The ‘Te’ Technique for Restoring Fingertip Stability Post Traumatic Acro-Osteolysis – A Report and Review of Management Options

2017 ◽  
Vol 22 (04) ◽  
pp. 441-444
Author(s):  
Yu-Te Lin ◽  
Charles Yuen Yung Loh
Keyword(s):  
Soft Tissue ◽  
Functional Assessment ◽  
Distal Phalanx ◽  
Management Options ◽  
Non Union ◽  
Tissue Dissociation ◽  
Novel Method ◽  
Post Traumatic ◽  
Bony Fixation

Background: Fractures of the distal phalanx can result in bony non-union, resulting in acro-osteolysis and subsequent fingertip instability due to soft tissue dissociation from bone. Conventional methods of treating this involve osseous fixation, but do not address the laxity and lack of soft tissue stability with bone. Current techniques also do not address the management of such conditions if bony fragments are too small to reduce. We present a novel method that addresses both soft tissue and bony deformity in this condition.Methods: A review of current techniques in the literature is provided as well as an in depth description of our technique using a representative case.Results: Follow-up results and photographs are presented in this article. Functional assessment is also provided in the article as part of the follow-up.Conclusions: This technique is applicable for cases where severe resorption of distal phalanx has occurred, leaving little or no purchase for bony fixation. Hence, the technique can not only be applied post traumatic acro-osteolysis, but also other conditions where secondary soft tissue lengthening occurs and fingertip instability is formed as a result.

scholarly journals Self-made adjustable external fixation device with progressive compression for the management of open fracture with bone defects of the distal hallux phalanx: a case report

2020 ◽  
Author(s):  
Ying-Guo YANG ◽  
Da-Ke Tong ◽  
peizhao Liu
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Open Fracture ◽  
Low Cost ◽  
Bone Defects ◽  
Distal Phalanx ◽  
Fixation Device ◽  
Non Union ◽  
External Fixation Device

Abstract Background: Open fractures with bone defects of the distal phalanx of the hallux are both rare and complicated, and these conditions pose great clinical challenge to orthopedists as improper handling can lead to distal tissue necrosis, osteomyelitis, malunion, non-union and even amputation. Due to the lack of soft tissue and bone and the blocking effect caused by un-disconnected soft tissue, it is relatively difficult to achieve effective reduction and fixation of the fracture by traditional methods. Methods: we present a patient, diagnosed with open fracture combined with bone defects of the distal segment of the great toe, who was treated using a self-made adjustable external fixation device by complete debridement, effective closed reduction and continuous adjustment. Complications were registered and clinical outcome was measured at the follow-up periods. Results: The device was simple to make with a low cost and practicality, and this technique resulted in effective maintenance of reduction and progressive compression in the fracture ends. The patient finally obtained optimal fracture healing and satisfactory function of the injured toe at last follow-up. Conclusions: The self-made adjustable external fixation device is reliable in maintaining reduction and fixation, which provides an alternative for the management of open fracture associated with bone absence of the distal phalanx of the hallux.

scholarly journals Nasolabial cyst: case report and review of management options

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdulhakeem Almutairi ◽  
Abeer Alaglan ◽  
Mazyad Alenezi ◽  
Sultan Alanazy ◽  
Osama Al-Wutayd
Keyword(s):  
Soft Tissue ◽  
Nasal Obstruction ◽  
Surgical Excision ◽  
Mass Effect ◽  
Treatment Modalities ◽  
Open Approach ◽  
Management Options ◽  
Case Presentation ◽  
Complete Surgical Excision

Abstract Background Nasolabial cysts are rare, non-odontogenic, soft-tissue cysts that develop between the upper lip and nasal vestibule with an overall incidence of 0.7% out of all maxillofacial cysts. The predominant presentation of a nasolabial cyst is a painless localized swelling with varying degrees of nasal obstruction. Several treatment modalities have described in the management of the nasolabial cyst. In this paper, we present a case of a nasolabial cyst in a 44 years old man with discussions of the treatment modalities in the lights of the literature. Case presentation We present a case of a nasolabial cyst in a 44-year-old man that slowly increased in size through a period of 3 years, with associated mild pain and nasal obstruction. It had caused a mass effect upon the maxilla, resulting in scalloping. The cyst was excised entirely with no evidence of recurrence at the two months follow up. Conclusions The nasolabial cyst is a rare soft-tissue cyst. Complete surgical excision using an open approach performed to our case, which considered with the complete endoscopic removal of the best treatment for the nasolabial cysts with a rare recurrence rate.

