Single-stage surgical correction of a bilateral acquired coxa vara deformity in a young woman

2021 ◽  
Vol 14 (10) ◽  
pp. e245754
Author(s):  
Aabid Husain Ansari ◽  
Amit Kumar Gupta ◽  
Abhishek Vaish ◽  
Raju Vaishya
Keyword(s):  
Internal Fixation ◽  
Secondary Hyperparathyroidism ◽  
Groin Pain ◽  
Treated Patient ◽  
Corrective Osteotomy ◽  
Single Stage ◽  
Coxa Vara ◽  
Plain Radiographs ◽  
Hip Motion ◽  
History Of

A 23-year-old female-treated patient of osteomalacia and secondary hyperparathyroidism with hypophosphatemia presented with a 5-year history of bilateral groin pain and stiffness of both hips and difficulty in walking. Plain radiographs of the pelvis showed bilateral coxa vara deformity. She was managed surgically by a single-stage bilateral subtrochanteric corrective osteotomy with the internal fixation. After the osteotomy healing at 3 months, the patient was pain free and walked comfortably with an increased range of hip motion.

scholarly journals Can Adding BMP2 Improve Outcomes in Patients Undergoing the SUPERhip Procedure?

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 495
Author(s):  
Dror Paley ◽  
Claire E. Shannon ◽  
Monica Nogueira ◽  
Catharina Chiari ◽  
Matthew Harris
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Varus Deformity ◽  
Drill Hole ◽  
Late Complications ◽  
Coxa Vara ◽  
Fixed Angle ◽  
Extremity Reconstruction ◽  
Delayed Ossification ◽  
Fixed Angle Device

Congenital femoral deficiency (CFD) Paley type 1b is characterized by severe bony deformity of the upper femur, extra-articular contractures of the hip, and, delayed ossification of the femoral neck and/or subtrochanteric region. The Systematic Utilitarian Procedure for Extremity Reconstruction of the hip (SUPERhip) procedure for the correction of CFD deformities was developed in 1997. Initially, a non-fixed angle device (rush rod) was used for fixation. Late complications of persistent delayed ossification and recurrent varus deformity occurred. In order to reduce and treat such complications, fixation with a fixed angle device and the off-label use of BMP2 to induce ossification of the un-ossified femoral neck were employed. The purpose of this study is to determine if the use of a fixed angle device, and, BMP2 inserted into a drill hole in the cartilage of the femoral neck, decreases the incidence of these late complications. We retrospectively reviewed 72 SUPERhip procedures performed for Paley type 1b CFD between 1997 and 2012. Due to recurrent varus or persistent delayed ossification of the femoral neck, 34 revision SUPERhip procedures were performed. In total, 106 SUPERhip procedures were studied. Sixty-eight SUPERhips were performed using internal fixation without BMP2, while 38 SUPERhips were performed with both internal fixation and the addition of BMP2. Forty-one were performed using non-fixed angle internal fixation while 65 had fixed angle internal fixation. Fixed angle devices significantly reduced the incidence of recurrent varus compared with non-fixed angle devices. Inserting BMP2 in the femoral neck significantly reduced the incidence of persistent delayed ossification. Using only a fixed angle device but no BMP2 did not reduce the incidence of delayed ossification. The combination of both a fixed angle device and BMP2 reduced the incidence of recurrent coxa vara and persistent delayed ossification of the femoral neck. The SUPERhip procedure corrects the pathoanatomy of the proximal femur in CFD Paley type 1b but is associated with a very high risk of recurrence of coxa vara and persistence of femoral neck delayed ossification, unless, a fixed angle internal fixation device is used to prevent recurrent coxa vara and BMP2 is used to induce ossification of the femoral neck.

scholarly journals Nascent Malunion of an Isolated Intraarticular Fracture of the Ulnar Head

2019 ◽  
Vol 09 (03) ◽  
pp. 240-243
Author(s):  
Frank Nienstedt ◽  
Markus Mariacher ◽  
Günther Stuflesser ◽  
Wilhelm Berger
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Excellent Result ◽  
Corrective Osteotomy ◽  
Fracture Dislocation ◽  
Intraarticular Fracture ◽  
Ulnar Head ◽  
Ulnar Styloid Fracture ◽  
Palmar Approach

