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Case Reports in Orthopedics

Kiyohisa Ogawa, Wataru Inokuchi, Takayuki Honma
Isolated fracture of the inferior scapular angle is extremely rare. We present the case of a 20-year-old female with persistent periscapular pain and a winged scapula caused by delayed union of an inferior scapular angle (ISA) fracture. Ten months previously, the patient had a car accident while seated in the left rear passenger seat. The patient visited an orthopedic clinic where a surgeon diagnosed left shoulder contusion without any abnormal radiographic findings. The left arm was kept in a sling for 2 months, as left arm elevation caused severe pain in the upper back...
2019: Case Reports in Orthopedics
Chelsea E Minoughan, Adam P Schumaier, Frank R Avilucea
Case: A 31-year-old male was involved in a dirt bike accident and sustained an isolated type II open mid-distal tibia fracture. The patient underwent suprapatellar intramedullary nailing and subsequently developed knee sepsis. Conclusion: This patient was managed with irrigation and debridements of the knee, fracture site, and intramedullary canal. A resultant soft-tissue defect over the fracture site obviated primary closure. Creation of an acute deformity stabilized by a Taylor spatial frame allowed primary wound closure...
2019: Case Reports in Orthopedics
Kohei Yamaura, Yutaka Mifune, Atsuyuki Inui, Hanako Nishimoto, Yasuhiro Ueda, Takeshi Kataoka, Takashi Kurosawa, Shintaro Mukohara, Takeshi Kokubu, Ryosuke Kuroda
Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated...
2018: Case Reports in Orthopedics
G Hoy, C Hasenkam, A Fock, C McLean
We present a case of severe supraspinatus muscle rhabdomyolysis following overexertion in a young male. Preexisting risk factors included illicit drug use. Even single muscle rhabdomyolysis can cause significant renal failure, and in our case the use of intravenous flushing was used in conjunction with hyperbaric oxygen after muscle compartment fasciotomy to maximize muscle recovery and renal protection in a manual worker (musician). Clinicians should be alert to severe muscle pain requiring narcotics after strenuous use...
2018: Case Reports in Orthopedics
Kevin M Dale, Samuel B Boggess, Blake Boggess, Claude T Moorman
Background: There are multiple causes of posterior knee pain and radicular symptoms. A symptomatic fabella is a rare cause but should be considered in the differential diagnosis. Purpose: Physicians should consider a symptomatic fabella as a diagnosis when common treatments for posterior knee pain have not alleviated the symptoms. Study Design: Case report. Methods: Review of clinical documentations of an orthopedist, physiatrist, physical therapist, 2 primary care sports medicine physicians, and the surgical report of an orthopedist...
2018: Case Reports in Orthopedics
Suguru Koyama, Keiji Tensho, Hiroki Shimodaira, Tomoya Iwaasa, Hiroshi Horiuchi, Hiroyuki Kato, Naoto Saito
Case: We report a rare case of prefemoral fat pad impingement syndrome that was caused by a hyperplasia of the normal suprapatellar fat pad. Pain and catching were observed in the proximal-lateral patellofemoral joint, and MRI imaging confirmed a hyperplasic mass in the same area. Although conservative treatment showed no signs of improvement, symptoms improved after an arthroscopic excision of the mass. Conclusion: Prefemoral fat pad impingement syndrome is related to patellar motion and should be considered as one of the underlying causes of anterior knee pain (AKP)...
2018: Case Reports in Orthopedics
M A Tranovich, J B Stirton, J C Maier, M B Tanios, J E Lea, N A Ebraheim, J D Miller
Case . Compartment syndrome following muscle rupture is a rare entity with few mentions in the literature. We present a case of pectoralis major rupture in a 38-year-old male that evolved into compartment syndrome of the anterior compartment of the arm. Rupture of the pectoralis is uncommon and most often occurs during weight lifting. Compartment syndrome secondary to this injury is extremely uncommon, with only one reported case in the pectoralis major itself and several cases of biceps compartment syndrome...
