ABSTRACT
Instability in the athlete presents a unique challenge to the orthopaedic surgeon. A spectrum of both static and dynamic pathophysiology, as well as gross and microscopic histopathology, contribute to this complex clinical continuum. Biomechanical studies of the shoulder and ligament cutting studies in recent years have generated a more precise understanding of the individual contributions of the various ligaments and capsular regions to shoulder instability. An understanding of the underlying pathology and accurate assessment of degree and direction of the instability by clinical examination and history are essential to developing appropriate treatment algorithms.
Subject(s)
Athletic Injuries/pathology , Athletic Injuries/physiopathology , Joint Instability/pathology , Joint Instability/physiopathology , Shoulder Injuries , Algorithms , Athletic Injuries/etiology , Athletic Injuries/therapy , Biomechanical Phenomena , Decision Trees , Humans , Joint Instability/etiology , Joint Instability/therapy , Medical History Taking , Physical Examination , Pressure , Range of Motion, Articular , Risk FactorsABSTRACT
A case report and literature review are presented involving a fatal case of squamous cell carcinoma of the lower extremity. The unique aspects of this patient include the young age at presentation (35 years old), and the association with both a burn scar (Marjolin's) ulcer and a draining osteomyelitis fistulus tract. Epidemiologic data for Marjolin's ulcers as well as squamous cell carcinoma associated with draining sinus tracts of osteomyelitis are reviewed, in addition to the recommended management of such patients. The case presented is a reminder of the need to maintain a high index of suspicion for malignant transformation within ulcerative lesions.
Subject(s)
Burns/complications , Carcinoma, Squamous Cell/etiology , Cicatrix/complications , Neoplasms, Post-Traumatic/etiology , Soft Tissue Neoplasms/etiology , Adult , Carcinoma, Squamous Cell/pathology , Chronic Disease , Fatal Outcome , Humans , Male , Osteomyelitis/complications , Soft Tissue Neoplasms/pathologyABSTRACT
This case report included roentgenographic and clinical findings of a condition of interest to the orthopedic surgeon. The medical history, physical findings, and results of roentgenographic examinations precede clinical and roentgenographic differential diagnoses.
Subject(s)
Arthralgia/etiology , Humerus/blood supply , Joint Instability/etiology , Osteonecrosis/diagnosis , Shoulder Dislocation/etiology , Shoulder Joint , Adult , Humans , Magnetic Resonance Imaging , Male , Osteonecrosis/complications , Osteonecrosis/rehabilitation , Range of Motion, Articular , Recurrence , Shoulder Joint/diagnostic imaging , Shoulder Joint/physiopathology , Tomography, X-Ray ComputedABSTRACT
Detailed knowledge of anticipated casualties is essential for the medical officer preparing to support a mission. To accurately describe the injuries inflicted upon the 2/75th Ranger Battalion involved in Operation Just Cause, 471 (75.5%) Rangers were personally interviewed. The average Ranger was 23 years old, an E-4 with 3 years of active duty service, and in a good to excellent fitness category. The majority went into battle with little sleep or food. Injuries forced 9.5% out of combat, and limited another 9.9%. The overall unit casualty rate was 35%, with 217 Rangers suffering 281 injuries. Most of the injuries were musculoskeletal (sprains) and non-surgical, with 90% occurring during the insertion. The lower extremity, particularly the ankle, was the most frequently injured area. It is hoped that this study will assist those who are planning to support future, similar nighttime parachute operations.
