Unanticipated Fractures of the Zygomatic-Maxillary Suture in LeFort III Internal Distraction: Salvage of Midfacial Advancement via Rigid External Distraction of an Orphaned LeFort II Segment

FACE ◽  
2021 ◽  
pp. 273250162110272
Author(s):  
Elam Coalson ◽  
Tulsi Roy ◽  
Timothy Bruce ◽  
Russell R. Reid
Keyword(s):  
Distraction Osteogenesis ◽  
Rare Complication ◽  
Aesthetic Result ◽  
Advantages And Disadvantages ◽  
First Case ◽  
A Subunit ◽  
Temporal Bones ◽  
Internal Distraction ◽  
Current Report ◽  
Maxillary Fracture

Currently, the most common approach for treating midface hypoplasia in syndromic craniosynostoses patients is the LeFort III with distraction osteogenesis. Distraction osteogenesis can be performed through either internal or external distraction systems. Each modality offers unique advantages and disadvantages. A rare complication associated with internal distraction is fracture of the zygomatic-maxillary suture caused by distraction forces on this area. This complication has been reported in patients with Pfeiffer and Apert syndromes, related to convexity of temporal bones increasing force on the zygomatic-maxillary suture. In the current report, we present the first case in the literature of an internal distraction associated zygomatic-maxillary fracture in a patient with Crouzon syndrome. We also present a subunit osteotomy salvage approach. Through mobilization of a LeFort II segment and rigid external distraction to advance orphaned segments of the midface, a favorable aesthetic result was salvaged from this complication.

scholarly journals First-ever intraosseous ancient schwannoma of the proximal ulna successfully treated using the cement technique

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098773
Author(s):  
Kai Xuan Lim ◽  
Karl Wu
Keyword(s):  
Rare Case ◽  
Pathological Fracture ◽  
Soft Tissue Neoplasm ◽  
Proximal Ulna ◽  
Intraosseous Schwannoma ◽  
First Case ◽  
Primary Bone ◽  
Primary Bone Tumours ◽  
Current Report ◽  
Neural Sheath

Schwannoma or neurilemmoma is a common soft tissue neoplasm arising from the neural sheath of Schwann cells. However, intraosseous schwannoma is rare, accounting for less than 0.2% of primary bone tumours. Several variants of schwannoma have been reported; among them, intraosseous schwannoma with ancient change is extremely rare. This current report presents an extremely rare case of ancient intraosseous neurilemmoma. The patient presented with right elbow pain and disability. A radiolucent, well-defined, lobulated lesion with a thin sclerotic rim in the proximal ulnar metaphysis that had caused a pathological fracture was noted. The mass was surgically excised using marginal resection and bone curettage was undertaken. The bone deficit was grafted with hydroxyapatite and β-tricalcium phosphate and augmented with bone cement. There were no signs of any recurrence after 3 years. This is the first case of an ancient intraosseous schwannoma of the proximal ulna. Although rare, intraosseous schwannoma should be considered in the differential diagnosis of radiographically benign-appearing osseous tumours in the bone. The cement technique is recommended for the treatment of intraosseous schwannoma.

scholarly journals Ascending Tonic Clonic Seizure Syndrome after Percutaneous Vertebroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Guido Zarattini ◽  
Adam Farrier ◽  
Federico Sibona
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Cement Leakage ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Leg Pain ◽  
Compression Fractures ◽  
First Case ◽  
Seizure Syndrome ◽  
Osteoporotic Compression Fractures

