scholarly journals Genu Recurvatum Deformity in a Child due to Salter Harris Type V Fracture of the Proximal Tibial Physis Treated with High Tibial Dome Osteotomy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Theodoros Beslikas ◽  
Andreas Christodoulou ◽  
Anastasios Chytas ◽  
Ioannis Gigis ◽  
John Christoforidis
Keyword(s):  
Tibial Tubercle ◽  
Rare Injury ◽  
Dome Osteotomy ◽  
Genu Recurvatum ◽  
Clinical Instability ◽  
Rare Lesion ◽  
Salter Harris ◽  
One Year ◽  
Type V ◽  
Immature Skeleton

Salter-Harris type V fracture is a very rare injury in the immature skeleton. In most cases, it remains undiagnosed and untreated. We report a case of genu recurvatum deformity in a 15-year-old boy caused by a Salter-Harris type V fracture of the proximal tibial physis. The initial X-ray did not reveal fracture. One year after injury, genu recurvatum deformity was detected associated with significant restriction of knee flexion and limp length discrepancy (2 cm) as well as medial and posterior instability of the joint. Further imaging studies revealed anterior bone bridge of the proximal tibial physis. The deformity was treated with a high tibial dome osteotomy combined with a tibial tubercle osteotomy stabilized with malleolar screws and a cast. Two years after surgery, the patient gained functional knee mobility without clinical instability. Firstly, this case highlights the importance of early identification of this rare lesion (Salter-Harris type V fracture) and, secondly, provides an alternative method of treatment for genu recurvatum deformity.

scholarly journals Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kevin Moerenhout ◽  
Georgios Gkagkalis ◽  
Rayan Baalbaki ◽  
Xavier Crevoisier
Keyword(s):  
Case Report ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Medial Malleolus ◽  
Distal Fibula ◽  
Rare Lesion ◽  
Ankle Trauma ◽  
One Year ◽  
Medial Malleolus Fracture ◽  
Hindfoot Arthrodesis

Introduction. A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture. Case Report. We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation. At one year postoperative, the patient developed an invalidating tibiotalar and subtalar arthrosis that eventually required an ankle-hindfoot arthrodesis. A Bosworth injury is an infrequent entity and is even rarer when associated with other fractures. Careful preoperative planning is necessary, as the combination of these fractures is a surgical challenge. Special care must be taken to preserve the neurovascular bundle. Discussion. The present case highlights a Bosworth injury involving a severity that has never been described before and suggests adding an eighth stage to the classification presented by Perry et al.

scholarly journals Delayed Peroneal Neuropathy After Bosworth Fracture Dislocation of the Ankle

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Sung Hoon Choi ◽  
Jeong Min Hur ◽  
Kyu-Tae Hwang
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Proximal Fragment ◽  
Rare Injury ◽  
Soft Tissue Swelling ◽  
Severe Soft Tissue

The Bosworth ankle fracture-dislocation is a rare injury and is often irreducible because of an entrapped proximal fragment of the fibula behind the posterior tibial tubercle. Repeated closed reduction or delayed open reduction may result in several complications. Thus, early open reduction and internal fixation enable a better outcome by minimizing soft-tissue damage. We report on a 27-year-old man who underwent open reduction and internal fixation after multiple attempts at failed closed reduction, complicated by severe soft-tissue swelling, rhabdomyolysis, and delayed peroneal nerve palsy around the ankle.

scholarly journals Is the Independent Tape Reinforcement a valid technique to reduce the rerupture rate of ACL reconstructions? A technical instruction and case series with 2-year follow up

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0030
Author(s):  
Stefan Schneider ◽  
René Kaiser ◽  
Ansgar Ilg ◽  
Johannes Holz
Keyword(s):  
Acl Reconstruction ◽  
Case Series ◽  
Technical Instruction ◽  
Clinical Instability ◽  
Internal Bracing ◽  
Internal Brace ◽  
Prospective Case Series ◽  
One Year ◽  
A Minor ◽  
Proprioceptive Function

Aims and Objectives: Although there is an ongoing development in ACL reconstruction techniques, a rerupture rate up to 20% still is discussed in the literature. Is the ACL reconstruction using a quadriple semitendinosus in combination with a polyurethane tape reinforcement a valid technique to reduce the retare rate? A clinical trial with 35 Patients compared to 320 patients using an isolated semitendinosus reconstruction without internal bracing. Materials and Methods: Additionally, to the quadruple semitendinosus technique with cortical button fixation, the transplant is parallelly stabilized by a polyurethane tape which is individually fixed in the femoral button. The tape secures the transplant during the remodeling episode since repeated small tensions on the transplant during this time are discussed as a reason for a rerupture. In this prospective case series 35 patients were treated with this technique, reexamined and VAS, Tegner, KOOS Jr. and SANE are preoperatively, two and six weeks, three and six month and after one, two and five years recorded using a PROMS system. Clinical instability and proprioceptive function were also surveyed at these timepoints. The results and rerupture rates were compared with 320 patients of our database who underwent a comparable reconstruction without using the internal brace. Patients with fractures and multi-ligament injuries were excluded. Results: Until now no reruptures were reported, there are no significant subjective or objective differences compared to the group without internal bracing. The two years results are pending. Preoperatively the VAS score was 2.2 +/- 2.0. Two weeks after the surgery 2.1 +/- 1.8 and one year postoperatively 0.5 +/- 0.7. Tegner score preoperatively: 4.6 +/- 2.7 after one year 4.7 +/- 3.0. KOOS jun. improves in both groups around 15%. Conclusion: Until now the ACL reconstruction using an internal brace seems to be a safe and effective technique. Biomechanical studies show beneficial stabilizing results and a minor rerupture rate might be possible due to reduced microlesions during the remodeling period. The study is still ongoing, longtime results are pending.

