RESUMO
Midtarsal dislocations of the foot are rare injuries. Most descriptions of these injuries state that they develop due to high-energy trauma. We present a case of low-energy trauma leading to a medial swivel dislocation of the talonavicular joint, which was reduced by a closed method and immobilized in a cast. A 48-year-old non-diabetic male with no rheumatoid symptoms or any steroid injection suffered low-energy trauma to his right foot and presented to the emergency department with pain, tenderness and with his foot adducted. On X-rays and NCCT, it was found to be medial type swivel dislocation of the Talonavicular joint with a fractured base of the fifth metatarsal and talar head impaction fracture with talocalcaneal joint subluxation. Closed reduction under sedation was done successfully, which was stable on stressing under fluoroscopy, so the foot was immobilized in a cast without internal fixation. Talonavicular dislocations are rare injuries, with most of them requiring open reduction and internal fixation. Low-energy trauma can also lead to talonavicular dislocations, which, if stable after reduction, can be immobilized in a cast without internal fixation.
RESUMO
Surgical management of knee synovitis secondary to mild haemophilia, without any significant previous medical history and an adverse family history of haematological disorders, is arduous. Due to its rare occurrence, the diagnosis is often delayed or sometimes missed, leading to the grave and often lethal consequences in intraoperative and postoperative periods. Hardly isolated knee arthropathy due to mild haemophilia has been reported in the available literature. In this report, we present the management of a case of a 16-year-old male with isolated knee synovitis with undiagnosed mild haemophilia, who came to us with the first episode of knee bleeding. We elucidate the signs and symptoms, investigations, surgical management, and difficulties faced, especially during the postoperative period. This case report is presented to enhance awareness of the existence of this disorder and its management to prevent postoperative complications.
RESUMO
Arthroscopic anatomic anterior cruciate ligament reconstruction (ACLR) is the gold standard treatment for an ACL tear and requires the use of fixed or adjustable-loop devices to fix a femoral-side graft. Although the adjustable mechanism is designed to provide one-way tensioning, there is a concern that the adjustable loop will loosen and lengthen during cyclic loads, creating graft laxity. The present paper is a retrospective study of patients who underwent ACLR with the fixation of a hamstring graft with an adjustable loop on the femoral side from November 2016 to October 2018. The knee's functional outcome was evaluated using an International Knee Documentation Committee (IKDC) score, Lysholm score, Lachman test, and pivot shift test. The patients were assessed preoperatively and finally postoperatively after two years of surgery. Thirty-two patients were analyzed. Significant improvement was obtained in the final clinical outcome of the patients. Twenty-seven patients (84.4%) were Lachman negative, and twenty-eight patients (87.5%) were pivot shift test negative, the mean Lysholm score was 96.91, and the IKDC score was 91.47 (p < 0.001). There was no infection, graft failure, or flexion restriction. Arthroscopic ACLR with an adjustable-loop suspensory device is a successful fixation method for femoral-side graft fixation and offers a similar functional outcome as with fixed-loop devices.
