Case Reports in Orthopedics最新文献

{"title":"Simultaneous Bilateral Proximal Humerus Fractures Treated with Single-Stage Bilateral Reverse Shoulder Arthroplasty","authors":"Taiki Tokuhiro, A. Urita, Y. Kameda, M. Motomiya, Naoya Watanabe, N. Iwasaki","doi":"10.1155/2022/2162331","DOIUrl":"https://doi.org/10.1155/2022/2162331","url":null,"abstract":"Introduction Simultaneous bilateral fractures of the proximal humerus are infrequent, and simultaneous bilateral three- or four-part fractures are even rarer. Reverse shoulder arthroplasty (RSA) is being used increasingly for the treatment of three- and four-part fractures of the proximal humerus. However, treatment of simultaneous bilateral fractures of the proximal humerus is difficult because of concern about postoperative immobilization and rehabilitation. Case Presentation. A 75-year-old woman presented with bilateral shoulder pain subsequent to a fall on the street. Physical examination and radiographs showed simultaneous bilateral fractures of the proximal humerus. The right side fracture was classified as a four-part fracture and the left side fracture as a three-part fracture, according to Neer's classification. The right shoulder had a risk of avascular necrosis of the humeral head. For the left shoulder, the fracture type had caused ischemia of the humeral head. Single-stage bilateral RSA was performed 9 days after the injury. An abduction pillow was applied for 5 weeks postoperatively. Passive motion exercises were permitted starting at 4 weeks postoperatively, and active range of motion exercises were permitted at 6 weeks postoperatively. At the patient's most recent follow-up 30 months after surgery, the patient reported no restriction of the activities of daily living. Radiographs revealed no lucent line on the humerus and glenoid components, although bone resorption and superior retraction of the tuberosities on both sides were observed. Conclusions Single-stage bilateral RSA improved shoulder function, but healing of the greater tuberosity can affect the improvement in external rotation after the operation. Although a long-term follow-up is needed, single-stage bilateral RSA appears to be a viable treatment option.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87481759","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":"Management of Tracheal Perforation following Anterior Cervical Spine Surgery: Report of Two Cases and Review of the Literature","authors":"Xinhu Guo, H. Ji","doi":"10.1155/2022/1914642","DOIUrl":"https://doi.org/10.1155/2022/1914642","url":null,"abstract":"Background Tracheal perforation is a complication very rare but challenging that follows anterior cervical spine surgery. This article describes the management of tracheal perforation due to instrument failure after anterior cervical spine surgery performed in two patients because of fracture dislocation of the subaxial cervical spine. Case Presentation. Two patients who suffered from a subaxial cervical fracture and dislocation were subjected to anterior cervical spine surgery for fracture reduction and cervical fusion. However, instrumentation failure occurred in both patients, resulting in implant displacement and penetration into the posterior tracheal wall. Revision surgery consisted of fracture reduction, multilevel posterior fixation, and removal of the displaced anterior cervical implants. Tracheal perforation was bypassed by placing a tracheostomy tube in a caudal position for the diversion of the airflow and tracheal hygiene. The thorough debridement and drainage performed in both patients allowed a complete healing of the anterior wound in both of them, with no sign of infection or subcutaneous emphysema, as confirmed by postoperative CT scan and flexible bronchoscopy. Both patients acquired a solid fusion of the cervical spine at last follow-up (16 months and 24 months). Conclusions The perforation of the trachea after anterior cervical spine surgery due to the displacement of the implants could be managed using posterior cervical instrumentation and fusion, the removal of the anterior implant, debridement and drainage, and the use of a distal bypassing tracheostomy tube.