scholarly journals Atypical Stress-Avulsion Fracture of the Lisfranc Joint Complex

2014 ◽  
Vol 7 (2) ◽  
pp. 155-158 ◽  
Author(s):  
Barry J. O’Neill ◽  
Laura A. Sweeney ◽  
Paul J. Moroney ◽  
Kevin J. Mulhall
Keyword(s):  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Avulsion Fracture ◽  
Stress Fractures ◽  
Therapeutic Level ◽  
Lisfranc Joint ◽  
Level Of Evidence ◽  
Ballet Dancers ◽  
Metatarsal Fractures ◽  
Unusual Injury

Antiphospholipid syndrome and systemic erythematosus have been associated with metatarsal stress fractures. Stress fractures of the Lisfranc joint complex are uncommon injuries but have been reported to occur most frequently in ballet dancers. We present a case of an avulsion fracture of the Lisfranc joint complex that occurred spontaneously. We have reviewed the association between systemic conditions and metatarsal fractures and proposed a series of hypothetical pathological events that may have contributed to this unusual injury. Level of Evidence: Therapeutic, Level IV: Case report

Cuboid Edema Syndrome Following Fixation of Proximal Fifth Metatarsal Fractures in Professional Athletes

2019 ◽  
Vol 12 (4) ◽  
pp. 373-379 ◽  
Author(s):  
Lauren Roberts ◽  
Alessio Bernasconi ◽  
Cesar de Cesar Netto ◽  
Andrew Elliott ◽  
William Hamilton ◽  
...  
Keyword(s):  
Case Report ◽  
Elite Athletes ◽  
Magnetic Resonance Images ◽  
Complete Healing ◽  
Professional Athletes ◽  
Screw Head ◽  
Level Of Evidence ◽  
Metatarsal Fractures ◽  
Literature Highlight ◽  
Intramedullary Screw

Stress fractures of the proximal fifth metatarsal are common injuries in elite athletes. Fixation using an intramedullary screw represents the most popular surgery performed for treating these injuries, with excellent results in most cases. However, multiple reports in the literature highlight the possibility of painful hardware, usually related to the presence of the screw head, following intramedullary fixation In this case report, we outline 4 cases of professional athletes who developed lateral-based foot symptoms following complete healing of their surgically treated proximal fifth metatarsal fractures and were found to have significant cuboid edema on magnetic resonance images. We also outline recommendations regarding specific surgical technique considerations aiming to minimize this possible complication. Level of Evidence: Level V: Case report.

Optimal management of physeal elbow injuries in the skeletally immature athlete remains undefined: a systematic review

2017 ◽  
Vol 3 (1) ◽  
pp. 38-45
Author(s):  
Brittany E Haws ◽  
Austin V Stone ◽  
Andrew O Usoro ◽  
Alejandro Marquez-Lara ◽  
Sandeep Mannava ◽  
...  
Keyword(s):  
Systematic Review ◽  
Avulsion Fracture ◽  
Stress Fractures ◽  
Medial Epicondyle ◽  
Return To Play ◽  
Skeletally Immature ◽  
Level Of Evidence ◽  
Elbow Injury ◽  
Average Return ◽  
Elbow Injuries

