaming and irrigation was performed. No further soft tissue coverage was required. The patient was treated with a prolonged course of intravenous vancomycin, followed by oral clindamycin. Since this episode, the patient has been asymptomatic and denied any further hospitalisations and the patient returned to full function without any limitations. The patient does not report any recurrent wounds, discharge, sinus or pain. Seventeen years later, after a closed blow to the knee, the patient present febrile with knee pain. He was found to have Methicillin-Resistant Staphylococcus aureus tibial osteomyelitis, most concentrated in the proximal medial tibial cortex. This was treated with targeted surgical debridement, an antibiotic nail and prolonged antibiotics. The patient has remained asymptomatic with apparent resolution of infection 6-months post. Conclusion: Our case report represents one of rare and longest document recurrence intervals of Methicillin-Resistant Staphylococcus aureus . Patients with Methicillin-Resistant Staphylococcus aureus osteomyelitis should have appropriate treatment and follow-up with orthopaedic surgeons and infectious disease physicians to monitor disease progression and to ensure resolution of the infection.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116546814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Maxillary Osteotomy Distraction Osteogenesis (Amodo) in the Treatment of Maxillary Hypoplasia in Unilateral Cleft Lip and Palate-A Case Report","authors":"S. Jyothi","doi":"10.23880/jobd-16000234","DOIUrl":"https://doi.org/10.23880/jobd-16000234","url":null,"abstract":"Distraction osteogenesis defines a technique of bone generation by distraction of native bony segments. The technique offers a promising treatment alternative for patients with maxillary or midfacial hypolasia. In this case report, the various steps in the treatment of an 18 year old boy with premaxillary hypoplasia and anterior crossbite are described. Patient was treated with a distraction osteogenesis technique and premaxillary advancement was performed using individual tooth - borne distraction device. The surgical procedure involved an anterior segmental maxillary osteotomy respecting the palatal periosteum. Distractor was cemented in the mouth after the surgical procedures. The patient was observed during a seven day latency period after which the device was activated 0.4mm every 12 hours. The anterior crossbite was eliminated and the occlusal correction and settling was achieved with fixed orthodontic appliances.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134025624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Hip Arthroplasty in Extensive Venous Malformations: An Experience of Four Cases","authors":"","doi":"10.23880/jobd-16000221","DOIUrl":"https://doi.org/10.23880/jobd-16000221","url":null,"abstract":"Background: Extensive venous malformation (VM) (Klippel-Trenaunay syndrome, KTS) and associated degenerative joint disease of the hip is a rare condition. The difficulty of total hip replacement (THR) depends on tissue involvement around the joint, with the risk of severe blood loss. To evaluate the feasibility and outcome of hip replacement in this disease. Methods: Between 2010 and 2020, 4 patients with extensive VM of the limb and degenerative joint disease had a total hip replacement. Investigations included X-ray exams, T2 MRI with fat saturation, and hematologic tests. The main outcome end- points of the study were success of hip replacement, postoperative complications and quality of life. Results: Four patients underwent THR. Le sex ratio was (3 males, 1 female) with a median age of 37 years (range 27-55). All were symptomatic, with worsening hip pain and use of a mechanical aid. MRI identified VM in the muscles and cellular space of the buttock. The choice of surgical approach was anterior in three patients, and lateral in one. Mean blood loss was 1500mL. Surgery was completed by peroperative sclerotherapy to reduce blood loss (3 patients). The median follow-up time was 82 months (range 12- 120). There were no postoperative complications. At 6 months, three patients were walking with normal gait, and one was using an orthopedic walker after knee arthrodesis. There was no reoperation during the follow-up. All patients returned to their professional activities. Conclusion: The difficulty of total hip replacement depends on the extent of involved soft tissue around the hip area. The choice of surgical approach, surgical skill in vascular and orthopedic procedures and per-operative sclerotherapy permit to reduce surgical risk.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129045127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Idiopathic Chondrolysis of the Hip","authors":"Owayed Ali Al Mutairia","doi":"10.23880/jobd-16000216","DOIUrl":"https://doi.org/10.23880/jobd-16000216","url":null,"abstract":"Idiopathic chondrolysis of the hip (ICP) is a rare condition of unknown etiology duo to progressive destruction of the hyaline cartilage that covers the femoral head and acetabulum. It has insidious beginning and affects more often female adolescents. This study aimed at reporting one case of that rare disease of a 14-year-old male adolescent with idiopathic chondrolysis of the hip presented to our out -patient clinic after three months of symptoms beginning. Early diagnosis is challenging. Clinicians must be aware of this rare diagnosis, because early diagnosis may improve the patient outcome.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115422523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glomic Tumors of the Finger: Diagnostic and Therapeutic Approach (About 24 Cases)","authors":"MR El Galiou","doi":"10.23880/jobd-16000232","DOIUrl":"https://doi.org/10.23880/jobd-16000232","url":null,"abstract":"Glomus tumor according to MASSON is a benign neuro-myo-arterial proliferation. It accounts for approximately 1%-5% of all hand tumors. Pain is the main clinical sign. The diagnosis of certainty is based on a bundle of arguments: clinical and radiological, but only histology allows confirmation. A series of 24 patients was reviewed retrospectively, the average age was 35 years with an average follow-up of 4 years , and extremes of 21 and 60 years. Surgical excision was performed in all patients. This strategy allowed us to obtain satisfactory results.