Vascularized Bone Grafting for the Treatment of Capitate Avascular Necrosis

2021 ◽  
Author(s):  
Jorge I. Quintero ◽  
Maria C. Herrand ◽  
Rodrigo Moreno
Keyword(s):  
Avascular Necrosis ◽  
Young Patients ◽  
Rare Condition ◽  
Type I ◽  
Carpal Collapse ◽  
History Of ◽  
Surgical Options ◽  
Revascularization Procedures ◽  
Capitate Bone ◽  
Vascularized Bone

AbstractAvascular necrosis (AVN) of the capitate bone is a rare condition and it can be related to major trauma or idiopathy. Different treatments are available including soft tissue interposition and intercarpal arthrodesis including lunocapitate, scaphocapitate, four corner, and carpometacarpal fusions. Other surgical options are resection of the proximal pole and revascularization procedures. The main purpose of this article is to present two cases of AVN of the capitate treated with a revascularization procedure using the 4th–5th extensor compartment artery (4th–5th ECA). Two female patients with capitate AVN are reported with an average age of 30.5 years. Both cases were classified as type-I according to Milliez classification. The major complaint in each case was wrist pain that increased during activity. In both cases there was no history of trauma, smoking, diabetes, or hematologic diseases. Both patients had a diminished range of motion, grip, and strength. The definitive diagnosis was made with magnetic resonance imaging. Both patients underwent treatment revascularization of the capitate using a vascularized bone graft based on the 4th–5th ECA. At average follow-up of 12 months, each patient had improved with regards to pain and had increased grip strength. The literature does not describe a specific algorithm treatment for capitate AVN. We recommend revascularization of the capitate using the 4th–5th ECA in type-I Milliez classification in young patients without signs of carpal collapse.

scholarly journals Bilateral Diabetic Knee Neuroarthropathy in a Forty-Year-Old Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Patrick Goetti ◽  
Nicolas Gallusser ◽  
Olivier Borens
Keyword(s):  
Joint Destruction ◽  
Young Patients ◽  
Joint Disease ◽  
Diabetic Patients ◽  
Type I ◽  
Bilateral Involvement ◽  
Satisfactory Outcome ◽  
History Of ◽  
Diabetes Type I ◽  
Low Incidence

Diabetic osteoarthropathy is a rare cause of neuropathic joint disease of the knee; bilateral involvement is even more exceptional. Diagnosis is often made late due to its unspecific symptoms and appropriate surgical management still needs to be defined, due to lack of evidence because of the disease’s low incidence. We report the case of a forty-year-old woman with history of diabetes type I who developed bilateral destructive Charcot knee arthropathy. Bilateral total knee arthroplasty was performed in order to achieve maximal functional outcome. Follow-up was marked by bilateral tibial periprosthetic fractures treated by osteosynthesis with a satisfactory outcome. The diagnosis of Charcot arthropathy should always be in mind when dealing with atraumatic joint destruction in diabetic patients. Arthroplasty should be considered as an alternative to arthrodesis in bilateral involvement in young patients.

Bilateral Preiser Disease in a Patient with Sickle Cell Anemia

2020 ◽  
Author(s):  
Joseph Catapano ◽  
Oluwatola O. Overduin ◽  
Herbert P. von Schroeder
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Scaphoid Fracture ◽  
Rare Condition ◽  
Dominant Male ◽  
Resonance Imaging ◽  
Steroid Use ◽  
History Of ◽  
The Right ◽  
Vascularized Bone

AbstractPreiser disease is a rare condition of avascular necrosis of the scaphoid occurring in the absence scaphoid fracture or trauma. While the etiology of Preiser disease remains unknown, it has been associated with steroid use, chemotherapy, and infrequently with systemic diseases. No reports have associated Preiser disease with hemoglobinopathy. Due to the rarity of Preiser disease, management remains controversial and evidence is limited. Here, we describe the case of a 32-year-old right-hand dominant male with sickle cell anemia and a 4-year history of bilateral wrist pain. Radiographs and gadolinium-enhanced magnetic resonance imaging revealed bilateral Preiser disease. He was successfully managed with a 1,2 intercompartmental supraretinicaular artery vascularized bone graft to the right scaphoid.

