RESUMO
Introduction: Prevalence of polio was very high in India before its eradication, with a number of people living with its residual effects. Anterior cruciate ligament (ACL) injury is the most common knee injury. To the best of our knowledge, this is the first report in literature presenting ACL injury in a poliotic limb and its management. Case Report: A 30-year-old male with poliotic limb and equinovarus deformity presented with ACL injury to the same limb. ACL reconstruction was done using Peroneus longus graft. Postoperatively patient was gradually returned to preinjury activity levels. Conclusion: ACL tears in a poliotic limb can be a challenging case. Proper preoperative planning and anticipation of problems can help in managing the case with a good outcome.
RESUMO
Introduction: Certain elbow pathologies can give rise to considerable loss of joint function, which would severely affect the daily living activities of the patients. Total elbow arthroplasty (TEA) can be a safe and reasonable motion-preserving and pain-relieving option in such debilitating elbow conditions. The aim of this case series is to evaluate the functional outcome of TEA in young patients with four different indications after an 8-year follow-up. Case Report: We report a case series of four TEA cases done for different indications, namely rheumatoid arthritis, chronic elbow dislocation, post-traumatic elbow ankylosis, and failed primary total elbow replacement, all in relatively young patients. All patients were given a semi-constrained Coonrad-Morrey prosthesis using a posterior Bryan-Morrey approach. The cases were done during the years 2013-2014. Eight-year follow-up of each case showed excellent functional outcome and persistent pain relief with a high Mayo Elbow Performance Score. All the patients have given written consent for publishing this article. Conclusion: Despite being uncommon, total elbow replacement can be the choice of surgery for certain elbow affections, giving satisfactory functional recovery and good pain relief, even in a younger population.
RESUMO
Introduction: The usual cause of a distal tibial fracture is a high-energy trauma. Although multiple options are available for their treatment such as intramedullary nailing, open plating, and external fixator, each of these options might result in a non-union. Knowing the type of non-union not only allows us to guess the cause but also directs us toward the best possible treatment. Despite this, we might still get surprises on the operating table due to pre-operative misdiagnosis. Case Report: Reporting a case of a 42-year-old male with a 15-month-old left distal tibia non-union. The index injury was a grade 1 distal third tibia fibula fracture which was fixed with a plate and screws 15 months back. All the clinical and biochemical signs hinted toward the diagnosis of an aseptic non-union and the treatment was planned accordingly. However, intraoperative findings were much different due to which the surgeons had to improvise and change the intervention to an antibiotic-coated nail. Conclusion: Although each variety of non-union has its set of signs and symptoms, they can be misleading. Different etiologies can coexist making it difficult to give a perfect pre-operative diagnosis and management. Non-unions, especially in the tibia, thus need meticulous understanding of the underlying disease process and extensive treatment strategies.
