RESUMO
Distal femur fractures present a substantial orthopedic challenge, necessitating a comprehensive exploration spanning epidemiology, anatomy, classification, diagnosis, and treatment strategies. This review thoroughly analyzes the multifaceted aspects surrounding distal femur fractures. It delves into the definition and epidemiology, shedding light on the incidence, age distribution, and associated risk factors. An exhaustive examination of the distal femur's anatomy, encompassing ligaments and tendons, establishes the groundwork for understanding fracture patterns and subsequent classification according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) system. Diagnostic considerations encompass physical examination and various imaging modalities, emphasizing the critical importance of prompt and accurate assessment. The extensive discussion on treatment options ranges from non-surgical management, including casting and traction, to surgical interventions, such as open reduction and internal fixation, intramedullary nailing, and external fixation. The implications for clinical practice underscore the necessity for tailored approaches based on fracture characteristics to optimize patient outcomes. However, this review also emphasizes areas necessitating further investigation, including exploring predictive biomarkers, advanced surgical techniques, and innovative rehabilitation protocols. Insights from long-term outcomes and quality-of-life assessments in diverse populations offer promising avenues for enhancing the comprehensive management of distal femur fractures. Continuous research in these areas can refine treatment strategies and elevate the standard of care for individuals grappling with this intricate orthopedic condition.
RESUMO
Background Chronic suppurative otitis media (CSOM) is described as middle ear cleft inflammation that results in long-term alterations to the tympanic membrane and/or the middle ear structures. In cases of CSOM, type 1 tympanoplasty, also known as myringoplasty, is a successful procedure for repairing the tympanic membrane and can even help restore hearing loss. This study aims to compare functional and clinical outcomes of type 1 tympanoplasty performed using transcanal endoscopic ear surgery (TEES) versus those performed via microscopic ear surgery (MES) for perforation in the tympanic membrane in the safe type of CSOM. Methodology Between January 2018 and January 2022, a retrospective analysis of 100 patients (47 men and 53 women) operated for the safe type of CSOM with a perforated tympanic membrane was conducted in our department. Based on the surgical methods, cases were randomly divided into two groups. There were 50 people in group 1 who underwent endoscopic tympanoplasty and 50 in group 2 who underwent microscopic tympanoplasty. The following factors were assessed: patient demographics; tympanic membrane perforation size at the time of surgery; operating room time; hearing outcomes, that is, closure of air-bone gap (ABG); graft uptake success rate; postoperative hospital stay; and medical resource usage. Patients were followed up for 12 weeks. Results Both groups shared similar epidemiological profiles, preoperative hearing status, and perforation sizes. In both groups, the rate of graft uptake was comparable. The average ABG closure was also quite comparable. In the case of endoscopic surgeries, the mean operative time was shorter; which was statistically significant, and complications were significantly lower in group 1. Conclusions Compared to its microscopic counterpart, endoscopic tympanoplasty has a similar graft uptake success rate and a comparable hearing outcome; however, it requires less operative time and hospital stay, has early recovery, and makes lesser use of medical resources, and it is cosmetically better.
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Cerebral palsy (CP) encompasses a range of conditions that impact an individual's mobility, balance, and posture, making it the most prevalent motor impairment in children. In spastic cerebral palsy, muscle stiffness hinders walking and, if left untreated, may lead to complications such as hip dislocations or dysplasia. Adductor spasticity is a common challenge in these children, significantly impeding mobility and daily activities. The risk of hip dislocation escalates as gross motor function declines, particularly in children with severe impairments. This case report highlights the successful application of bilateral adductor tenotomy with gracilis release in a 9-year-old child diagnosed with spastic cerebral palsy, exhibiting a scissoring and in-toeing gait. Additionally, this report prompts consideration of the potential benefits of gracilis release in addressing the in-toeing gait observed in children affected by spastic cerebral palsy.
RESUMO
Neurofibroma (NF) is a tumour of peripheral nerves, which would be seldom seen in the limbs, particularly in children's limbs. Soft, skin-coloured papules or small sub-mucosal nodules appear as these lesions. Neurofibroma is classified into three types: localized, diffuse, and plexiform. The vast majority of nerve injury is sporadic and localized, with an incredibly low risk of tumour formation. Neurofibromatosis can present as multiple skin lesions along with bone deformities in which a full investigation is critical where an undiscovered widespread illness may arise. This case study describes a neurofibroma on the common peroneal nerve of the left lower limb in a 6-year-old child who visited our hospital with chief complaints of pain and swelling around the left proximal leg.