CLASSIFICATION AND TREATMENT OF HAMATE FRACTURES

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 151-157 ◽  
Author(s):  
Kenichi Hirano ◽  
Goro Inoue
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Open Reduction ◽  
Functional Results ◽  
Non Union ◽  
Cast Immobilisation ◽  
Classification And Treatment

Twenty-nine patients with hamate fractures were treated. The two main types of hamate fractures are hook fractures (type 1) and body fractures (type 2). We sub-divided type 2 fractures according to the fracture line into coronal, type 2a and transverse, type 2b. There were 15 type 1, 11 type 2a and three type 2b fractures. For type 1, nine were treated with excision, one with open reduction and internal fixation (ORIF) and five with cast immobilisation, in which two resulted in non-union followed by excision. For type 2, five type 2a cases were treated with ORIF and the others with closed reduction and pinning. Most of the patients had satisfactory results at the seventh month follow-up. However, those with associated neurovascular and musculotendinous injuries were likely to have unfavourable results. On the basis of study findings, it appears that functional results are influenced mainly by the associated soft tissue damage.

Treatment of Post-traumatic Ankle Arthrosis with Bipolar Tibiotalar Osteochondral Shell Allografts

2002 ◽  
Vol 23 (12) ◽  
pp. 1091-1102 ◽  
Author(s):  
Choll W. Kim ◽  
Amir Jamali ◽  
William Tontz ◽  
F. Richard Convery ◽  
Michael E. Brage ◽  
...  
Keyword(s):  
Failure Rate ◽  
Joint Space Narrowing ◽  
Clinical Status ◽  
Joint Space ◽  
Physical Exam ◽  
Viable Alternative ◽  
Maximum Score ◽  
Non Union ◽  
Post Traumatic

We report on tibiotalar osteochondral shell allografts for post-traumatic ankle arthropathy in seven patients. Average follow-up was 148 months (range, 85 to 198). Patients were evaluated by a questionnaire, SF-12 survey, ankle score, physical exam and radiographs. The ankle score increased from 25 preoperatively to 43 at latest follow-up (maximum score 100). SF-12 scores increased from 30 to 38 (Physical Component) and 46 to 53 (Mental Component). The failure rate was 42%. Four of seven patients reported good or excellent results. Five patients stated they would undergo a similar procedure again. Complications included graft fragmentation, poor graft fit, graft subluxation, and non-union. Follow-up radiographs demonstrated joint space narrowing, osteophytes, and sclerosis, even in cases with excellent clinical status. Fresh osteochondral shell allografting may provide a viable alternative for the treatment of post-traumatic ankle arthrosis in selected individuals.

scholarly journals Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases

2013 ◽  
Vol 46 (03) ◽  
pp. 543-548 ◽  
Author(s):  
Gurdayal Singh Kalra ◽  
Pradeep Goel ◽  
Pradeep Kumar Singh
Keyword(s):  
Soft Tissue ◽  
Bone Defect ◽  
Bone Defects ◽  
High Energy ◽  
Long Bone ◽  
Non Union ◽  
Skeletal Defects ◽  
Free Fibula ◽  
Post Traumatic ◽  
Long Bone Defect

ABSTRACT Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma.

Total Hip Arthroplasty in a Patient Affected by Post-Traumatic Acetabular Non-Union: Case Report and Review of the Literature

2008 ◽  
Vol 18 (4) ◽  
pp. 324-328 ◽  
Author(s):  
E. Tassinari ◽  
A. Sudanese ◽  
F. Traina ◽  
M. De Fine ◽  
A. Toni
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Acetabular Cup ◽  
Non Union ◽  
Total Hip ◽  
Post Traumatic ◽  
One Year

Total hip arthroplasty in the presence of acetabular non-union can be demanding. The irregular anatomy, the defect, and the presence of fibrous and necrotic tissue can hamper insertion of the acetabular component. We present a case of total hip arthroplasty in a patient with post-traumatic necrosis of the femoral head and non-union of the acetabulum and follow-up one year after the operation. Following accurate preoperative planning, removal of the pseudarthrosis material, and the use of the femoral head as an autograft, it was possible to insert the acetabular cup satisfactorily in a single-stage procedure.

Longitudinal Changes in Individual BrainAGE in Healthy Aging, Mild Cognitive Impairment, and Alzheimer’s Disease

GeroPsych ◽  
2012 ◽  
Vol 25 (4) ◽  
pp. 235-245 ◽  
Author(s):  
Katja Franke ◽  
Christian Gaser
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Healthy Aging ◽  
Brain Aging ◽  
Elderly Subjects ◽  
Additional Increase ◽  
Longitudinal Changes ◽  
Novel Method ◽  
The Brain

We recently proposed a novel method that aggregates the multidimensional aging pattern across the brain to a single value. This method proved to provide stable and reliable estimates of brain aging – even across different scanners. While investigating longitudinal changes in BrainAGE in about 400 elderly subjects, we discovered that patients with Alzheimer’s disease and subjects who had converted to AD within 3 years showed accelerated brain atrophy by +6 years at baseline. An additional increase in BrainAGE accumulated to a score of about +9 years during follow-up. Accelerated brain aging was related to prospective cognitive decline and disease severity. In conclusion, the BrainAGE framework indicates discrepancies in brain aging and could thus serve as an indicator for cognitive functioning in the future.