Abstract Background Isolated fractures of the ulnar head are rare. Only few cases have been reported in literature. Case Description We report a case of a 16-year-old student who was treated for an ulnar styloid fracture conservatively. An associated displaced intraarticular fracture of the ulnar head has been overlooked. He presented late in our clinic with a symptomatic nascent malunion of the ulnar head fracture. A corrective osteotomy by a palmar approach was performed. Fixation by screws was used with an excellent result at 7-year follow-up. Literature Review The rare cases of isolated ulnar head fractures reported in literature were treated by open reduction and internal fixation only in case of fracture dislocation. Clinical Relevance The authors highlight the fact that even a nascent malunion of an isolated intraarticular fracture of the ulnar head may be treated successfully by open reduction and internal fixation.

Osteogenic Sarcoma of the Frontal Sinus

1973 ◽  
Vol 82 (2) ◽  
pp. 162-165 ◽  
Author(s):  
Robert C. Bone ◽  
Hugh F. Biller ◽  
Bernard L. Harris
Keyword(s):  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Frozen Section ◽  
English Literature ◽  
Osteogenic Sarcoma ◽  
Facial Bones ◽  
Plain Radiographs ◽  
History Of ◽  
Histologic Lesion ◽  
The Right

Although osteogenic sarcoma occurs in the head and neck, it is almost exclusively limited to the maxilla and the mandible. Single, rare cases of this tumor in other facial bones are mentioned in foreign reports, but a discussion in the English literature has not come to our attention. The case history of a 58-year-old woman with a nonspecific frontal sinus pain and right-sided proptosis is presented. Plain radiographs of the paranasal sinuses revealed a radiopaque, calcific mass in the right frontal sinus approximately 3 × 5 cm in diameter. It was noted that the mass had an “onionskin” lamination. Laminography aided in the exact localization of the mass; further, it was noted on arteriography that the frontal sinus mass did not invade the dura. A frozen section biopsy at the time of craniotomy suggested a benign histologic lesion. However, subsequent review of permanent sections showed findings typical of an osteogenic sarcoma. The patient was treated with irradiation and in the first postoperative year has done well.

scholarly journals 64-year-old male with septic arthritis of the pubic symphysis

2011 ◽  
Vol 1 (3) ◽  
pp. 76 ◽  
Author(s):  
Ewa Konik ◽  
Brent Bauer ◽  
Mark Lee
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Septic Arthritis ◽  
Groin Pain ◽  
Pubic Symphysis ◽  
Pelvic Malignancy ◽  
Incontinence Surgery ◽  
Streptococcus Anginosus ◽  
Hip Motion

Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors.

scholarly journals Exceptional response to nivolumab of a heavily pre-treated patient with metastatic renal-cell cancer: from a case report to molecular investigation and future perspectives

2020 ◽  
Vol 12 ◽  
pp. 175883592094615
Author(s):  
Foteinos-Ioannis D. Dimitrakopoulos ◽  
Eleni Kourea ◽  
George Nasioulas ◽  
Eirini Papadopoulou ◽  
Achilles Nikolakopoulos ◽  
...  
Keyword(s):  
Treated Patient ◽  
Cytotoxic T Cells ◽  
Cell Cancer ◽  
Metastatic Tumor ◽  
Foxp3 Expression ◽  
Metastatic Tumors ◽  
Tumor Mutational Burden ◽  
Clinical Responses ◽  
History Of ◽  
Antigen Presenting

