RESUMO
Fracture of the talar body is rare, it reaches articular congruence and determines the ankle's functional prognosis. The authors report a case of a combination of a sagittal talar body fracture with fracture of the medial malleolus in a 52-year-old following a road traffic accident. The association talus body fracture with a medial malleolus fracture is exceptional. Stable internal fixation can yield good functional results.
Assuntos
Fraturas do Tornozelo/patologia , Fraturas Ósseas/patologia , Tálus/lesões , Acidentes de Trânsito , Fraturas do Tornozelo/etiologia , Fraturas do Tornozelo/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/etiologia , Fraturas Ósseas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Tálus/patologia , Tálus/cirurgiaAssuntos
Tornozelo/patologia , Pé/patologia , Complicações na Gravidez/diagnóstico , Distrofia Simpática Reflexa/diagnóstico , Adulto , Tornozelo/diagnóstico por imagem , Feminino , Morte Fetal/etiologia , Ruptura Prematura de Membranas Fetais/diagnóstico , Pé/diagnóstico por imagem , Humanos , Achados Incidentais , Gravidez , Distrofia Simpática Reflexa/complicaçõesRESUMO
We treated a patient with a rare combination of ipsilateral fractures of the distal and proximal ends of the radius. A man aged 42 years had simultaneous fractures of the distal and proximal ends of the radius (radial neck) following a roadside accident. The distal end fracture of the radius was treated with surgical reduction and T-plate volar fixation, and the undisplaced radial neck fracture was treated by an above elbow splintage for 2 weeks. The elbow mobilization was started at 2 weeks. The distal radius was protected for another 4 weeks in a below elbow functional brace. Ipsilateral proximal and distal radial fracture is an uncommon injury pattern. The series illustrates a number of problems associated with this combination. Firstly, one should be aware of this rare injury pattern and there should be greater emphasis on clinical examination of elbow in cases of wrist injuries and vice versa. Once diagnosed, one faces the dilemma of appropriate management in these cases. The appropriate management will depend on the injury characteristics including the age of the patient and the fracture pattern. One should try to preserve the radial head to prevent a possible proximal radial migration especially in younger patients.
Assuntos
Fixação Interna de Fraturas/métodos , Fraturas do Rádio/patologia , Rádio (Anatomia)/lesões , Acidentes de Trânsito , Adulto , Braquetes , Articulação do Cotovelo , Humanos , Masculino , Fraturas do Rádio/cirurgia , ContençõesRESUMO
Calcaneal fractures are infrequent but, more often, serious. We report a series of 29 cases of calcaneal fractures surgically treated in the Orthopaedics and Traumatology in the University Hospital (CHU) Hassan II of Fez. This retrospective study aims to present the principles and to evaluate the results of surgical treatment for articular fractures of the calcaneus, in comparison with conservative treatment. Our study included 21 men and 8 women, the average age was 21-61 years. Etiology was dominated by road traffic accidents as wel as by falls from a high place. The evaluation of the lesions was based on the classification of Duparc. The treatment was based on open reduction associated with Y-plate osteosynthesis or one-third tubular plate osteosynthesis using triangulation. Clinical results were evaluated on the basis of kitaoka score, with an average follow-up period of 24 months. 86% of patients have had good medium-term results.
Assuntos
Calcâneo/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Placas Ósseas , Calcâneo/patologia , Feminino , Seguimentos , Fraturas Ósseas/etiologia , Fraturas Ósseas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
We conducted a retrospective study of bifocal closed fractures of the tibia in order to assess the severity of this unusual lesion. We analyzed the entry point for intramedullary nailing as well as the different therapeutic options. Sixteen patients with AO type 42C2 bifocal leg fractures were treated in our Traumatology-Orthopedics Unit A at the University Hospital Hassan II, Fez. The subjects were young, victims of medium to high energy trauma. Five subjects were polytraumatized patients and two were poly-traumatized patients with fractures. Six patients underwent locked intramedullary nailing with reaming while seven patients underwent intramedullary nailing without reaming. Two cases of compartment syndrome were recorded after nailing. Mean fracture consolidation time was twelve months. Two cases of pseudarthroses were successfully treated by nailing with reaming. Bifocal leg fractures pose many challenges for the surgeon due to weak vascular supply of the intermediate segment and to severe deterioration of the surrounding soft tissues. They should be detected among the leg fractures based on their context of occurrence, difficulties in fixation as well as slow consolidation time.
Assuntos
Fixação Intramedular de Fraturas/métodos , Fraturas Fechadas/cirurgia , Fraturas da Tíbia/cirurgia , Adulto , Idoso , Síndromes Compartimentais/epidemiologia , Síndromes Compartimentais/etiologia , Feminino , Consolidação da Fratura/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Subtalar dislocation is a very rare injury. It is an orthopedic emergency. External dislocation is exceptional. It uncommonly occurs after a sport accident. We here report the case of a footballer presenting with Cauchoix and Duparc type II open external subtalar dislocation following an accident during a sport competition. The patient underwent orthopedic treatment. At 1-year follow-up, functional outcome was satisfactory.
Assuntos
Traumatismos em Atletas/terapia , Luxações Articulares/terapia , Procedimentos Ortopédicos/métodos , Articulação Talocalcânea/lesões , Adulto , Seguimentos , Humanos , Masculino , Futebol/lesõesRESUMO
The association of shoulder dislocation with fracture of the ipsilateral humeral diaphysis is a rare injury. We report two cases of anterior shoulder dislocation associated with concomitant ipsilateral humeral fracture. Reduction of shoulder dislocation followed by screw-plate fixation of the fracture of the humeral diaphysis was performed in both cases. At 4-months follow-up, the fracture of the humeral diaphysis was well consolidated. At 1-year both patients had returned to normal levels of activity. Primary reduction of shoulder dislocation followed by osteosynthesis of the humeral diaphysis yields good results.