The FUSION iENA Study: Comparison of I-124-PET/US Fusion Imaging with Conventional Diagnostics for the Functional Assessment of Thyroid Nodules by Multiple Observers

2019 ◽  
Vol 58 (06) ◽  
pp. 434-442 ◽  
Author(s):  
Thomas Winkens ◽  
Philipp Seifert ◽  
Christian Hollenbach ◽  
Christian Kühnel ◽  
Falk Gühne ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Thyroid Nodules ◽  
Radioiodine Therapy ◽  
Fusion Imaging ◽  
Needle Aspiration ◽  
Patient Case ◽  
Positron Emission ◽  
Thyroid Medication ◽  
Case Files

Abstract Aim To investigate the value of I-124 positron emission tomography (PET) / ultrasound (US) fusion imaging in comparison to conventional diagnostics (CD) of Thyroid nodules (TN) by multiple observers. Methods Digital patient case files (PCF) of patients that received CD and I-124-PET/US in clinical routine were prepared containing cine-loops of the examinations. All physicians with nuclear medicine specialty from Germany, Austria, and Switzerland were invited to participate. 106 acquired observers completed 7.2 ± 1.8 (median: 8, range: 4–14) randomly assigned PCF (CD only or CD+PET/US). They assessed the TN function, stated their confidence in functional assessment, and suggested a treatment course for each TN. Results 68 PCF of 34 patients comprising 66 TN ≥ 1 cm (= 1.94 TN/patient) were created. A total of 748 (11.2/TN), and 751 ratings (11.4/TN) were recorded for CD only, and CD+PET/US, respectively. The functional assessment revealed more hyper- or hypofunctioning (524 vs. 320, p < 0.0001) and less indifferent or not rateable (209 vs. 428, p < 0.0001) TN in CD+PET/US vs. CD only. The observers’ confidence in functional assessment was superior in CD+PET/US (p < 0.0001). Furthermore, the ratings were carried out more homogeneous in CD+PET/US (p < 0.0001). Fewer suggestion of follow up (p < 0.0001), and more (p < 0.0001) suggestion of invasive treatments (fine-needle aspiration & surgery) was observed in CD+PET/US. Radioiodine therapy was more often (p = 0.0036), and thyroid medication less often (p = 0.0167) advised in CD+PET/US. Conclusion Functional assessment of equivocal TN shows frequent failures in CD, underestimating the incidence of hyper- and hypofunctioning lesions. Confidence in functional assessment significantly increases with additional PET/US. This influences the proposed treatment course.

Inflammatory Myofibroblastic Tumour in Antimesenteric Border of Descending Colon of Children: A Case Report

2015 ◽  
Vol 3 (1) ◽  
pp. 47-50
Author(s):  
Shahnoor Islam ◽  
AKM Amirul Morshed ◽  
Afiqul Islam
Keyword(s):  
Soft Tissue ◽  
Spindle Cell ◽  
Inflammatory Myofibroblastic Tumour ◽  
Pathological Findings ◽  
Soft Tissue Lesion ◽  
Soft Tissue Tumours ◽  
Inflammatory Pseudotumour ◽  
Erythrocyte Sedimentation ◽  
Antimesenteric Border

Inflammatory myofibroblastic tumour (IMT) occurring at intraabdominal sites in children has rarely been described. Inflammatory pseudotumour is a soft tissue lesion that may be confused with a sarcoma. It is abbreviated as IMT. Inflammatory myofibroblastic tumour, also known as soft tissue tumours, atypical fibromyxoid tumours, pseudosarcomatous fibromyxoid tumour, plasma cell granuloma, pseudosarcomatous myofibrotic proliferation, post-operative spindle cell nodules. In this paper, we describe a case of inflammatory myofibroblastic tumour (IMT) with an unusual constellation of clinical, pathological findings. A 10-year-old girl had an 7-cm intraabdominal mass accompanied by severe anemia, fever, constipation, weight loss, thrombocytosis, elevated erythrocyte sedimentation rate. Laparotomy was performed. The final pathologic diagnosis was IMT. At the most recent follow up (12months) after excision of the tumour, the patient was symptom-free and there was no evidence of tumour recurrence.J. Paediatr. Surg. Bangladesh 3(1): 47-50, 2012 (January)

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