Traumatic Dislocation of Tibialis Posterior Tendon: A Case Report and Literature Review.

Traumatic dislocation of the tibialis posterior tendon is one of the significantly rare conditions that we might deal with in the emergency department. Approximately only 50 cases have been reported in the literature, and, usually, this condition is misdiagnosed as an ankle sprain in acute settings. It might be neglected in case of improper clinical examination and imaging techniques. We present a case of a 39-year-old patient diagnosed with traumatic dislocation of the tibialis posterior tendon as a result of twisting injury after falling from a 1-meter jump height while playing basketball; the patient was clinically diagnosed primarily as a case of simple ankle sprain in the emergency department and treated conservatively with cold compression. The patient was seen in the clinic after five days with the same complaint, which was medial ankle pain without any improvement. Proper examination and imaging techniques lead us to the accurate diagnoses. The patient was managed surgically and had an excellent outcome postoperatively with a full range of motion of the ankle joint and full weight-bearing without any complaint. Tibialis posterior dislocation should be one of the possible differential diagnoses while dealing with any ankle injury even with unremarkable X-rays. History and physical examination, if conducted correctly, are the keys to making an accurate diagnosis. Therefore, we recommend a proper history-taking and precise physical examination with a high index of suspicion for any possible diagnoses. Early surgical intervention for such cases is the preferable method of treatment to avoid further complications and promote early functional recovery.

Venous thromboembolism after shoulder arthroplasty: a report of three cases.

Venous thromboembolism after shoulder arthroplasty is considered a rare phenomenon, but can be a dangerous and life-threatening condition. We report three cases of venous thromboembolism sustained after shoulder arthroplasty. One of the patients had a non-fatal pulmonary embolism. The other two had deep vein thrombosis, one in the operated upper extremity, and the other in a lower extremity. The cases are described in detail and discussed to reveal the possible contributing risk factors. The purpose of this case series is to increase awareness of this relatively rare, but potentially serious complication.

Venous thromboembolism after shoulder arthroplasty: a systematic review.

BACKGROUND: Shoulder arthroplasty (SA) is a common orthopaedic procedure that is being performed on a more and more frequent basis. Venous thromboembolism (VTE) as a complication has received little attention when it occurs after SA. The literature lacks a comprehensive summary of the incidence, risk factors, and prophylaxis of VTE in this population of patients. METHODS: Literature on VTE after SA has been identified from 5 scientific databases: EMBASE, MEDLINE, Web of Science, CINAHL, and Cochrane. All primary full-text articles reporting at least 1 case of deep vein thrombosis or pulmonary embolism after SA were included. Articles were critically appraised and systematically analyzed to determine the incidence, risk factors, thromboprophylaxis, diagnosis, and management of VTE after SA. RESULTS: This study included 14 articles. The reported incidence of VTE after SA was 0.2% to 16.0%. The most serious risk factors for development of VTE included history of VTE, thrombophilia, major surgery, advanced age, current malignant disease, immobility, and bed confinement. Diagnosis was typically determined by duplex scan and chest computed tomography scan. VTE prophylaxis was used in 6 (43%) of the included studies, with the ideal method of prophylaxis unknown. CONCLUSIONS: Although variability exists in the reported incidence of VTE, surgeons should still be aware of the potential for this serious complication after SA. We recommend assessing the risk factors and estimating the VTE risk status for all patients undergoing SA. The ideal method of prophylaxis for this population of patients remains unknown and should be investigated in future high-quality clinical studies.

Prevalence of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia.

OBJECTIVE: The aim of this study was to assess the prevalence of neuropathic pain among patients suffering from chronic low back pain using the Leeds assessment of neuropathic symptoms and signs (LANSS) pain scale. METHODS: This was a pilot study collected from 10 centers in the Middle East Region, with each center enrolling 10 patients between November 2004 and January 2004. In total, 100 patients with chronic low back pain were included in the study. The LANSS clinical assessment score was used to assess the presence of neuropathic pain. Patients with score >12 were considered to have neuropathic pain, while patients with score a < 12 were considered as having nociceptive pain. RESULTS: We found that 41% of the chronic low back pain patients had neuropathic pain and 59% had nociceptive pain. CONCLUSION: The ability to identify neuropathic pain mechanisms should lead to individualized treatment resulting in improved pain control in this group of patients with chronic low back pain.

Prevalence of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia.

OBJECTIVE: The aim of this study was to assess the prevalence of neuropathic pain among patients suffering from chronic low back pain using the Leeds assessment of neuropathic symptoms and signs (LANSS) pain scale. METHODS: This was a pilot study collected from 10 centers in the Middle East Region, with each center enrolling 10 patients between November 2004 and January 2004. In total, 100 patients with chronic low back pain were included in the study. The LANSS clinical assessment score was used to assess the presence of neuropathic pain. Patients with score > or =12 were considered to have neuropathic pain, while patients with score a less than 12 were considered as having nociceptive pain. RESULTS: We found that 41% of the chronic low back pain patients had neuropathic pain and 59% had nociceptive pain. CONCLUSION: The ability to identify neuropathic pain mechanisms should lead to individualized treatment resulting in improved pain control in this group of patients with chronic low back pain.