Case report: Plate-assisted bone transport with uniplanar external fixator in large bone defects of the humerus.

INTRODUCTION: We present a case series of two patients who underwent plate-assisted bone transport (PABT) with a uniplanar external fixator for the treatment of large bone defects of the humerus. The efficacy and outcomes were evaluated. CASE PRESENTATION: A retrospective review of patients treated with PABT for humeral defects over a 2-year period was performed. Proper gap healing occurred within 3 months, and a long course of physiotherapy was involved in obtaining satisfactory outcomes. DISCUSSION: Our results demonstrate that PABT might be a potentially effective alternative for large humeral defects, allowing controlled bone lengthening and healing without disrupting vascularity and providing stability for early motion. CONCLUSION: PABT appears to be a viable option for the management of large humeral defects with good functional outcomes and a manageable complication profile.

Self-inflicted tourniquet application resulted with two fasciotomies: Case report of an initially omitted Munchausen case.

INTRODUCTION: Compartment syndrome is an emergency which requires prompt intervention. While main challenge typically revolves around determining necessity for fasciotomy in suspected cases, etiology is often pronounced, leaving little room for differential diagnosis. CASE REPORT: We report a case with unconventional presentation and clinical course, ultimately diagnosed as Munchausen Syndrome. DISCUSSION: It has been reported that individuals with Munchausen syndrome are successful at manipulating healthcare professionals. They often study the symptoms of their sickness, examination findings, and findings that may alert doctors, mastering their techniques over time. CONCLUSION: It is of importance to consider Munchausen Syndrome as a potential cause, particularly in cases where clinical history and course of symptoms do not align with our experiences and cannot be reconciled with other possible diagnostic patterns.

Treatment of hip instability after total hip replacement with pelvic osteotomy using a modified Stoppa approach.

INTRODUCTION AND IMPORTANCE: Hip dislocation remains a significant complication following total hip arthroplasty, even though its incidence has decreased. While closed reduction is typically performed for early dislocations, delayed or chronic dislocations often necessitate acetabular or femoral component revision. CASE PRESENTATION: This document describes the treatment of hip dislocation in a 56-year-old patient through pelvic osteotomy without component revision. An acetabular component malposition was identified, exhibiting an 80-degree inclination and 20-degree cup anteversion. Owing to limited bone stock, a modified Stoppa approach was used for pelvic osteotomy to reduce acetabular inclination. The patient displayed remarkable clinical improvement, achieving a Harris Hip Score of 85 at the two-year check-up with no signs of dislocation. CLINICAL DISCUSSION: Recurrent hip dislocation is difficult to manage. It frequently necessitates component revision, presenting a challenge due to issues with cup extraction and limited bone stock. Preoperative detection of loosened components is crucial. If it goes undetected, the extraction process can result in bone loss, potentially leading to pelvic insufficiency. CONCLUSION: Successful revisions of hip arthroplasties can be achieved with geometric modifications to the pelvis.

Case report: Distraction osteogenesis of focal fibrocartilaginous dysplasia and literature review.

INTRODUCTION AND IMPORTANCE: Focal fibrocartilaginous dysplasia (FFCD) is a rare disease of the ulna that requires early surgical intervention. CASE PRESENTATION: We present a juvenile case and the outcomes of a corrected deformity. The fibrotic band that adhered to the ulna was resected, the ulna was osteotomized, and then an external fixator was placed for lengthening. The ulna's distal physis line was extended by 18 mm so that it would be the same length as the distal physis line of the radius. Full functional recovery occurred within three months. CLINICAL DISCUSSION: There have been 22 cases of ulnar FFCD reported in the literature. Our patient is the oldest reported thus far who developed radial head subluxation, but no dislocation occurred. CONCLUSION: FFCD is a broad-spectrum disease. Although its course is generally poor for patients with a late diagnosis, it is possible to obtain good results with correction procedures.