Immunotherapy may result in long-lasting exceptional clinical responses, the molecular background of which is inadequately understood. Here, we present the case of a 63-year-old patient with a past medical history of renal cancer who relapsed many years later. Several treatment lines were administered prior to immunotherapy, which was administered in the ninth line, achieving complete remission which had lasted for more than 3 years. Genomic alterations, tumor mutational burden (TMB), and microsatellite instability as well as PD-L1, MLH1, MSH2, MSH6, PMS2, CD3, CD8, CD20, CD138, CD1a, and FoxP3 expression were assessed in primary and metastatic tumors. Primary and metastatic tumors were microsatellite stable with high TMB, while somatic mutations in MLH1 and TP53 genes were detected, respectively. Although the primary tumor was negative for PD-L1 expression, the lung metastasis was positive. Interestingly, metastasis displayed a dramatically increased infiltration by CD1a-positive dendritic cells in addition to increased CD3+ and CD8+ cytotoxic T cells. Increased infiltration of the metastatic tumor by CD1a+ antigen presenting cells warrants further investigation to assess its potential predictive value.

scholarly journals Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion

2013 ◽  
Vol 2013 (may24 1) ◽  
pp. bcr2013009230-bcr2013009230 ◽  
Author(s):  
S. S. Jeevannavar ◽  
K. S. Shenoy ◽  
R. M. Daddimani
Keyword(s):  
Internal Fixation ◽  
Corrective Osteotomy ◽  
Fracture Site ◽  
Type I

scholarly journals Le Fort III in Syndromic Craniosynostosis: Cost Comparison of Distraction Osteogenesis Versus Single-Stage Internal Fixation Techniques

2019 ◽  
Vol 27 (2) ◽  
pp. 125-129
Author(s):  
Adam J. Mosa ◽  
Elizabeth Zellner ◽  
Emily S. Ho ◽  
Mark D. Fisher ◽  
John H. Phillips ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Internal Fixation ◽  
Distraction Osteogenesis ◽  
Single Stage ◽  
Cost Data ◽  
Cost Comparison ◽  
Le Fort ◽  
Rigid Internal Fixation ◽  
Syndromic Craniosynostosis ◽  
Le Fort Iii

Purpose: In syndromic craniosynostosis, the Le Fort III osteotomy is used to correct dental/skeletal imbalance, improve exorbitism, and increase the airway. The purpose of this study is to perform a cost comparison between the standard technique of single-stage rigid internal fixation and distraction osteogenesis (DO) in the Le Fort III osteotomy in this patient population. Method: Hospital cost accounting databases were queried for patients undergoing single-stage advancement (SS) or DO from 2007 to 2016. Nominal cost data were adjusted using the Bank of Canada Consumer Price Index. Reported costs represented the full length of stay for all utilization per patient. Demographic information and cost data for single-stage osteotomy and DO were compared. Results: Total costs for single-stage (n = 8) were higher than distraction (n = 6; mean $CAD57 825 vs $38 268, P < .05). Intensive care unit (ICU) costs for single-stage were significantly higher than distraction (mean, $17 746 vs $5585, P < .005). Distraction cases had higher operating room (OR) costs than single stage, but the difference was not significant (mean, $12 540 vs $9696). Length of stay was significantly longer for SS patients (mean, 11 days vs 7 days, P < .05). Conclusions: This single-institution retrospective cost analysis indicates standard SS rigid internal fixation Le Fort III is more costly than DO. Despite higher OR costs, prolonged ICU and hospital stay was the primary reason behind this difference. This information may be of benefit when advocating for new technology perceived as high cost.

scholarly journals Femoral Nerve Palsy due to Anticoagulant Induced Retroperitoneal Hematoma

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Orcun Gurbuz ◽  
Abdulkadir Ercan ◽  
Gencehan Kumtepe ◽  
İlker Hasan Karal ◽  
Yusuf Velioglu ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Groin Pain ◽  
Femoral Nerve ◽  
Flexion Contracture ◽  
Retroperitoneal Hematoma ◽  
Rare Presentation ◽  
Femoral Neuropathy ◽  
History Of ◽  
One Year ◽  
Hip Flexion

A forty-one-year-old man who, sought evaluation for a sudden hip flexion contracture and groin pain with a history of mechanical mitral valve replacement, had been misdiagnosed and treated as having lumbar discopathy for two days. This patient finally was diagnosed with compressive femoral neuropathy due to warfarin-induced retroperitoneal hematoma and successfully managed nonoperatively. This case is reported in order to draw attention to this rare presentation.

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