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76016359","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":"“The Baltic Sea Germ”: A Case Report of Necrotizing Fasciitis following Vibrio vulnificus Infection","authors":"Heinz-Lothar Meyer, Christina Polan, M. Burggraf, L. Podleska, Paula Beck, H. Steinau, M. Dudda, F. Farzaliyev","doi":"10.1155/2022/5908666","DOIUrl":"https://doi.org/10.1155/2022/5908666","url":null,"abstract":"Reported is an 80-year-old patient with septic shock from necrotizing fasciitis secondary to a Vibrio vulnificus (Vv) infection. The patient reports having been swimming in the Baltic Sea after a minor trauma to the left leg. Emergency superficial necrosectomy followed by intensive medical therapy was performed. Antibiotic therapy was initiated with a third-generation cephalosporin and a tetracycline. Vv was detected in the intraoperative microbiological smears. Instead of a leg amputation and a flap, due to the patient's age, a split skin covering to consolidate the wound was performed. Vv is a gram-negative rod bacterium of the genus Vibrio. Vv occurs in warm, low-salinity seawater (brackish water). In Germany, Vv occurs primarily in river mouths of the low-salinity Baltic Sea. Infections by Vv can occur through open wounds or by eating raw infected seafood, especially oysters. Infection via wounds often take a fulminant lethal course. Patients with chronic diseases, weakened immune system, and open wounds are particularly at risk. Infections with Vv are rare, but occur worldwide. Global warming is expected to spread Vv as water temperature increases and the dilution effect of sea level rise further decreases ocean salinity, and natural disasters promote the spread of Vv.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"173 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91042947","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":"Dural Injury Treatment with a Full-Endoscopic Transforaminal Approach: A Case Report and Description of Surgical Technique","authors":"J. P. Bergamaschi, Fernando Flores de Araújo, Thiago Queiroz Soares, Kelsen de Oliveira Teixeira, L. H. Sandon, Ricardo Graciano Squiapati, G. Depieri, A. Lugão, Rangel Roberto de Assis, Esthael Cristina Querido Avelar Bergamaschi","doi":"10.1155/2022/6570589","DOIUrl":"https://doi.org/10.1155/2022/6570589","url":null,"abstract":"Introduction The objective of this study was to describe a surgical technique that uses transforaminal full-endoscopic access, which is different from the existing protocol, and to demonstrate another method of dural tear repair during endoscopic spine surgery. Background Endoscopic spine surgery was initially described for lumbar disc pathologies. Technical advances and new materials have made it possible to treat cervical and thoracic spinal degenerative disorders. These advances have also made it possible to treat surgical complications, notably dural tears with CSF fistulas. The literature indicates that the incidence of these injuries ranges from 1% to 17%. Materials and Methods Descriptive technical note of innovative and improved endoscopic surgical procedure exemplified with illustrative clinical case and comparative literature review. Results There is only one report describing a full-endoscopic suture technique for dural sac repair. The gold standard for treatment of the most significant nonpunctate lesions continues to be a conversion to open surgery for lesion closure. Conversion can be problematic because most surgeries are performed under sedation and local anesthesia. Conclusions In this case report and the new endoscopic suture technique described here, we show that primary correction of dural tears through endoscopy is possible. In addition to representing a paradigm break in solving one of the main complications of these procedures, it can expand the possibilities of spine endoscopy.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91068422","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":"Brachymetatarsia: Surgical Management, Case Report, and Literature Review.","authors":"David Zhu,&nbsp;Maxime Lefèvre,&nbsp;Andréa Fernandez,&nbsp;Laurent Galois","doi":"10.1155/2022/8253096","DOIUrl":"https://doi.org/10.1155/2022/8253096","url":null,"abstract":"<p><strong>Background: </strong>Brachymetatarsia is defined by an abnormal shortening of the metatarsal bone. This rare condition is mostly primary and congenital. Consequences of this malformation are both esthetic and functional, due to pain and mechanical problems in the forefoot. Surgical management is an important part of patient care. There are two main options: gradual lengthening by progressive callotosis distraction using an external fixator and one stage lengthening using bone graft and osteotomy of the bone. This review presents two cases using the one stage lengthening surgical management method. We also discuss some reports in the literature with the aim to compare the advantages and disadvantages of the two surgical methods. Literature concerning the surgical management of brachymetatarsia was identified using the PubMed and Google Scholar databases. <i>Patient Presentation</i>. We describe two female patients aged 20 and 26 years who underwent one stage lengthening surgery of the fourth toe with isolated brachymetatarsia using an iliac bone graft and internal fixator plate. The two patients had a lengthening of around 10 mm after postoperative evaluation. No skin complications were noted, but one of the patients reported flexor stiffness after surgery. Concerning the functional and cosmetic aspects, the two patients are satisfied with the management.