Case Reports in Orthopedics最新文献

{"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}

{"title":"Neglected Stress Fracture of the Second Proximal Phalanx in a Teenage Triathlete","authors":"S. Tejero, F. J. Durán-Garrido","doi":"10.1155/2022/8898876","DOIUrl":"https://doi.org/10.1155/2022/8898876","url":null,"abstract":"We present a case of nondiagnosed comminuted stress fracture of the base of the proximal phalanx associated with flexor digitalis longus rupture in a teenage athlete. To our knowledge, there is no description in the literature of such a combination of injuries due to delayed diagnosis and incorrect treatment, including injections in the metatarsophalangeal joint of the second toe. The present article focuses on the importance of clinical suspicion of this rare lesion to achieve early diagnosis and avoid surgical treatment. Finally, the surgical technique used to treat this uncommon injury in the chronic phase, which yielded an excellent outcome in this teenage athlete, is described.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78662206","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":"Delayed Treatment of Traumatic Cervical Dislocation: A Case Report and Literature Review","authors":"Fabian Roland Bechet, P. Stassen, Dan Scorpie, Thierry Della Siega","doi":"10.1155/2022/7756484","DOIUrl":"https://doi.org/10.1155/2022/7756484","url":null,"abstract":"Neglected unreduced cervical dislocation is very uncommon. In our case (a lady who stayed asymptomatic for 13 months before development of cervicobrachialgia), the anterior reduction/arthrodesis was easy, and we did not find any benefit from an additional posterior procedure thanks to a congenital block between C7 and T1 vertebral bodies. This point is nevertheless a matter of debate. After a review of the literature, we did not find any consensus about the ideal scheme and sequence to reduce and stabilize this delayed type of cervical trauma. We emphasize the need of dynamic radiographies to exclude unstable injuries but also a prereduction MRI (especially in unexaminable patients) to detect any dangerous disc fragment. If there is no visible change in the radiological status while attempting to reduce the dislocation by external maneuvers, there is little chance to reduce it successfully only by a single approach. Therefore, in irreducible delayed dislocations, it seems safer to prepare the reduction/fusion stage (either anterior/posterior, depending on the habits and skills of the surgeon) by a first stage carrying out a release of the fibrous tissues on the opposite side (either posterior to release the facet joints or anterior to release the intervertebral disc), followed by the reduction/fusion stage itself and then by a third stage to lock the level. Like many authors, we recommend an anterior approach first in case of an extruded disc visible on the MRI, and therefore, we show a preference for the anterior-posterior-anterior sequence in irreducible delayed cervical dislocations.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82275439","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":"Penetrating Endplate Screw Fixation for Thoracolumbar Pathological Fracture of Diffuse Idiopathic Skeletal Hyperostosis","authors":"T. Ishikawa, M. Ota, Tomotaka Umimura, Takahisa Hishiya, J. Katsuragi, Y. Sasaki, S. Ohtori","doi":"10.1155/2022/5584397","DOIUrl":"https://doi.org/10.1155/2022/5584397","url":null,"abstract":"With the advancement of cancer treatment and minimally invasive surgery, the indications for surgery for metastatic spinal tumors are expanding. Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory skeletal disease characterized by calcification and ossification of ligaments and entheses. In Japan, the prevalence of DISH is increasing with its superaging society. The purpose of this article is to report a case of applying a novel screw technique for pathological fracture in a patient with DISH and spinal metastasis. An 80-year-old man with spinal metastasis presented with acute onset of severe back pain, and investigations revealed a fracture of a metastatic lesion in T10–T12 in the range of DISH. We performed posterior fixation with a percutaneous pedicle screw system using a penetrating endplate technique. The patient's back pain improved, and he was able to mobilize with minimal assistance and survived for 8 months with a good quality of life. Spinal fracture accompanied by DISH sometimes occurs with severe instability because of injury across 3-column injury and its long lever arm. Spinal instability neoplastic score indicates instability of pathological fractures of spinal metastases but needs to be evaluated carefully when DISH is present. The prevalence of DISH is increasing in the elderly, and penetrating endplate screws can be an effective option in posterior fusion surgery for patients with DISH and spinal metastases.","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88868075","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 Postoperative Recurrent Lumbar Disc Herniation Conservatively Treated with Novel Intradiscal Condoliase Injection.","authors":"Toru Funayama,&nbsp;Yusuke Setojima,&nbsp;Yosuke Shibao,&nbsp;Hiroshi Noguchi,&nbsp;Kousei