2018: Case Reports in Orthopedics
Satoshi Ichihara, Masao Suzuki, Akira Hara, Toshiya Kudo, Yuichiro Maruyama
We developed a new fixation method that involves the insertion of two wires and external wire fixation using a metal clamp. The aim of this technique was to increase the stability and rigidity of conventional percutaneous Kirchner wire fixation. Here, we present a patient with dislocation of the fourth and fifth carpometacarpal joints who was satisfactorily treated with closed reduction and percutaneous fixation with a linking external wire fixator (Ichi-Fixator). Operative treatment using the Ichi-Fixator system facilitates anatomical reduction and immediate full mobilization, resulting in good outcomes...
2018: Case Reports in Orthopedics
Mika Nakada, Kaoru Tada, Tadahiro Nakajima, Masashi Matsuta, Hiroyuki Tsuchiya
The treatment methods used for Blauth type IIIB hypoplastic thumbs are controversial. We performed a nonvascularized, hemilongitudinal metatarsal bone transfer on a 5-year-old boy with a type IIIB hypoplastic thumb. Despite the child's age, the growth of the thumb was confirmed and the thumb had stabilized. Moreover, growth disorder of the donor toe was not observed. This method is relatively easy to perform. And donor toe deformation can be prevented, because of the preservation of more than half of the metatarsal bone...
2018: Case Reports in Orthopedics
John J Carroll, Sean P Kelly, James N Foster, Derek A Mathis, Joseph F Alderete
Introduction: Fatigue fractures are stress fractures resulting from repetitive trauma in areas of stress concentration. Prior case reports and studies have described stress fractures through persistent physes about the olecranon and distal fibula, as evidenced by hyaline cartilage on histologic analysis. However, there have been no documented proximal tibia stress fractures through persistent physes. Case Presentation: A 29-year-old military male basic trainee with varus alignment about his knees suffered bilateral medial tibial plateau stress fractures several weeks into military basic training...
2018: Case Reports in Orthopedics
Othmane Miri, Nicolas Bonnet, Philippe Lysy, Naima Loucheur, René Gayito, Pierre Louis Docquier
Noonan-like/multiple giant cell lesion (NS/MGCL) is a rare condition overlapping with Noonan syndrome. Once thought to be a specific and separate entity, it is now suggested to be a variant of the Noonan syndrome spectrum. We report the case of an 8-year-old boy with a typical clinical picture of Noonan syndrome with a de novo germline mutation of PTPN11 (c.854 T>C). During his follow-up, the patient developed multifocal pigmented villonodular synovitis which first affected the left knee and shortly after both elbows...
2018: Case Reports in Orthopedics
Thiago Alvim do Amaral, David Sadigursky
A 25-year-old man initially presented with right knee extension deficit after an acute trauma, caused by a condition known as arthrogenic muscle inhibition. This should not be confused with a mechanical block caused by intra-articular pathology. The loss of knee extension, even if minimal, is disabling and leads to worse results after knee surgical treatment. Therefore, it is necessary to recognize and diagnose arthrogenic muscle inhibition to ensure the best treatment for patients with this condition. In this case report, the patient was managed with a rehabilitation technique resulting in an effective functional gain of the quadriceps and full restoration of knee extension...
2018: Case Reports in Orthopedics
Andrew Golz, Michael Murphy, Lukas Nystrom, Adam Schiff
Case: Giant cell tumor of bone is a benign, aggressive neoplasm commonly arising in the femur, tibia, and distal radius and less commonly in the hands and feet. We describe a 22-year-old woman who underwent wide resection of multiply recurrent first metatarsal giant cell tumor and reconstruction with iliac crest arthrodesis. Conclusion: To our knowledge, there have been no previous reports of managing multiply recurrent giant cell tumor of the first metatarsal. The patient was without pain and exercising without difficulty 18 months following surgery...
2018: Case Reports in Orthopedics
Celeste Tavolaro, Richard Bransford, Aditya Yerrapragada, Carlo Bellabarba, Haitao Zhou
Traumatic occipitocervical dislocation (OCD) is described in the literature as a potentially fatal injury secondary to high-energy trauma. We describe a case of OCD occurring in a patient who sustained a ground-level fall whose only clinical symptom was posterior neck pain without neurologic compromise. Computed tomography (CT) and magnetic resonance imaging (MRI) were used to diagnose severe injury to the structurally important ligamentous complex that stabilizes the base of the skull to the spine, along with unstable fractures of the occipital condyle and C1...