Background Context. Cement leakage is not a rare complication of vertebroplasty, but ascending tonic clonic seizure syndrome is exceptionally rare. We herein report the first case to our knowledge of this complication related to vertebroplasty.Purpose. We herein report the first case of ascending tonic clonic seizure syndrome following epidural cement leakage after percutaneous vertebroplasty in a patient with multiple osteoporotic compression fractures.Study Design. Case report.Methods. A 64-year-old woman with T8, T10, L2, and L4 osteoporotic compression fractures underwent percutaneous vertebroplasty using polymethylmethacrylate. 40 minutes after the procedure the patient started suffering back and leg pain, having repetitive myoclonic jerks lasting 15 seconds of the lower extremities, spasm of the back, dyspnea, sinus tachycardia, hypoxemia, and metabolic acidosis.Results. The patient recovered completely due to a combination of early effective resuscitation and considered definitive management.Conclusions. Percutaneous vertebroplasty with polymethylmethacrylate is relatively safe but has few dangerous complications, which should be prevented by a meticulous technique and excellent image quality.

Internal Distraction Osteogenesis in Mandibular Reconstruction: Clinical Experience in 10 Cases

2008 ◽  
Vol 121 (2) ◽  
pp. 563-575 ◽  
Author(s):  
Raúl González-Garcia ◽  
Pilar Rubio-Bueno ◽  
Luis Naval-Gías ◽  
Francisco J. Rodríguez-Campo ◽  
Verónica Escorial-Hernández ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Distraction Osteogenesis ◽  
Mandibular Reconstruction ◽  
Internal Distraction

Iatrogenic Intraprosthetic Dislocation of Dual Mobility Cup. Case Study

2021 ◽  
Vol 23 (1) ◽  
pp. 51-57
Author(s):  
Kamil Kurczyński ◽  
Artur Pepłoński ◽  
Piotr Cieślik ◽  
Marta Burbul(
Keyword(s):  
Closed Reduction ◽  
Rare Complication ◽  
Medical Institute ◽  
Dual Mobility Cup ◽  
Acetabular Cup ◽  
Dual Mobility ◽  
First Case ◽  
The Military ◽  
Intraprosthetic Dislocation

Intra-prosthetic dislocation of the dual-mobile acetabular cup is a rare complication. Most often, it is the result of wear of the polyethylene liner. It can also occur during a closed reduction of a dislocated dual-mobile cup. It is extremely important to recognize this complication immediately in order to avoid the consequences. This paper presents the first case of iatrogenic intraprosthetic dislocation at the Traumatology and Orthopaedics Department of the Military Medical Institute, our management of the case and suggestions for treating patients with a dislocation of the dual-mobile acetabular cup.

scholarly journals Inadvertent Trypan Blue Staining of Posterior Capsule during Cataract Surgery Associated with “Argentinian Flag” Event

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Robert A. Prinzi ◽  
Neeti M. Alapati ◽  
Shawn S. Gappy ◽  
Jason S. Dilly
Keyword(s):  
Cataract Surgery ◽  
Trypan Blue ◽  
Rare Complication ◽  
Posterior Capsule ◽  
Blue Staining ◽  
Anterior Surface ◽  
Anterior Capsule ◽  
Trypan Blue Staining ◽  
First Case

Trypan blue is common in visualizing the anterior capsule during cataract surgery. Inadvertent staining of the posterior capsule during phacoemulsification is a rare complication and there are few reports in the literature. The proposed mechanism of posterior capsule staining in previous reports includes a compromised zonular apparatus or iris retractors facilitating the posterior flow of trypan blue. We report the first case of trypan blue staining of the posterior capsule associated with the “Argentinian flag” sign. In our case, the “Argentinian flag” allowed the trypan blue to seep between the posterior capsule and the lens, staining the anterior surface of the posterior capsule.

scholarly journals Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
M. Abu Hishmeh ◽  
P. Srivastava ◽  
Q. Lougheide ◽  
M. Srinivasan ◽  
S. Murthy
Keyword(s):  
Pleural Effusion ◽  
Health Care Providers ◽  
Rare Complication ◽  
Pigtail Catheter ◽  
Care Providers ◽  
Nonvalvular Atrial Fibrillation ◽  
Vein Thrombosis ◽  
Spontaneous Hemothorax ◽  
First Case ◽  
Iatrogenic Trauma

Introduction. Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax. Case Presentation. A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days. Discussion. Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days. Conclusion. Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.