scholarly journals Traumatic lumbar espondylolisthesis: a case report

2014 ◽  
Vol 13 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Enrique Vargas Uribe ◽  
José Luis González Gallegos ◽  
Leonardo Gutiérrez Ramírez
Keyword(s):  
Neurological Deficit ◽  
Posterior Instrumentation ◽  
High Energy ◽  
Autologous Bone Graft ◽  
Intervertebral Disk ◽  
Complete Fusion ◽  
Radiographic Evidence ◽  
Rare Injury ◽  
One Year ◽  
Car Accident

We present a case of traumatic espondylolisthesis L5 S1 A0 53 B3.3 ASIA B in a young patient after a high energy car accident. This entity is a rare injury that requires immediate attention. Treatment should be prompt in order to provide the best prognosis since this is an unstable and severe lesion that presents with neurological deficit in half of the patients. Computed tomography and magnetic resonance imaging have shown to be extremely valuable for the diagnosis and are mandatory for this kind of injuries. In this case it is noteworthy that the intervertebral disk was intact. It is reported that if surgery is performed 24 to 48 hours after the accident, the improvement of neurological deficit is very feasible. In this case posterolateral fusion with autologous bone graft and multiplanar transpedicular posterior instrumentation and decompression were performed 52 hours after the accident. The patient presents one year after surgery with improvement in movement and sphincter control and with radiographic evidence of a complete fusion.

scholarly journals Salter-Harris type V fracture

2020 ◽  
Author(s):  
Jeremy Jones ◽  
Chris Rothe
Keyword(s):  
Salter Harris ◽  
Type V

Effect of home-based telecardiology on chronic heart failure: Costs and outcomes

2005 ◽  
Vol 11 (1_suppl) ◽  
pp. 16-18 ◽  
Author(s):  
S Scalvini ◽  
S Capomolla ◽  
E Zanelli ◽  
M Benigno ◽  
D Domenighini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Usual Care ◽  
Usual Care Group ◽  
Care Group ◽  
Home Based ◽  
Clinical Instability ◽  
One Year ◽  
The One ◽  
The Cost

Chronic heart failure (CHF) remains a common cause of disability. We have investigated the use of home-based telecardiology (HBT) in CHF patients. Four hundred and twenty-six patients were enrolled in the study: 230 in the HBT group and 196 in the usual-care group. HBT consisted of trans-telephonic follow-up and electrocardiogram (ECG) monitoring, followed by visits from the paramedical and medical team. A one-lead ECG recording was transmitted to a receiving station, where a nurse was available for reporting and interactive teleconsultation. The patient could call the centre when assistance was required (tele-assistance), while the team could call the patient for scheduled appointments (telemonitoring). The one-year clinical outcomes showed that there was a significant reduction in rehospitalizations in the HBT group compared with the usual-care group (24% versus 34%, respectively). There was an increase in quality of life in the HBT group (mean Minnesota Living Questionnaire scores 29 and 23.5, respectively). The total costs were lower in the HBT group (107,494 and 140,874, respectively). The results suggest that a telecardiology service can detect and prevent clinical instability, reduce rehospitalization and lower the cost of managing CHF patients.

scholarly journals A Rare Case of Traumatic Bilateral Fibular Head Fractures

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Anastasios Chytas ◽  
Antonios Spyridakis ◽  
John Gigis ◽  
Theodoros Beslikas ◽  
Nikolaos Panos ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Epileptic Seizure ◽  
Rare Case ◽  
Full Range ◽  
Knee Instability ◽  
Fibular Head ◽  
Rare Injury ◽  
Bone Bruises ◽  
Knee Braces ◽  
One Year

Avulsion fibular head fractures are rare. There is only one reference of bilateral fibular fractures after epileptic seizure. We aim to present the mechanism and the treatment of this rare injury. We present the case of a 30-year-old woman who was hit by a car on the anteromedial side of both knees. Clinical and radiographic control showed bilateral fibular head fractures. Knee instability was not found at both knees and MRI did not show any concomitant ligament ruptures. Bone bruises of both medial condyles found in MRI explain the mechanism of this injury. The patient was treated conservatively with functional knee braces for 6 weeks allowing full range of motion, but otherwise mobilised as normal without any support. Six weeks after the trauma, there were no symptoms while the fractures sites had united completely after 6 months. One year postinjury the patient was free from symptoms.