Miura,&nbsp;Fumihiko Eto,&nbsp;Kosuke Sato,&nbsp;Mamoru Kono,&nbsp;Tomoyuki Asada,&nbsp;Hiroshi Takahashi,&nbsp;Masaki Tatsumura,&nbsp;Masao Koda,&nbsp;Masashi Yamazaki","doi":"10.1155/2022/3656753","DOIUrl":"https://doi.org/10.1155/2022/3656753","url":null,"abstract":"<p><p>Although postoperative recurrent lumbar disc herniation (rec-LDH) is uncommon, it is a challenging situation that requires revision surgery when conservative treatment fails. Recently, an agent inducing chemical dissolution of the nucleus pulposus using condoliase has been approved as a novel intradiscal treatment for LDH. To date, no evidence has been reported regarding its effectiveness in the treatment of postoperative rec-LDH. A 25-year-old man with a history of LDH in L4/5, who underwent transforaminal full endoscopic lumbar discectomy when he was 17 years old, complained of severe pain radiating to his left leg since 1 month. The straight leg-raising test was limited to 25° on the left side. Lumbar T2-weighted magnetic resonance imaging (MRI) showed intracanal, left-sided transligamentous disc herniation at L4/5 with high-signal intensity. Because the conservative treatment with oral analgesics and selective left L5 nerve root block failed, the patient requested intradiscal condoliase injection instead of revision surgery. There were no adverse events reported after the condoliase treatment, and the pain radiating to the left leg improved within 2 weeks. A lumbar MRI performed 2 months after treatment revealed that the disc herniation had significantly decreased in size. The straight leg-raising test examined 3 months after treatment was negative. In this case, the disc herniation was of the transligamentous type and showed a high-signal intensity on T2-weighted MRI which could be suitably treated by condoliase injection therapy. This case report is the first to suggest that intradiscal condoliase injection could be a useful and novel conservative treatment option to treat postoperative rec-LDH.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":" ","pages":"3656753"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834671","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":"Total Hip Arthroplasty with a Cementless Acetabular Component and Impaction Bone Grafting for Dysplastic Osteoarthritis Complicated by Multiple Myeloma.","authors":"Ryo Ogawa,&nbsp;Maki Hirao,&nbsp;Taro Umezu,&nbsp;Shigeru Yanagimoto","doi":"10.1155/2022/3939356","DOIUrl":"https://doi.org/10.1155/2022/3939356","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) for pathologic and impending fracture due to periacetabular multiple myeloma (MM) lesions has been reported. We report a case of radiographic progression of dysplastic osteoarthritis, complicated by periacetabular MM lesions, treated by THA. A 69-year-old female with a 13-year history of MM presented with right hip pain. Plain radiographs and CT showed that dysplastic osteoarthritis had progressed, while the periacetabular MM lesions remained unchanged. Pathologic fracture was not observed on MRI. THA with a cementless acetabular component and impaction bone grafting was done. Bone graft incorporation was confirmed on CT at 1 year after surgery. There were no signs of bone absorption or implant loosening at last follow-up 3 years after surgery. Due to the advances in the treatment of MM and antiresorptive drugs, cementless acetabular component and impaction bone grafting may be an option for dysplastic osteoarthritis complicated by acetabular bone loss due to MM.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":" ","pages":"3939356"},"PeriodicalIF":0.0,"publicationDate":"2022-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39804546","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":"Lisfranc Sprain with Second Metatarsal Base Adaptive Stress Response in High-Level Athletes: Case Series and Novel Perspective on a Distinct Entity of Chronic Low-Energy Lisfranc Injury.","authors":"WanYin Lim,&nbsp;Jonathan Heysen,&nbsp;James Ilic,&nbsp;Ben Beamond,&nbsp;Steven Zadow","doi":"10.1155/2022/1030829","DOIUrl":"https://doi.org/10.1155/2022/1030829","url":null,"abstract":"<p><p>Lisfranc injury is increasingly being recognised in the high-performance athletic cohort, particularly in contact sports. In this cohort, there is a pattern of low-energy Lisfranc injury which combines magnetic resonance findings of both ligamentous sprain and adaptive bone stress response that infers a longer timeframe of stress than the duration of symptoms would suggest. This has not been previously described, and the authors believe that this is an unrecognized subset of midfoot sprain in the context of sustained stress to the midfoot. This retrospective case report describes MRI findings of three index cases of this entity in professional athletes presenting with acute foot pain. Two responded with conservative management whilst the third ultimately required surgery. All athletes were eventually able to return to play.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":" ","pages":"1030829"},"PeriodicalIF":0.0,"publicationDate":"2022-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39940406","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}