</p><p><strong>Conclusions: </strong>In the literature, one stage lengthening seems to be the most favorable option for the care of brachymetatarsia. Studies show a short healing time and fewer complications like infection, stiffness, malalignment, and malunion. Some reviews note the utility of the gradual lengthening of severe brachymetatarsia when a longer lengthening is necessary. There is no definite consensus concerning the management of brachymetatarsia.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":" ","pages":"8253096"},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8930250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40308422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Child with a Painful Foot: How to Get a Definitive Diagnosis","authors":"R. J. L. L. van de Kimmenade, D. Meijer, D. Hoornenborg, H. M. van der Vis","doi":"10.1155/2022/5105078","DOIUrl":"https://doi.org/10.1155/2022/5105078","url":null,"abstract":"This case report describes an 8-year-old healthy boy with a retained wooden foreign body in his 4th metatarsal bone of his right foot. He was presented several months after the initial trauma, stepping into a toothpick, had occurred. He was operated in our hospital, and the wooden toothpick was removed. The operation and recovery were both uncomplicated. History and physical examination are essential in these types of cases with a history of penetrating trauma but can be inconclusive due to the delay in presentation. Aggressive treatment on the other hand is necessary to prevent bigger problems such as the development of inflammatory problems and persisting complaints. A thorough, systematic, and complete work-up from the history to treatment is therefore necessary and will be described in this case report.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76862175","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":"Rare Presentation of Angiolipoma Affecting an Intact Achilles Tendon","authors":"Takeo Mammoto, N. Takahashi, N. Takayashiki","doi":"10.1155/2022/6997320","DOIUrl":"https://doi.org/10.1155/2022/6997320","url":null,"abstract":"Musculoskeletal lipomatous lesions are common in soft tissues. However, these are rarely associated with tendon sheaths or tendon compartments. Moreover, angiolipoma of the Achilles tendon is yet to be described. Here, we report an angiolipoma of an intact Achilles tendon, which has not been described previously. A 54-year-old woman presented with a two-year history of a palpable mass in the posterior aspect of the left ankle. The mass caused an intermittent localized pain while walking and a catching phenomenon induced by the plantar dorsiflexion movement of the ankle joint. Magnetic resonance imaging revealed a well-circumscribed, oval lesion on the lateral aspect of the Achilles tendon. The location and shape of the lesion had changed over time, suggesting that the lesion was moving in and out around the Achilles tendon. At the surgery, the tumor was confirmed under the crural fascia. Histopathological examination revealed that the tumor comprised mature adipocytes covered peripherally with a fibrovascular capsule. Based on these features, the tumor was diagnosed as an angiolipoma. Angiolipomas are typically treated surgically by simple excision, and lipomatous lesions of the tendon sheath are not different. From this case report, angiolipomas are rare but should be considered in the differential diagnosis and treatment of Achilles tendon tumors.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84057573","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":"Pleomorphic Liposarcoma of Femur: A Rare Soft Tissue Sarcoma Metastasized to the Bone—Case Report and Review of Literature","authors":"Thanate Poosiripinyo, Thanapon Chobpenthai, T. Wisanuyotin, W. Sirichativapee","doi":"10.1155/2022/9195529","DOIUrl":"https://doi.org/10.1155/2022/9195529","url":null,"abstract":"Background Pleomorphic liposarcoma (PLPS) accounts for less than 5% of liposarcoma, and its metastasis to bone is rare. As a high-grade tumor, PLPS is reported to be more invasive with high local recurrence and distant metastasis. Here, we report a case of PLPS of the femur and undertake a review of the literature. Case Presentation. A 58-year-old man presented with a big mass at posterior aspect of his left thigh. The computed tomography of the chest for staging revealed two nodules at the left upper lung field. Wide resection of the soft tissue mass at the left thigh was performed by a general surgeon. Thoracotomy and wedge resection of the lung nodules was carried out by a cardiothoracic surgeon. Pathologic diagnosis suggested PLPS. Three years later, he was presented with sudden right hip pain after he slipped. The plain radiograph revealed an