ImportancePhyseal elbow injury remains common for the youth athlete. In this patient population, the most effective treatment strategy for these injuries is not established.ObjectiveThis systematic review aimed to synthesise current literature regarding treatment and outcomes of physeal elbow injuries in the skeletally immature athlete.Evidence reviewA systematic literature review was completed using two databases (PubMed and ScienceDirect). Search terms included ‘paediatric elbow injury’, ‘adolescent elbow injury’, ‘elbow physeal injury’, ‘avulsion fracture medial epicondyle’ and ‘little league elbow’. Inclusion criteria were: English language, Level of Evidence I–IV, physeal elbow injury as a direct consequence of athletic activity, involvement of a distinct treatment modality and/or outcome, publication after 1989 and skeletal immaturity demonstrated through radiographic measurements.FindingsTwelve studies consisting of treatment of avulsion fractures of the medial epicondyle, medial epicondyle fragmentation, olecranon stress fractures and olecranon apophysitis met criteria and were included in this study. The most common injury was avulsion fracture of the medial epicondyle. Of these patients, 68.5% underwent operative fixation with average return to play at 3.3 months and 31.5% underwent non-operative treatment with an average return to play of 8.4 months. For medial epicondylar fragmentation, 90.2% of patients were treated non-operatively with average return to play at 3.8 months. Operative intervention was performed on 85.7% of patients with olecranon epiphysial stress fractures and average return to play was at 7 months. Operative intervention was performed on 87.5% of patients with persistence of the olecranon physis with average return to play of 4 months. All cases of olecranon apophysitis were treated non-operatively and return to play was not documented.Conclusions and relevanceThis systematic review demonstrates the heterogeneity of the treatment options for physeal injury in the adolescent athlete. This analysis supports that operative management may expedite return to play for avulsion fracture of the medial epicondyle, though medial epicondylar stress fractures can be successfully managed non-operatively. Limited data suggest surgical intervention of olecranon epiphysial stress fractures and persistence of the olecranon physis may allow athletes faster return to play.Level of evidenceIV.

Plantar Medial Avulsion Fracture of the Calcaneus With Acute Tarsal Tunnel: Case Report and Technique Tip

2020 ◽  
Vol 41 (8) ◽  
pp. 1002-1006
Author(s):  
Kempland C. Walley ◽  
William L. Johns ◽  
J. Benjamin Jackson ◽  
Tyler A. Gonzalez
Keyword(s):  
Case Report ◽  
Expert Opinion ◽  
Avulsion Fracture ◽  
Tarsal Tunnel ◽  
Level Of Evidence ◽  
Evidence Level ◽  
Fracture Of The Calcaneus

Level of Evidence: Level V, expert opinion.

Multiple Simultaneous Metatarsal Stress Fractures in the Same Foot

2015 ◽  
Vol 105 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Murat Mert ◽  
Ethem Ayhan Unkar ◽  
Ali Volkan Ozluk ◽  
Tolga Tuzuner ◽  
Sinan Erdoğan
Keyword(s):  
Case Report ◽  
Stress Fractures ◽  
Demographic Characteristics ◽  
Overuse Injuries ◽  
Ballet Dancers ◽  
Military Recruits ◽  
Poor Outcomes

Metatarsal stress fractures are common overuse injuries in athletes, military recruits, and ballet dancers, usually occurring in the second, third, and fourth metatarsals, respectively. Such fractures may also occur in a variety of other individuals, regardless of demographic characteristics, sex, or profession, and they are highly associated with excessive activity. Moreover, these types of fractures are usually diagnosed late and have poor outcomes. To our knowledge, there has been only one case report of an individual with stress fractures of all three central metatarsals in the same foot. We describe herein a racehorse training jockey who presented with multiple simultaneous metatarsal stress fractures in the same foot. We also discuss the possible mechanisms by which this entity occurred, as well as its management and outcome.

scholarly journals Pediatric Posterior Cruciate Ligament Avulsion Fracture of the Tibial Insertion: Case Report and Review of the Literature

2017 ◽  
Vol 03 (03) ◽  
pp. e134-e138 ◽  
Author(s):  
Yannick Hurni ◽  
Vincenzo De Rosa ◽  
Jorge Gonzalez ◽  
Mario Mendoza-Sagaon ◽  
Flurim Hamitaga ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Cruciate Ligament ◽  
Avulsion Fracture ◽  
Pediatric Population ◽  
Cruciate Ligament ◽  
Correct Diagnosis ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Rare Injury ◽  
Tibial Insertion

