RESUMO
CASE: One week after receiving a COVID-19 vaccine in his left deltoid, a 34-year-old man developed severe right periscapular pain that lasted 2 weeks and was followed by profound right shoulder girdle atrophy and weakness. Both the pain and motor deficits resolved over the subsequent 4 months. CONCLUSION: Parsonage-Turner syndrome (PTS) is an idiopathic brachial plexopathy that can develop in the setting of recent vaccination and lead to significant shoulder pain and weakness. Given the worldwide increase in newly vaccinated patients, orthopaedic surgeons should take detailed histories to identify potential triggers (recent vaccination or illness) that point toward PTS rather than musculoskeletal pathology.
Assuntos
Neurite do Plexo Braquial , Vacinas contra COVID-19 , COVID-19 , Adulto , Humanos , Masculino , Neurite do Plexo Braquial/etiologia , COVID-19/prevenção & controle , COVID-19/complicações , Vacinas contra COVID-19/efeitos adversos , Dor de Ombro , Vacinação/efeitos adversosRESUMO
PURPOSE: The purpose of this study was to investigate the intermediate-term results of a retrospective clinical trial designed to establish the value of lateral retinaculum release of the patella in conjunction with partial lateral patella facetectomy in patients with stage III or stage IV patellofemoral arthritis. METHODS: Between October 1992 and January 2005, all patients undergoing arthroscopy, lateral patellar retinaculum release, and lateral patella facetectomy were evaluated. In total, 66 knees in 63 patients (89%) were available for evaluation at a mean of 60 months after the index surgery. Evaluations consisted of preoperative and postoperative questionnaires, physical examinations, and radiographs. The main outcome measure was the Kujala patellofemoral score. RESULTS: For those patients not undergoing total knee arthroplasty before evaluation, the mean Kujala score was 45.6 preoperatively and 72.0 postoperatively (P < .001); subjectively, 56% of patients were very satisfied, 32% satisfied and would repeat the procedure, 5% were indifferent, and 7% were dissatisfied and would not repeat the procedure. Including all patients who underwent total knee arthroplasty before evaluation and those who would not repeat the procedure or were indifferent, our accumulative failure rate was 17%. Correlations of several measures with the Kujala score, as well as subgroup comparisons of several measures between patients who were satisfied and those who were not satisfied with their reconstructions, were performed. However, all of these failed to achieve statistical significance after adjustment for multiple comparisons and so are not reported in this report. CONCLUSIONS: Lateral patella retinaculum release and partial lateral patella facetectomy for end-stage patellofemoral disease provides up to 5 years of symptomatic relief in over 80% of carefully selected patients who do not have significant arthritis (grade IV) in the medial or lateral knee compartments. Significant lateral facet patellofemoral arthritis (grade IV) even in association with medial facet and femoral sulcus involvement is not a contraindication to this surgical approach. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Assuntos
Artrite/etiologia , Artrite/cirurgia , Artropatias/complicações , Articulação do Joelho , Patela/cirurgia , Adulto , Idoso , Artrite/diagnóstico por imagem , Artrite/patologia , Artroplastia do Joelho , Fêmur , Humanos , Artropatias/cirurgia , Pessoa de Meia-Idade , Patela/patologia , Satisfação do Paciente , Pressão , Radiografia , Índice de Gravidade de Doença , Inquéritos e Questionários , Síndrome , Resultado do TratamentoAssuntos
Anti-Infecciosos/efeitos adversos , Ciprofloxacina/efeitos adversos , Traumatismos do Joelho/induzido quimicamente , Músculo Quadríceps/lesões , Ruptura/induzido quimicamente , Tendinopatia/induzido quimicamente , Traumatismos dos Tendões/induzido quimicamente , Fluoroquinolonas/efeitos adversos , Humanos , Traumatismos do Joelho/etiologia , Masculino , Pessoa de Meia-Idade , Ruptura/etiologia , Tendinopatia/etiologia , Traumatismos dos Tendões/etiologiaRESUMO
The superficial location of ulnar fractures allows minimally invasive insertion of percutaneous plates, which improves stability and creates a friendly healing environment.