2018: Case Reports in Orthopedics
Yuyu Ishimoto, Mamoru Kawakami, Elizabeth Curtis, Cyrus Cooper, Nami Moriguchi, Yukihiro Nakagawa
Ligamentum flavum hematoma (LFH) is a rare cause of spinal nerve compression. This condition remains challenging to diagnose using MRI due to the changing intensity of the hematoma on imaging. The aim of this study was to describe the patient with LFH who had a succession of MRI scans carried out. We report on a 71-year-old woman with a mass at L4/5 and decompression surgery was performed for her left leg symptom. She had MRI carried out in a previous hospital and also had MRI again in our hospital. In a 2nd MRI of the same area, after a 2-week interval, a newly isointense mass was present within the anterior part of the previously identified lesion on T1-weighted image and the hyperintense area in the lesion was a little extended on T2-weighted imaging...
2018: Case Reports in Orthopedics
Hayato Kinoshita, Naohisa Miyakoshi, Michio Hongo, Akiko Misawa, Daisuke Kudo, Yoichi Shimada
Purpose: Congenital heart disease (CHD) is associated with an increased risk of scoliosis. The prognosis of scoliosis patients with CHD has improved because of advances in cardiac care. As a result, the frequency of surgery for scoliosis in this population has increased, although the risk of perioperative complications remains high. We treated two patients with CHD who underwent surgery for severe scoliosis. To avoid perioperative complications, we evaluated the preoperative cardiac status and anesthetic risks before posterior correction and fixation in both patients...
2018: Case Reports in Orthopedics
Rebecca F Lyons, Kevin McSorely, Mutaz Jadaan, J P McCabe, Colin G Murphy
Posterior atlantoaxial ligament disruption in children is a rare diagnosis. We present a case of a young girl with cervical spine posterior atlantoaxial ligament disruption post a fall from a climbing frame. Presenting with minimal symptoms other than neck pain, this case highlights the diagnostic difficulty and need for further radiological imaging in paediatric patients with neck pain post trauma.
2018: Case Reports in Orthopedics
Ichiro Tonogai, Eiki Fujimoto, Koichi Sairyo
The use of standard anterolateral and anteromedial portals in ankle arthroscopy results in reduced risk of vascular complications. Anatomical variations of the arterial network of the foot and ankle might render the vessels more susceptible to injury during procedures involving the anterior ankle joint. The literature, to our knowledge, reports only one case of a pseudoaneurysm involving the peroneal artery after ankle arthroscopy. Here, we report the unusual case of a 48-year-old man in general good health with the absence of the anterior tibial artery and posterior tibial artery...
2018: Case Reports in Orthopedics
Fumiaki Takase, Kyoko Yamasaki, Takeshi Kokubu, Yutaka Mifune, Atsuyuki Inui, Ryosuke Kuroda
Dorsal extension block pinning is a commonly performed surgical technique for acute bony mallet fingers. However, the treatment of chronic bony mallet finger remains controversial. We investigated the use of dorsal extension block pinning with percutaneous curettage for chronic bony mallet fingers. Seven patients with chronic bony mallet fingers were treated by dorsal extension block pinning with percutaneous curettage. The average age was 17 (range, 12-23) years, and the average time from injury to surgery was 20 (range, 7-49) weeks...
2018: Case Reports in Orthopedics
Junya Shimizu, Makoto Emori, Yohei Okada, Tadashi Hasegawa, Toshihiko Yamashita
A 16-year-old woman presented to her local hospital with a few-month history of right knee pain. On MRI, the lesion exhibited an intermediate signal on T1-weighted and T2-weighted images. The orthopedic physician made a diagnosis of osteochondritis dissecans. After 13 months from the first visit, the patient underwent MRI of the knee once more, which demonstrated that the osteolytic lesion grew larger. To achieve a definitive diagnosis, we attempted to perform a resection biopsy with knee arthroscopy. We performed biopsy, and the tumor was removed completely...
2018: Case Reports in Orthopedics
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