Primary Vascularized Distal Radius Bone Graft for Nonunion of the Scaphoid

2000 ◽  
Vol 25 (3) ◽  
pp. 266-270 ◽  
Author(s):  
C. UERPAIROJKIT ◽  
S. LEECHAVENGVONGS ◽  
K. WITOONCHART
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Distal Radius ◽  
Pinch Strength ◽  
Type I ◽  
Vascularized Bone Graft ◽  
Proximal Pole ◽  
The Mean ◽  
Mean Time ◽  
Vascularized Bone

A vascularized bone graft from the dorsoradial aspect of the distal radius was used with internal fixation to treat nonunion of the scaphoid in ten patients who had not received any previous surgical treatment. Five cases were classified as Lichtman type I and five as type II. The average age was 30 years (range, 18–40 years). Associated avascular necrosis was observed in five cases. Post-operatively pain was relieved and union was achieved in all cases. The mean time to union was 6.5 weeks. Range of motion, grip strength and pinch strength were also restored satisfactorily. These results suggest that this vascularized bone graft should be used as the primary procedure in Lichtman type I and II of scaphoid nonunions, regardless of the presence of avascular necrosis of the proximal pole.

Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis

2018 ◽  
Vol 44 (6) ◽  
pp. 600-606 ◽  
Author(s):  
Kathleen M. Kollitz ◽  
Nicholas Pulos ◽  
Allen T. Bishop ◽  
Alexander Y. Shin
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Femoral Condyle ◽  
Primary Treatment ◽  
Medial Femoral Condyle ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Carpal Collapse ◽  
Time From Injury ◽  
Vascularized Bone

This study aimed to determine the outcome of free vascularized medial femoral condyle bone grafts in the primary treatment of scaphoid nonunions with scaphoid foreshortening or carpal collapse and intraoperatively documented avascular necrosis. Thirty-two patients (28 male, four female) met the inclusion criteria. Median time from injury to surgery was 70 weeks. Thirty of 32 patients healed at a median of 12 weeks. There was significant improvement from preoperative to postoperative lateral intrascaphoid angle, scapholunate angle, and radiolunate angle. Two scaphoids failed to unite; one patient underwent scaphoidectomy and four-corner fusion 15 months postoperatively after suffering a subsequent injury. Another patient underwent 1,2-intercompartmental supraretinacular artery-based vascularized bone grafting at 4 months postoperatively and then scaphoid excision with four-corner fusion 4 years later. The free vascularized medial femoral condyle bone graft restores scaphoid vascularity and architecture while promoting union in a subset of scaphoid nonunions that has historically been a clinical challenge. Level of evidence: IV

scholarly journals Halo Nevi Are Not Trivial: About 2 Young Patients of Regressed Primary Melanoma That Simulates Halo Nevi

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. De Schrijver ◽  
I. Theate ◽  
O. Vanhooteghem
Keyword(s):  
Literature Search ◽  
Case Reports ◽  
Young Patients ◽  
Primary Melanoma ◽  
Rare Condition ◽  
Warning Signs ◽  
Spontaneous Bleeding ◽  
Case Presentation ◽  
Detailed History ◽  
History Of

Background. Halo nevi are often considered benign, and the possibility of malignancy is not always clear to practitioners. We present two case reports suggesting that a halo nevus appearance can be seen in melanoma, even in young adults. A literature search for halo nevi revealing melanoma shows that this is a very rare condition. Case presentation. This report of two young patients indicates the importance of obtaining a detailed history to detect warning signs such as itching, pain, spontaneous bleeding, and previous alterations according to the patient, including a previously totally black colour in an already fully regressed melanoma. Conclusions. The risk of a halo nevus being malignant is higher if there is only one unique halo nevus and no personal or familial history of vitiligo. We postulate that a regressing atypical nevus or a regressing melanoma may be induced by an immunologic reaction as halo nevus type of clinical picture.

scholarly journals Lumbar disc herniation associated with scoliosis in a 15-year-old girl: case report

2002 ◽  
Vol 60 (2A) ◽  
pp. 295-298 ◽  
Author(s):  
Fernando Campos Gomes Pinto ◽  
Arthur W. Poetscher ◽  
Fausto Ricardo Erba Quinhones ◽  
Mário Pena ◽  
Mário Augusto Taricco
Keyword(s):  
Disc Herniation ◽  
Structural Changes ◽  
Lumbar Disc ◽  
Previous History ◽  
Young Patients ◽  
Rare Condition ◽  
Intervertebral Disc Herniation ◽  
Childhood And Adolescence ◽  
Disc Herniations ◽  
History Of

Intervertebral disc herniation is a rare condition in childhood and adolescence, although some cases have already been reported in the literature. We present the case of a 15 year-old-girl with low back pain and scoliosis. She had no previous history of trauma or collagen diseases. MRI showed L4-L5 and L5-S1 disc herniations and no further bone and structural changes. After two level discectomy, pain ceased and scoliosis improved, without further treatment. Based on her evolution and on what has already been reported in literature, we consider that scoliosis associated with disc herniation in young patients is most likely to be only an anthalgic position, not indicative of further structural changes.

