scholarly journals Symptomatic Os Subtibiale Following Injury: A Case Report of Failed Conservative Treatment, Leading to Differential Diagnosis Made Intraoperatively

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abhijit Bandyopadhyay
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Treatment Plan ◽  
Treatment Options ◽  
Distal Tibia ◽  
Radiographic Examination ◽  
Bone Fragment ◽  
History Of ◽  
Os Subtibiale

Introduction: Introduction: Os subtibiale is a rare accessory bone found adjacent to the distal tibia and is mostly asymptomatic. Differentiating it from a medial malleolar fracture is challenging. Most cases of acute ankle trauma that presents with an Os subtibiale are initially diagnosed as fractures by treating physicians at emergency centers. It is therefore critical for an orthopedic surgeon who gets referral for such cases to consider complete history of such patients to understand the cause of their symptoms. The goal is to avoid unnecessary surgical treatment and to realize that a symptomatic Os subtibiale can be successfully managed by conservative means. Nonetheless, certain cases may require surgical treatment if conservative treatment options fail. This is a case report of a patient that was diagnosed as a case of symptomatic Os subtibiale intraoperatively, after conservative options were unsuccessful. Case Presentation: An 18-year-old patient with an injured right ankle was referred to our clinic after failed attempts to resolve his symptoms conservatively. Based on our initial clinical and radiographic examination, the patient was continued on a conservative treatment plan assuming, it was a case of unsuccessful fracture union. After almost a year of failed conservative treatments, surgery was offered to the patient, with the understanding that the bone fragment might either be fused or completely removed based on intraoperative diagnosis. At surgery, it was observed that the bone fragment had the characteristic of an Os subtibiale. It presented as a round, smooth structure with well-formed cortical boundaries, and minimal attachment to the distal tibia. A diagnosis of symptomatic Os subtibiale was made intraoperatively, which was then successfully excised using standard orthopedic instrumentation. The patient healed uneventfully and reported a pain free, normal ankle range of motion at latest follow-up of 18 months. Conclusion: Accurate diagnosis of O

scholarly journals Bone Remineralization around Dental Implants following Conservative Treatment after Peri-Implantitis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Algirdas Puisys ◽  
Viktorija Auzbikaviciute ◽  
Renata Simkunaite-Rizgeliene ◽  
Dainius Razukevicius ◽  
Rokas Linkevicius ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Dental Implants ◽  
Dental Implant ◽  
Posterior Part ◽  
Treatment Method ◽  
Color Changes ◽  
Implant Placement ◽  
History Of

The aim of this case report is to show that bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and only conservative treatment is performed. Patient came to the clinic after three years of dental implant placement complaining about swelling, sensitivity and gingiva color changes at the posterior part of the maxilla. During radiographic and intraoral examinations peri-implantitis of the #24 implant site was diagnosed. The surgical treatment method was rejected and performed conservative treatment instead. The outcome is promising; periapical radiographs three months later showed bone remineralization as well as stable bone after 10 years. A key clinical message: Bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and conservative treatment performed.

scholarly journals Generalised versus Regional Odontodysplasia: Diagnosis, Transitional Management, and Long-Term Followup—A Report of 2 Cases

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Mostafa Ibrahim Mostafa ◽  
Nehad Samir Taha ◽  
Mennat Allah Ismail Mehrez
Keyword(s):  
Case Report ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Tooth Extraction ◽  
Treatment Plan ◽  
Treatment Options ◽  
Uncommon Condition ◽  
Regional Odontodysplasia ◽  
Left Quadrant

Background. Odontodysplasia is an uncommon condition. It can be localised or generalised, isolated or part of a syndrome.Case Report. We first report the case of an 8.5-year-old boy who presented with abnormally shaped teeth and multiple intraoral abscesses. Findings of clinical and radiographic examinations were consistent with those of generalised odontodysplasia. A 2-step, conservative treatment plan was executed with a 10-year followup. Step 1 was root canal treatment of nonvital teeth. Step 2 was crowning without preparation of new vital, erupted, and malformed teeth. The second case is that of a 12-year-old girl who presented with lack of teeth in the upper-left quadrant. The impacted teeth were exposed surgically, and fixed restoration was performed for temporary aesthetic improvement.Conclusion. Instead of tooth extraction, an approach previously used in similar cases, conservative management is feasible and offers better prosthetic treatment options for the future.