Background Posterior cruciate ligament (PCL) avulsion fracture of the tibial insertion is a very rare injury in children. In addition to performing an attentive clinical examination, radiologic studies are fundamental for its correct diagnosis and treatment. Its management may be either conservative or operative. So far, only a few cases treated conservatively have been reported in the pediatric population, with controversial results. Methods We prospectively collected and reviewed clinical and radiographic data of an 11-year-old boy with avulsion fracture of the tibial insertion of the PCL. In addition, we performed a systematic review of the literature available to date. Results We decided to treat the avulsion fracture in a conservative way. The patient has been followed with accurate clinical and radiological follow-up controls until complete recovery. Conclusion Posterior cruciate avulsion fracture is a very rare finding in children, and no definitive indications for its appropriate management exist. With this report, we demonstrate that these fractures can be treated conservatively in selected cases with good results, avoiding potential surgical-related complications. Study Design This is a case report (level of evidence V).

Catastrophic antiphospholipid syndrome with bilateral adrenal hemorrhage: a case report

2019 ◽  
Author(s):  
De Marchi Lucrezia ◽  
M K de Filette Jeroen ◽  
Sol Bastiaan ◽  
E Andreescu Corina ◽  
Kunda Rastislav ◽  
...  
Keyword(s):  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Adrenal Hemorrhage ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Bilateral Adrenal Hemorrhage

scholarly journals Ischemic priapism due to coagulopathy of severe COVID-19 infection

2021 ◽  
pp. 205141582110259
Author(s):  
Dominic C Grimberg ◽  
Rohit Tejwani ◽  
Armand Allkanjari ◽  
Michael T Forrester ◽  
Bryan D Kraft ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Disease ◽  
Disease Process ◽  
Hypercoagulable State ◽  
Management Approach ◽  
Single Center ◽  
Level Of Evidence ◽  
Ischemic Priapism

Initially thought to be a primarily respiratory disease process, the hypercoagulable state associated with COVID-19 has been associated with myriad clinical sequelae. We report a case of stuttering ischemic priapism associated with COVID-19, and describe a management approach to achieve detumescence in patients undergoing ventilatory proning limiting penile access. Level of evidence: Not applicable for this single center case report.

Fifth Metatarsal Jones Fractures in the Athlete

2017 ◽  
Vol 39 (2) ◽  
pp. 250-258 ◽  
Author(s):  
David A. Porter
Keyword(s):  
Screw Fixation ◽  
Nonoperative Treatment ◽  
Fracture Site ◽  
Medullary Canal ◽  
Return To Sports ◽  
Stress Reactions ◽  
Current Standard ◽  
Level Of Evidence ◽  
Metatarsal Fractures ◽  
Intramedullary Screw

Fifth metatarsal fractures, otherwise known as “Jones” fractures, occur commonly in athletes and nonathletes alike. While recent occurrence in the popular elite athlete has increased public knowledge and interest in the fracture, this injury is common at all levels of sport. This review will focus on all three types of Jones fractures. The current standard for treatment is operative intervention with intramedullary screw fixation. Athletes typically report an acute episode of lateral foot pain, described as an ache. Radiographic imaging with multiple views of the weightbearing injured foot are needed to confirm diagnosis. If these images are inconclusive, further magnetic resonance imaging (MRI) or computed tomography (CT) is used. Nonoperative treatment is not commonly used as the sole treatment, except when following reinjury of a stable screw fixation. While screw selection is still controversial, operative treatment with intramedullary screw fixation is the standard approach. Technical tips on screw displacement are provided for Torg (types I, II, III) fractures, cavovarus foot fractures, recurrent fractures, revision surgery, occult fractures/high-grade stress reactions, and Jones’ variants. Excellent clinical outcomes can be expected in 80% to 100% of patients when using the intramedullary screw fixation to “fit and fill” the medullary canal with threads across the fracture site. Most studies show the timing for return to sports with optimal healing to be seven to twelve weeks after fixation. Level of Evidence: Level V, expert opinion.

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