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114830961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of the Posterior Condylar Axis as an Alternative Reference for Femoral Rotation in Japanese Patients with Varus Knee Osteoarthritis Undergoing Total Knee Arthroplasty","authors":"Y. Hattori","doi":"10.23880/jobd-16000225","DOIUrl":"https://doi.org/10.23880/jobd-16000225","url":null,"abstract":"Background: This study aimed to assess the reliability of the posterior condylar axis (PCA), the most widely used alternative reference for the surgical transepicondylar axis (sTEA), as a reference for appropriate femoral rotational alignment in total knee arthroplasty (TKA) by comparing variances with other alternative reference axes. Methods: A total of 305 knees in 233 Japanese patients who underwent TKA due to varus knee osteoarthritis were assessed in this study. Variances and relationships between alternative references were determined. Angles of alternative reference axes relative to the sTEA in the axial plane were measured using computer software based on computed tomography. Results: The PCA line was 3.0°±1.8° (range, -2.1° to 8.8°) internally rotated relative to the sTEA. No significant differences were observed in the PCA angle relative to the sTEA angle between males and females. The variance with respect to the sTEA was significantly smaller in the order of anatomical transepicondylar axis (aTEA), PCA, and antero-posterior axis (APA). The variance of the APA and that of the femoral anterior tangent line (FAT) did not significantly differ, while the variance of the FAT was significantly smaller than that of the trochlear anterior line (TAL). The proportion of outliers for PCA (>3° away from the average value) was 9.8%. The PCA was weakly correlated with the aTEA, APA, FAT, and TAL. Conclusions: In terms of variance with respect to the sTEA, the PCA was second to aTEA in reliability as an alternative reference axis, and was on average 3.0°±1.8° internally rotated relative to the sTEA. Our findings suggest that the PCA is a reliable and reproducibly identifiable alternative axis for accurately determining femoral rotational alignment in TKA.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126204127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impingement Syndrome: A Review of the Literature","authors":"S. Bernardino","doi":"10.23880/jobd-16000217","DOIUrl":"https://doi.org/10.23880/jobd-16000217","url":null,"abstract":"Rotator Cuff tendinopathy (RCT) is a common disorder that poses challenges for effective treatment. Evidence suggests that extrinsic, intrinsic, and combinations of biomechanical mechanisms play a role. There are no significant differences in outcome between conservatively and surgically treated patients with subacromial impingement syndrome (SAIS). For most patients with subacromial impingement syndrome (SAIS), nonsurgical treatment is successful. Surgical intervention is successful in patients who fail nonsurgical treatment. Surgeon experience and intraoperative assessment may guide the method of surgical treatment. Studies have shown that many surgical interventions, including debridement and open and arthroscopic acromioplasty, have been successful. However, there remains a need for high-quality clinical research on the diagnosis and treatment of SAIS. In this review, there are not figures and outcomes.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123632605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: A Ghost Story","authors":"Jaime Hinzpeter C","doi":"10.23880/jobd-16000233","DOIUrl":"https://doi.org/10.23880/jobd-16000233","url":null,"abstract":"Ghost doctors in white coats. The topic surprised me and it kept going around in my mind (see previous editorial: The Strange Case of Galté). The article about the Chilean lawyer Galté is illustrative and exciting. Nevertheless, it is not the only one. There is a fair amount of literature on the subject and also renowned mediums who have published books","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130760182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis of Patient Reported Outcome and Return to Work after Surgical vs Non-Surgical Mid Shaft Humerus Fracture","authors":"Hakeem Nn","doi":"10.23880/jobd-16000220","DOIUrl":"https://doi.org/10.23880/jobd-16000220","url":null,"abstract":"Background: Several recent reviews demonstrate that in patients with humeral shaft fractures, surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients' outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials from 2010 to January 2022 to search potential randomised controlled trials (RCTs) and cohort studies comparing the patients' related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/ nail fixation, while the non-surgical intervention used splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123988694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extra Periosteal Sliding Plate, a New Surgical Technique for the Treatment of Fractures of the First Metacarpal and Proximal Phalanx","authors":"C. Fuentes","doi":"10.23880/jobd-16000237","DOIUrl":"https://doi.org/10.23880/jobd-16000237","url":null,"abstract":"Background: One of the most important objectives when performing an open reduction of a fracture is to achieve a stable internal fixation with minimal damage of the periosteum to preserve irrigation in the fracture site and thus promote adequate healing. Minimally Invasive plate osteosynthesis (MIPO) follow this key technical point with great effectiveness and efficiency, however, a reduction technique with these characteristics for the management of hand fractures has not yet been widely described for the management of hand fractures. Methods: The authors technique proposes a new surgical technique “extra-periosteal sliding plate” fixation for first metacarpal and proximal phalanx fractures. Data are obtained from 9 patients from June 2022 to January 2023 and a threemonth postoperative follow-up is performed where functionality and rehabilitation results are evaluated. Results: In total nine patients underwent to the described technique achieving adequate fracture stability and total bone healing with favorable functional outcomes without sequelae. Conclusion: Extra-periosteal sliding plate fixation is considered a great surgical option for the management of hand fractures, specially in those patients with severe trauma in whom vascular and soft tissue integrity must be preserved, providing suitable functional outcomes.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"456 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124259534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}