Impaired Extension of the Digits due to Bilateral Idiopathic Intrinsic Contracture: A Case Report

2019 ◽  
Vol 24 (03) ◽  
pp. 383-385
Author(s):  
Yuki Kawasaki ◽  
Soichi Ejiri ◽  
Michiyuki Hakozaki ◽  
Shinichi Konno
Keyword(s):  
Eating Disorder ◽  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Medical History ◽  
Rare Condition ◽  
Tendon Sheath ◽  
Past Medical History ◽  
Thenar Muscle ◽  
History Of

Idiopathic intrinsic contracture (IIC) with no history of trauma, ischemia, or spasticity is extremely rare. We report herein a case of impaired extension of the digits due to bilateral IICs occurred in a 30-year-old woman with a past medical history of eating disorder and amenorrhea. Although no previous case has been reported in the literature, eight similar cases of IIC have been presented at Japanese domestic conferences. In these eight cases and the present case, resection of the thenar muscle cords and unilateral resection of the lateral band were effective. Since IIC in patients with an eating disorder is a rare condition, it would be treated conservatively at first as tendon sheath inflammation or locking. However, this condition may be resistant to conservative treatment, and surgical treatment should be considered in such cases.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals External fixator for the treatment of narrowed pelvic canal in a cat

2021 ◽  
Author(s):  
S Pinna ◽  
C Tassani ◽  
M Rossini ◽  
F Lanzi
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Clinical Examination ◽  
External Fixator ◽  
Invasive Procedure ◽  
Sacral Fracture ◽  
Minimally Invasive Procedure ◽  
Canal Stenosis ◽  
Applied Tension ◽  
History Of

The aim of this study was to report the outcome of the use of an external fixator to treat a pelvic canal stenosis in a 5-month-old female cat. The cat was referred with a history of 3 weeks of intermittent signs of constipation refractory to the medical management, occurring after surgical treatment for a bilateral sacroiliac luxation and sacral fracture. The clinical examination revealed instability of the pelvis and a radiograph showed a pelvic canal stenosis and megacolon. External fixator was the method of choice to be used in this case. The manually applied tension on an external fixator resulted in a widening of the pelvic canal. At 45 days after surgery, there were no signs of constipation, and the radiological examination showed progressive bone healing. At 18 months post-op, the cat had no abnormalities both on the clinical examination and on the radiography. In conclusion, the use of an external fixator led to the widening of the pelvic canal using a minimally invasive procedure. To the authors’ knowledge, this case report represents the first surgical description and clinical outcome of the widening of the pelvic canal in cats using an external skeletal fixator.

scholarly journals Fourth mandibular molar in a pediatric patient – Case report

2015 ◽  
Vol 5 (20) ◽  
pp. 229-231
Author(s):  
Atanas Vlaykov ◽  
Dian Sharlanov ◽  
Dilyana Vicheva
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Treatment Modality ◽  
Treatment Plan ◽  
Female Child ◽  
Permanent Teeth ◽  
Radiographic Examination ◽  
Supernumerary Teeth ◽  
Patient Case ◽  
Mandibular Molar

Abstract Background. Supernumerary teeth are described as an excess of the normal teeth number of 20 deciduous and 32 permanent teeth and can occur in any dental region. Material and methods. The authors present the case of a 12-year-old female child with a paramolar in the maxilla, discovered accidentally during an orthopantomogram, emphasising the treatment modality and the complications that can appear. Conclusion. Supernumerary teeth can be present in any region of the oral cavity. Both practitioners and clinicians should be aware of the various types of paramolars and make a treatment plan after an accurate clinical and radiographic examination.

