ABSTRACT
Persistent left superior vena cava is a rare but well-recognised condition. We describe a case of persistent left superior vena cava draining directly into the left atrium, with a fixed anatomical right-to-left shunt and paradoxical embolic events causing recurrent brain abscess. Surgical ligation was curative.
Subject(s)
Brain/pathology , Cardiovascular Abnormalities/surgery , Embolism/surgery , Heart Atria/surgery , Vena Cava, Superior/abnormalities , Vena Cava, Superior/surgery , Abscess , Blood Vessel Prosthesis Implantation/instrumentation , Brain Abscess/etiology , Cardiovascular Abnormalities/complications , Catheterization, Central Venous , Female , Humans , Ligation/methods , Middle Aged , Pacemaker, Artificial , RecurrenceABSTRACT
The tarsometatarsal (Lisfranc) joint suffers a spectrum of injuries ranging from solely ligamentous injury to fracture dislocation. The authors evaluated eighteen consecutive patients who underwent surgery for tarsometatarsal joint injuries, utilising 4.5 mm cancellous screws and 1.6 mm K-wires. The outcome of function and anatomical reduction were assessed by AOFAS (American Orthopedic Foot and Ankle Society) midfoot score and radiography. Patients with only ligamentous injury scored poorer partly due to delay in diagnosis and the nature of the injury. The technique used maintained anatomical reduction at the time of review.
Subject(s)
Tarsal Joints/injuries , Tarsal Joints/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Radiography , Recovery of Function , Retrospective Studies , Tarsal Joints/diagnostic imaging , Treatment OutcomeABSTRACT
We reviewed 15 adult patients with intra-articular fractures of the distal humerus treated over a period of 2 years. All patients underwent primary open reduction and internal fixation, which included 11 double plating procedures. The fractures were classified according to the AO/ASIF system. Patient outcome was assessed subjectively by scoring the patients' residual symptom of pain and their overall satisfaction of the treatment received. Objective assessment was performed using the Mayo Elbow Performance Index (range of motion, assessment of functional status, pain and stability of the joint). At a mean follow-up of 12.3 months, 7 patients were rated as excellent; 6, as good; one, as fair; and one, as poor. These cases had an average arc of flexion of 109.7 degrees. The sub-group of type C fractures without revision surgery had a mean flexion arc of 110.7 degrees (95-140 degrees ), with 100% Good to Excellent scores. Complications included two post-operative ulnar nerve neuropraxia, one wound infection, and one fracture fibrous non-union. Three patients required revision surgery which included a total elbow arthroplasty for implant failure, whilst four patients (including the patient with the subsequent arthroplasty) required joint mobilisation procedures for residual stiffness.
Subject(s)
Fracture Fixation, Internal/methods , Humeral Fractures/surgery , Adult , Aged , Aged, 80 and over , Bone Plates , Female , Follow-Up Studies , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/rehabilitation , Humans , Humeral Fractures/diagnostic imaging , Humeral Fractures/rehabilitation , Male , Middle Aged , Paralysis/etiology , Patient Satisfaction , Radiography , Range of Motion, Articular , Reoperation , Retrospective Studies , Treatment Outcome , Ulnar Nerve/injuriesABSTRACT
We report a case of Bizarre Parosteal Osteochondromatous Proliferation (BPOP) of the hand that was initially misdiagnosed as an osteochondroma. BPOP, although a benign lesion, behaves aggressively with rapid growth and high risk of local recurrence after local resection. The distinguishing features of BPOP as opposed to an osteochondroma are discussed.
