RESUMO
A 68-year-old woman who suffered from polycythemia vera presented at our clinic with the chief complaints of pain, swelling, and a warm sensation in her left thigh. She had undergone a left bipolar hemiarthroplasty following a hip fracture 24 days prior to this presentation. Her erythrocyte sedimentation rate and C-reactive protein (CRP) levels were elevated. In addition, a postoperative infection was suspected in the 3-phase bone scan; therefore, she received intravenous antibiotic therapy. This approach proved to be ineffective and she was subsequently diagnosed with a deep vein thrombosis via color Doppler ultrasonography. It is interesting to note that a deep vein thrombosis can present with symptoms similar to those of a postoperative infection. Furthermore, an elevated CRP level is frequently observed in patients suffering from polycythemia vera. Therefore, the two conditions, which require completely different treatments, can be confused. We report on this case with a review of the relevant literature.
Assuntos
Idoso , Feminino , Humanos , Sedimentação Sanguínea , Proteína C-Reativa , Hemiartroplastia , Quadril , Policitemia Vera , Sensação , Coxa da Perna , Ultrassonografia Doppler em Cores , Trombose VenosaRESUMO
Posttraumatic volar instability of the thumb metacarpophalangeal joint with hyperextensile laxity makes pain and weakness during pinch or grip exercise. Several surgical procedures have been described to eliminate thumb metacarpophalangeal joint hyperextension. We treated a patient who had suffered from volar instability with pain for 17 years using volar plate repair and capsulodesis with suture anchor. The result was successful with satisfactory recovery of the hand function.
Assuntos
Humanos , Mãos , Força da Mão , Articulação Metacarpofalângica , Âncoras de Sutura , Polegar , Placa PalmarRESUMO
There are few reports on intraneural ganglion, and this malformations mainly occurs in peripheral nerves of the upper and lower extremities. In the lower extremity, it often occurs in the common peroneal nerve, with neurologic symptoms such as motor weakness and sensory changes. We experienced a case of intraneural ganglion of the common peroneal nerve around the fibular head and this was associated with neurologic symptoms, including weakness of the motor power in the ankle and great toe dorsiflexion and sensory change in the foot dorsum. It was successfully treated by complete excision. We report here on this unusual case and we review the relevant literature.
Assuntos
Animais , Tornozelo , Pé , Cistos Glanglionares , Cabeça , Extremidade Inferior , Manifestações Neurológicas , Paralisia , Nervos Periféricos , Nervo Fibular , Dedos do PéRESUMO
We analyze ninty-seven cases of Colles fractures treated with closed reduction and sugar tong splint immobilization and followed for more than 1 year at Seoul National University from January 1981 to Decmber 1985. The results of this study were as follows; l. All of 97 cases were closed fractures and the incidence was high in females who aged over 6th decades. The main cause of this injury was slipping down accident comprising of 68.0%. 2. 63 cases (64.9%) were simple extra-articular fractures, and 34 cases (35.1%) were comminuted intra-articular fractures. 3. In a group of simple extra-articular fracture the functional end result was satisfactory in 88.9%, so closed reduction and sugar tong splint were thought to be a good procedure in this group. 4. In a group of comminuted intra-articular fracture the functional end result was satisfactory in 58.9% only. In the cases which show unacceptable loss of position during first two weeks of routine sugar tong splint immobilization we feel another technique is indicated, such as.pin and plaster immobilization or percutaneous pinning. 5. The main cause of unsatisfactory result was malunion, which was produced by loss of reduction position.
Assuntos
Feminino , Humanos , Estudo Clínico , Fratura de Colles , Fraturas Fechadas , Imobilização , Incidência , Fraturas Intra-Articulares , Seul , ContençõesRESUMO
Giant cell tumor is a relatively uncommon neoplasm with high rate of local recurrence following curettage and bone graft. The histologic grading was not proven useful in predictiog outcome. Histologically benign giant cell tumor may metastasize. We report a case of histologically benign giant cell tumor occurred at left distai femur with local recurrences and multiple pulmonary metastases which was proven by percutaneous needle aspiration lung biopsy. Recurred local lesion was treated by curettage and filling with methylmethacrylate and pulmonary metastases was treated with adriamycine and dacarbazine.
Assuntos
Biópsia , Curetagem , Dacarbazina , Doxorrubicina , Fêmur , Tumores de Células Gigantes , Células Gigantes , Pulmão , Metilmetacrilato , Agulhas , Metástase Neoplásica , Recidiva , TransplantesRESUMO
In certain low-grade malignant tumors such as chondrosarcoma and giant cell tumor, radical treatments may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free tissue transfer a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defects with excellent clinical results. We tried wide excision and free vascularized bone graft in 6 patients with malignant or aggressive bone tumor from April 1981 to November 1985 and followed up for more one year. Mean follow up of free vascularized bone graft is 26.4 months and that of devascularized bone graft is 22.6 months. The results of the free vascularized bone graft were compared with 10 patients who were treated with the wide excision and the devascularized bone graft. In this analysis, free vascularized bone graft is superior to devascularized bone graft in bony union, complications and functional results.