scholarly journals Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review

2021 ◽  
Vol 15 (3) ◽  
pp. 129-136
Author(s):  
Nesrin Mwafi ◽  
Ali Alasmar ◽  
Monther Al-Momani ◽  
Sattam Alazaydeh ◽  
Omar Alajoulin ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Sudden Onset ◽  
Flexor Hallucis Longus ◽  
History Of ◽  
Complete Disruption ◽  
Collagenous Tissues

Abstract Background Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.

scholarly journals Surgical treatment for irreducible pediatric subaxial cervical unilateral facet dislocation: case report

2016 ◽  
Vol 17 (5) ◽  
pp. 607-611 ◽  
Author(s):  
Wei Qu ◽  
Dingjun Hao ◽  
Qining Wu ◽  
Zongrang Song ◽  
Jijun Liu
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Complete Resolution ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Facet Dislocation ◽  
Unilateral Approach ◽  
Subaxial Cervical Spine

Unilateral facet dislocation at the subaxial cervical spine (C3–7) in children younger than 8 years of age is rare. The authors describe a surgical approach for irreducible subaxial cervical unilateral facet dislocation (SCUFD) at C3–4 in a 5-year-old boy and present a literature review. A dorsal unilateral approach was applied, and a biodegradable plate was used for postreduction fixation without fusion after failed conservative treatment. There was complete resolution of symptoms and restored cervical stability. Two years after surgery, the patient had recovered range of motion in C3–4. In selected cases of cervical spine injury in young children, a biodegradable plate can maintain reduction until healing occurs, obviate the need to remove an implant, and recover the motion of the injured segment.

scholarly journals Muir-Torre Syndrome: case report and molecular characterization

2014 ◽  
Vol 132 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Carolina Alejandra Rios ◽  
Ricardo Villalon ◽  
Jorge Munoz ◽  
Monica Acuna ◽  
Lucia Cifuentes
Keyword(s):  
Case Report ◽  
Autosomal Dominant ◽  
Treatment Options ◽  
Skin Lesions ◽  
Molecular Techniques ◽  
Causative Mutation ◽  
Colorectal Tumors ◽  
History Of ◽  
Repair Genes ◽  
Microsatellite Instability Analysis

CONTEXT: Muir-Torre syndrome is a rare autosomal dominant genodermatosis caused by mutations in the mismatch repair genes. It is characterized by the presence of sebaceous skin tumors and internal malignancies, affecting mainly the colon, rectum and urogenital tract. Awareness of this syndrome among physicians can lead to early diagnosis of these malignancies and a better prognosis. CASE REPORT: We report the case of a Chilean patient who, over the course of several years, had multiple skin lesions, endometrial cancer and colon cancer. The syndrome was diagnosed using molecular techniques such as microsatellite instability analysis, immunohistochemistry and DNA sequencing, which allowed us to find the causative mutation. CONCLUSION: Molecular diagnostics is a highly useful tool, since it allows clinicians to confirm the presence of mutations causing Muir-Torre syndrome. It is complementary to the analysis of the clinical data, such as dermatological presentation, presence of visceral malignancies and family history of colorectal tumors, and it provides important knowledge to help physicians and patients choose between treatment options.

scholarly journals  Atresia coli in a Japanese black calf diagnosed by a barium sulphate enema contrast radiograph in the standing position: a case report

2012 ◽  
Vol 57 (No. 7) ◽  
pp. 376-379
Author(s):  
K. Abouelnasr ◽  
M. Ishii ◽  
H. Inokuma ◽  
Y. Kobayashi ◽  
K. Lee ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Abdominal Distension ◽  
Standing Position ◽  
Barium Sulphate ◽  
Radiographic Examination ◽  
Anal Opening ◽  
Old Japanese ◽  
History Of ◽  
Colon And Rectum

A three day-old Japanese black calf was admitted with a history of abdominal distension and absence of defecation. Dilated loops of the small intestine and hypoplasia of the colon and rectum was observed upon a contrast radiographic examination in the standing position. At necropsy atresia coli with undeveloped rectum and patent anal opening was found. We conclude that a contrast radiograph in the standing position is useful for diagnosing atresia coli in such cases.  

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