Fracture of the Occipital Condyle as an Incidental Finding during CT-Evaluation of a Maxillary Fracture

1994 ◽  
Vol 35 (1) ◽  
pp. 90-91 ◽  
Author(s):  
R. Olsson ◽  
R. Kunz
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Incidental Finding ◽  
Occipital Condyle ◽  
Facial Trauma ◽  
Coronary Ct ◽  
First Case ◽  
Ct Evaluation ◽  
Condyle Fracture ◽  
Maxillary Fracture

A 43-year-old male presented with blunt facial trauma after a motor-vehicle accident. CT-evaluation revealed a right-sided maxillary fracture and a fracture of the left occipital condyle. The fracture of the occipital condyle is potentially unstable and fatal cases have been described. Plain radiographs are not diagnostic. This occipital condyle fracture was an incidental finding during CT-evaluation of a maxillary fracture and is probably the first case with coronary CT scans of this type of fracture.

scholarly journals Escherichia Coli Subscapular Abscess as a Rare Complication of Manual Therapy in Frozen Shoulder: A Case Report

2021 ◽  
Author(s):  
Dong Hun Ham ◽  
Sungil Wang
Keyword(s):  
Escherichia Coli ◽  
Manual Therapy ◽  
Rare Complication ◽  
Fluid Collection ◽  
Frozen Shoulder ◽  
Etiologic Agent ◽  
Left Shoulder ◽  
Recent Infection ◽  
Limited Range Of Motion ◽  
First Case

Abstract Background: Subscapular abscess is a rare condition usually secondary to immunocompromised state and recent infection. Staphylococcus aureus (S. aureus) is the most common etiologic agent. To the best of our knowledge, we present the first case of a patient with a frozen shoulder performing manual therapy, which resulted in an Escherichia coli subscapular abscess.Case presentation: A 72-year-old male was referred from the respiratory department with pain and a limited range of motion in the left shoulder. He complained that the pain was exacerbated with popping sound during manual therapy for frozen shoulder two weeks ago. Magnetic resonance imaging revealed a large intramuscular complicated fluid collection at the level of the subscapularis muscle 10.0 × 5.2 × 11 cm in size, and a bloody but turbid pus-like discharge was observed upon aspiration. He underwent urgent surgical drainage. The cultures from the abscess fluid revealed extended-spectrum beta-lactamases (-) E. coli. After 4 weeks of Ceftazidime intravenous treatment, symptoms of the patient had improved. Conclusions: This case highlights the risks of aggressive manual therapy in severe frozen shoulder. It also presents a clinical scenario in which practitioners of manual therapy in frozen shoulder should be aware of the risk of subscapular abscess in patients undergoing recent infection therapy

scholarly journals Deformation of cranioplasty titanium mesh in a paediatric patient following head trauma

2019 ◽  
Vol 12 (6) ◽  
pp. e230421
Author(s):  
Basel Sharaf ◽  
Malke Asaad ◽  
Joseph Banuelos ◽  
Jesse Meaike
Keyword(s):  
Paediatric Patient ◽  
Head Trauma ◽  
Titanium Mesh ◽  
Brain Protection ◽  
Contact Sports ◽  
Advantages And Disadvantages ◽  
First Case ◽  
Alloplastic Materials ◽  
Life Saving ◽  
Titanium Cranioplasty

Decompressive craniectomy is a life-saving procedure performed to treat intracranial hypertension caused by a variety of conditions. Subsequent cranioplasty reconstruction is needed for brain protection. Different alloplastic materials with different advantages and disadvantages are available for cranial reconstruction. We present the first case of a deformed titanium cranioplasty mesh in a paediatric patient following head trauma. Children who have undergone cranioplasty reconstruction should be counselled to wear a protective helmet when involved in contact sports or activities that may put their implant at risk of trauma.

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