osteolytic lesion at the right proximal femur with minimally displaced pathological fracture. The MRI showed the presence of a tumor at the proximal part of the right femur and its soft tissue invasion. The patient underwent en bloc proximal femur wide resection followed by cemented long-stem bipolar hemiarthroplasty. The final histopathology report from definite surgery specimen revealed pleomorphic spindle, round, and polygonal cells arranged in sheets, short fascicles, and storiform arrays. There were no complications, adverse outcomes, or recurrence reported at six months after surgery. The patient could walk without gait aid and had good functional outcomes according to the TESS questionnaire. Conclusion PLPS is a highly aggressive tumor with a high distant metastatic rate. The definite diagnosis of PLPS is made on the basis of histopathology. Surgical treatment involving wide resection that aims to achieve a negative margin is the best option currently available, and we recommend treating bone metastasis from PLPS as the primary site of the tumor. The effect of chemotherapy and radiotherapy in preventing postoperative recurrence is still unclear and requires further studies.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75812778","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":"A Case of Recurrent Compartment Syndrome with Concomitant Use of Eliquis","authors":"James A Nemunaitis, Jason P Den Haese, M. Buseck, Shawn W Storm, J. Tuck, A. Ferretti","doi":"10.1155/2022/1863538","DOIUrl":"https://doi.org/10.1155/2022/1863538","url":null,"abstract":"Introduction. Acute compartment syndrome (ACS) occurs secondary to increasing pressure within a fascial compartment that exceeds perfusion pressure. This can be caused by spontaneous hematomas, which can be secondary to prolonged anticoagulation therapy. Eliquis® has not been associated with ACS of the thigh in any of the currently published literature. Identifying ACS early is important because it can reduce the risk of permanent structural damage, limb amputations, and mortality rates. Case Report. A 43-year-old male with past medical history of unprovoked Deep Vein Thrombosis (DVT) eight months prior to presentation on Eliquis® presented to the emergency department for significant right thigh pain after riding a roller coaster. There was increased tone/firmness of the anterior compartment and tenderness on palpation of the proximal two-thirds of the anterior thigh. Imaging, clinical findings, and Stryker needle measurements confirmed ACS secondary to hematoma, which required fasciotomy and evacuation of the hematoma. The patient was temporarily switched to aspirin for DVT prophylaxis postoperatively to prevent new hematoma formation. Six weeks later, the patient arrived at the ED with a DVT that was treated with Eliquis®. Eight months later, the same patient presented with acute right thigh pain that started while lying in bed. A diagnosis of recurrent ACS in the right anterior thigh was made, requiring a fasciotomy. Surgery was successful without any complications. Discussion. Eliquis® is associated with an increased risk of hematoma formation, which can lead to ACS. This is a rare adverse effect that providers should be aware of because it requires early management to prevent ACS-associated complications. This is significant because no currently published literature has identified an association of Eliquis® with ACS in the thigh. In cases of atraumatic ACS, we were unable to find any protocols advocating for or against the use of DVT prophylaxis postfasciotomy in the literature.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85215522","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":"Baseball Related Injuries: A Case Report on Acute Compartment Syndrome of the Forearm","authors":"C. Pasque, C. Hendrix","doi":"10.1155/2022/5449913","DOIUrl":"https://doi.org/10.1155/2022/5449913","url":null,"abstract":"Acute compartment syndrome is a difficult diagnosis to make due to its wide range of clinical presentations. Delay or misdiagnosis can cause devastating consequences such as Volkmann's ischemic contracture, permanent nerve damage, amputation, and death. Lower extremity compartment syndrome is more common than upper extremity compartment syndrome, with the forearm being the most common location for upper extremity compartment syndrome. Acute compartment syndrome is most caused by acute fracture trauma but can also be due to soft tissue crush injuries or vascular problems. We report a unique case of a male umpire being struck on the forearm by a baseball with subsequent progression to an acute compartment syndrome that required emergent fasciotomies. The patient made a full recovery with no known long-term sequelae.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90443442","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}