Avascular necrosis of humeral trochlea: A case report of the rare condition

2021 ◽  
Vol 17 ◽  
Author(s):  
Temel Fatih Yilmaz ◽  
Ahmet Emin Okutan ◽  
Muhammet Salih Ayas ◽  
Mehmet Emin Dada ◽  
Ahmet Uğur Turhan
Keyword(s):  
Case Report ◽  
Avascular Necrosis ◽  
Rare Condition ◽  
Response To Treatment ◽  
Proton Density ◽  
Sports Activity ◽  
Radiologic Findings ◽  
Clinical Scenarios ◽  
Common Etiology ◽  
History Of

İntroduction: Avascular necrosis of humeral trochlea is a very rare condition and was described by Hegemann in 1957. We reported two cases of avascular necrosis of humeral trochlea and also performed a literature review of the reported cases. We expect that this case report will assist clinicians to make timely diagnosis when encountering similar clinical scenarios. Materials and Methods: We presented 11-year-old and 14 year-old two cases with avascular necrosis of humeral trochlea. The common etiology was idiopathic because there were no recent trauma history and sports activity. Also there was no history of drug use. We discussed the clinical and radiologic findings of these cases. Results: These cases were diagnosed as Hegemann’s disease with clinical and radiologic outcomes. We found the etiology of both two cases is idiopathic. Both two cases were boys and teenagers. The number of previously reported cases in the literature is limited to 63. In our study there was a lateral crest in one of our two cases and a posteromedial involvement in another. The radiograph of two trochlea of these two cases showed irregularity and granular appearance. In our case, heterogeneous signal changes and irregularities are accompanied by hypointense changes on T1-weighted images. Also hyperintense changes on proton density sequences were detected. Conclusion: Radiological evaluation plays an important role in the diagnosis and evaluation of response to treatment in avascular necrosis of the humeral trochlea. Avascular necrosis should be one of the differential of lesions involving the trochlea. Recognition of avascular necrosis in the trochlea may prevent unnecessary biopsy.

The Frequency of Type I Heterozygous Protein S and Protein C Deficiency in 141 Unrelated Young Patients with Venous Thrombosis

1988 ◽  
Vol 59 (01) ◽  
pp. 018-022 ◽  
Author(s):  
C L Gladson ◽  
I Scharrer ◽  
V Hach ◽  
K H Beck ◽  
J H Griffin
Keyword(s):  
Venous Thrombosis ◽  
Protein C ◽  
Antithrombin Iii ◽  
Young Patients ◽  
Protein S ◽  
Type I ◽  
Protein S Deficiency ◽  
Protein C Deficiency ◽  
Low Protein ◽  
S Deficiency

SummaryThe frequency of heterozygous protein C and protein S deficiency, detected by measuring total plasma antigen, in a group (n = 141) of young unrelated patients (<45 years old) with venous thrombotic disease was studied and compared to that of antithrombin III, fibrinogen, and plasminogen deficiencies. Among 91 patients not receiving oral anticoagulants, six had low protein S antigen levels and one had a low protein C antigen level. Among 50 patients receiving oral anticoagulant therapy, abnormally low ratios of protein S or C to other vitamin K-dependent factors were presented by one patient for protein S and five for protein C. Thus, heterozygous Type I protein S deficiency appeared in seven of 141 patients (5%) and heterozygous Type I protein C deficiency in six of 141 patients (4%). Eleven of thirteen deficient patients had recurrent venous thrombosis. In this group of 141 patients, 1% had an identifiable fibrinogen abnormality, 2% a plasminogen abnormality, and 3% an antithrombin III deficiency. Thus, among the known plasma protein deficiencies associated with venous thrombosis, protein S and protein C. deficiencies (9%) emerge as the leading identifiable associated abnormalities.

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