scholarly journals Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Rasesh R. Desai ◽  
Shital N. Parikh
Keyword(s):  
Tibial Tubercle ◽  
Skeletally Immature ◽  
Radiographic Evidence ◽  
Rare Injury ◽  
Sleeve Fracture ◽  
Initial Injury ◽  
Final Followup ◽  
Suture Anchor Fixation ◽  
Anchor Fixation ◽  
Skeletally Immature Patient

Tibial tubercle sleeve fracture is a rare injury. In concept, it is similar to the patellar sleeve fracture in a skeletally immature patient. We describe a unique case of simultaneous bilateral tibial tubercle sleeve fractures in a 12-year-old boy. Radiographs and MRI confirmed the injury. The patient underwent open surgical repair of bilateral sleeve fractures with suture anchor fixation. At the final followup, 3 years after his initial injury, the patient demonstrated full knee function bilaterally without radiographic evidence of growth disturbances.

Bilateral Tibial Tubercle Avulsion Fractures in Children – Clinical Results of a Rare Fracture

2019 ◽  
Vol 158 (05) ◽  
pp. 466-474
Author(s):  
Francisco Fernandez Fernandez ◽  
Oliver Eberhardt ◽  
Steffen Schröter ◽  
Thomas Wirth ◽  
Christoph Ihle
Keyword(s):  
Clinical Results ◽  
Tibial Tubercle ◽  
Avulsion Fractures ◽  
Type Iv ◽  
Fractures In Children ◽  
Activity Scale ◽  
K Wires ◽  
Type V ◽  
Tegner Activity Scale

Abstract Background Tibial tubercle avulsion fractures are rare, they represent less than 1% of all physeal fractures. Compared to monolateral tibial tubercle avulsion fractures, bilateral occurrence is even rarer. The purpose of this study is to report about the so far largest group of bilateral avulsion fractures and to compare them to unilateral fractures as well as to current literature. Method All patients who suffered from bilateral tibial tubercle fractures between January 2009 and March 2019 were included. All medical records and radiographs were reviewed and a clinical follow-up was performed. The examined criteria were age, gender, mechanism of injury, classification, risk factors, complications, management and outcomes. Clinical outcome was measured using the well established Tegner activity scale and Lysholm-Gillquist score. The same criteria were analyzed in a literature review of bilateral tibial tubercle fractures to compare our results to available literature. Results We found four children with bilateral tibial tubercle avulsion fractures. All patients were male with a mean age of 14.5 ± 0.7 years (13 – 15). Mean follow-up examination was 13.6 ± 6.5 months (8 – 29) after surgery. The avulsions occurred during jumping activities in all cases. All children could no longer stand or move because of sudden pain in the knee. We found type IV fractures in three cases, type III fractures in four cases and one type V fracture according to the Ogden classification. All children were treated by open or closed reduction and stabilization with screws or K-wires. Follow-up showed complete fracture healing without complications in all patients. There were no changes in Tegner activity scale and Lysholm-Gillquist Score and knee function comparable to prior to the accident was achieved in all cases. Conclusion Good clinical results without restrictions regarding function of the knee joint can be achieved by direct operative treatment of bilateral tibial avulsion fractures. A reduction in sporting activity has not to be expected. There were no differences between bilateral or unilateral tibial tubercle avulsion fractures.

The patterns of phalangeal fractures in children and adolescents: a review of 512 cases

2019 ◽  
Vol 51 (01) ◽  
pp. 49-53
Author(s):  
Rok Kralj ◽  
Zoran Barcot ◽  
Tomislav Vlahovic ◽  
Mario Kurtanjek ◽  
Ivan Petracic
Keyword(s):  
Children And Adolescents ◽  
Outcome Measures ◽  
Volar Plate ◽  
Secondary Outcome ◽  
Collateral Ligament ◽  
Fractures In Children ◽  
Salter Harris ◽  
One Year ◽  
Condylar Fractures ◽  
First Contact

Abstract Introduction Fractures of the phalanges in children can often be underappreciated by the physician of first contact. Therefore it is necessary to point out which of these fractures, because of the risk of possible future complications, need special mention. Materials and Methods A retrospective review of 512 fractures of the phalanges in children and adolescents during an one year period. Fractures were subdivided into the following categories – physeal fractures, intraarticular (phalangeal neck and condylar) fractures, shaft fractures, tuft fractures, “mallet finger” fractures, volar plate avulsion injuries and collateral ligament avulsion injuries. Main outcome measures was the necessity for operation while the average age at which the injury has occured, the cause of the injury, the frequency of injury of each finger, the necessity for reduction, and the duration of splinting were the secondary outcome measures. Results Collateral ligament avulsion injuries and intraarticular (phalangeal neck and condylar) fractures were injuries which most often necessitated operative treatment. Physeal injuries were the most common injuires with avulsions of the volar plate being the second most common. Accidents during sport was by far the most common cause of injuires in all categories apart from tuft injuries. Conclusion The findings regarding the incidence and the cause of these injuries in this study support the already published dana in the literature. The physician of first contact has to be capable to recognise the problematic fractures – intraarticular (phalangeal neck and condylar), significantly displaced Salter-Harris type III and IV fractures and collateral ligament avulsion injuries and Seymour fractures.

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