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INTRODUCTION: Percutaneous sacroiliac fixation is an effective minimally invasive method for posterior pelvic ring stabilization. Screw misplacement, and subsequent neurologic injury are two well described complications. Managing those complications however is under-reported. CASE: A young female, sustained an unstable pelvic ring injury as a victim of motor vehicle collision. Following percutaneous sacroiliac screw fixation, she complained of L5 nerve root radiculopathy, and muscle weakness. Percutaneous removal of the screw after a wait period for fracture union resulted in immediate symptoms relief. DISCUSSION: Safe sacroiliac screw placement is technically demanding requiring good understanding of sacral complex morphology and its anatomic variants. Risk of screw misplacement, and potential neurologic injury increases in dysmorphic sacra, or with inaccurate fracture reduction. Advances in intraoperative imaging modalities have been introduced in an attempt to improve accurate screw insertion. Literature is scarce with reports discussing removal of sacroiliac screw. Technique of screw retrieval is also controversial. CONCLUSION: This case addresses management of an iatrogenic neurologic complication following percutaneous sacroiliac screw fixation. Our experience showed that, percutaneous retrieval of an intact misplaced sacroiliac screw is achievable, resulting in complete resolution of neurologic symptoms.
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INTRODUCTION: Neck of femur fracture in osteogenesis imperfecta is rarely reported. The management is uncertain and always reported as difficult. Clinical outcomes are not well described. CASE PRESENTATION: A teenage girl, who is known to have osteogenesis imperfecta, sustained neck of femur fracture in the presence of a previously inserted implant. She was treated by percutaneous screw fixation. In both immediate and long term follow up, our patient had satisfactory outcome and return to pre-fracture functional status. DISCUSSION: Dealing with fragility fracture in small abnormal hips is challenging especially, in the presence of a retained implant in- situ. Intra-operative difficulty were encountered during positioning, reduction, and screw insertion attempt. CONCLUSION: This rare case illustrates the anticipated difficulties in managing neck of femur fracture in osteogenesis imperfect patients. It also emphasize on the importance of surgical fixation to control pain and allow for healing in anatomically functional position.
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BACKGROUND: Development of effective educational strategies should accompany increases in public awareness and the availability of genetic testing for breast cancer (BC). These educational strategies should be designed to fulfill the knowledge gap while considering factors that influence women's interest in order to facilitate decision making. OBJECTIVE: To determine the possible correlates of Saudi women's interest in BC genes testing including socio-demographics, the level of awareness towards BC genes, the family history of BC and the perceived personal risk among adult Saudi women in Al Hassa, Saudi Arabia. SUBJECTS AND METHODS: This cross-sectional study was carried out during the second BC community-based campaign in Al Hassa, Saudi Arabia. All Saudi women aged ≥ 18 years (n=781) attending the educational components of the campaign were invited to a personal interview. Data collection included gathering information about socio- demographics, family history of BC, the perceived personal risk for BC, awareness and attitude towards BC genes and the women's interest in BC genes testing. RESULTS: Of the included women (n=599), 19.5% perceived higher risk for BC development, significantly more among < 40 years of age, and with positive family history of BC before 50 years of age. The participants demonstrated a poor level of awareness regarding the inheritance, risk, and availability of BC genetic testing. The median summated knowledge score was 1.0 (out of 7 points) with a knowledge deficit of 87.8%. The level of knowledge showed significant decline with age (> 40 years). Of the included women 54.7% expressed an interest in BC genetic testing for assessing their BC risk. Multivariate regression model showed that being middle aged (Odds Ratio 'OR'=1.88, confidence intervals 'C.I'=1.14-3.11), with higher knowledge level (OR=1.67, C.I=1.08-2.57) and perceiving higher risk for BC (OR=2.11, C.I=1.61-2.76) were the significant positive correlates for Saudi women interest in BC genetic testing. CONCLUSION: Saudi women express high interest in genetic testing for BC risk despite their poor awareness. This great interest may reflect the presence of inappropriate information regarding BC genetic testing and its role in risk analysis.