Assuntos
Fixação Interna de Fraturas/métodos , Fraturas do Úmero/cirurgia , Luxação do Ombro/cirurgia , Adulto , Placas Ósseas , Parafusos Ósseos , Diáfises , Seguimentos , Humanos , MasculinoAssuntos
Artroplastia de Quadril , Neoplasias Ósseas/diagnóstico , Fraturas do Colo Femoral/diagnóstico , Prótese de Quadril , Osteossarcoma/diagnóstico , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Diagnóstico Diferencial , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas do Colo Femoral/cirurgia , Humanos , Masculino , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/cirurgia , Adulto JovemRESUMO
Classic Kaposi sarcoma is a multifocal rare tumor originating from vascular endothelial cells with progressive evolution and little malignant predisposition. Although Kaposi sarcoma with extensive visceral involvement is sometimes observed among HIV-positive patients, tumor dissemination to visceral lymph nodes in classic SK remains very rare. We report a rare case of aggressive classic Kaposi sarcoma of the hand with a rapid and destructive development.
Assuntos
Osso e Ossos/patologia , Sarcoma de Kaposi/patologia , Idoso de 80 Anos ou mais , Humanos , Metástase Linfática , MasculinoRESUMO
Failure of internal fixation of intertrochanteric fracture is associated with delayed union or malunion resulting in persistent pain and diminished function. We report a rare case of implant failure of the gamma nail with intertrochanteric fracture non union treated by DCS plate screw and bone graft.
Assuntos
Fixação Interna de Fraturas/métodos , Fraturas não Consolidadas/cirurgia , Fraturas do Quadril/cirurgia , Idoso , Pinos Ortopédicos , Placas Ósseas , Transplante Ósseo/métodos , Feminino , Humanos , Falha de TratamentoAssuntos
Deformidades Adquiridas da Mão/cirurgia , Hanseníase/complicações , Transferência Tendinosa/métodos , Adulto , Deformidades Adquiridas da Mão/etiologia , Deformidades Adquiridas da Mão/microbiologia , Humanos , Masculino , Nervo Ulnar/microbiologia , Nervo Ulnar/patologia , Neuropatias Ulnares/microbiologia , Neuropatias Ulnares/patologiaRESUMO
We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). Mucoid degeneration of the ACL is a very rare cause of knee pain. There have been only some reported cases of mucoid degeneration of the ACL in the English literature. We reviewed previous reports and summarized clinical features and symptoms, including those found in our case. Magnetic Resonance Imaging is the most useful tool for differentiating mucoid degeneration of the ACL from an intraligamentous ganglion or other lesions in the knee joint. If this disease is considered preoperatively, it can be diagnosed easily based on characteristic findings.
Assuntos
Ligamento Cruzado Anterior/patologia , Ligamento Cruzado Anterior/cirurgia , Ligamento Cruzado Anterior/fisiopatologia , Artralgia/etiologia , Artralgia/cirurgia , Artroscopia , Feminino , Humanos , Hipertrofia/patologia , Hipertrofia/fisiopatologia , Hipertrofia/cirurgia , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologiaRESUMO
Lipomas are common benign neoplasms consisting of mature fatty tissue. They are usually of roundish or ovoid shape and are situated in a single anatomical region. They most frequently occur on the back and in the extremities. Most lipomas are subcutaneous and require no imaging evaluation. When deep, large and unusual in location, MRI can identify and localise these tumours and is the best exploration to differentiate lipoma and lipo-sarcoma. We describe a case of a patient with an intramuscular lipoma of the biceps brachii.
Assuntos
Lipoma/patologia , Neoplasias Musculares/patologia , Músculo Esquelético/patologia , Feminino , Humanos , Lipoma/diagnóstico , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Musculares/diagnósticoAssuntos
Placas Ósseas , Fraturas do Rádio/cirurgia , Fraturas da Ulna/cirurgia , Adulto , Traumatismos em Atletas/cirurgia , Força Compressiva , Feminino , Humanos , Masculino , Marrocos , Procedimentos Ortopédicos/instrumentação , Procedimentos Ortopédicos/métodos , Desenho de Prótese , Fraturas do Rádio/complicações , Estudos Retrospectivos , Fraturas da Ulna/complicações , Adulto JovemRESUMO
Isolated palmar dislocation of the fifth carpometacarpal joint is an uncommon injury and classified as radio-palmar or ulno-palmar according to the direction of displacement of the fifth metacarpal base. This very rare injury is often difficult to recognize. A careful neurologic assessment of the patient is a necessity, as well as obtaining proper radiographs of the hand. The purpose of this report is to present a patient with a pure isolated volar dislocation of the fifth carpometacarpal joint that was satisfactorily treated with closed reduction and casting. A review of the literature is presented.
Assuntos
Articulações Carpometacarpais/lesões , Luxações Articulares/diagnóstico , Adulto , Humanos , Incidência , Luxações Articulares/epidemiologia , MasculinoRESUMO
An 18 year old male patient was hit by a car to his motorcycle causing a unicondylar Hoffa fracture and an ipsilateral patella fracture. Hoffa fracture is a rare lesion and this association of injury has not been reported before.