scholarly journals A study of periprosthetic fractures following hemi-arthroplasty of hip in elderly population: diagnosis and management

2020 ◽  
Vol 6 (5) ◽  
pp. 902
Author(s):  
Gagandeep Mahi ◽  
Milind Atmaram Lokhande ◽  
Lokesh Kumar Yogi ◽  
Ankit Gawri
Keyword(s):  
Indian Population ◽  
Correct Diagnosis ◽  
Anatomical Variations ◽  
Special Focus ◽  
X Rays ◽  
Diagnosis And Management ◽  
Appropriate Treatment ◽  
Type C ◽  
Hemi Arthroplasty

<p class="abstract"><strong>Background:</strong> Hemi-arthroplasty of hip for intracapsular fractures of femoral neck is one of the most commonly done surgical procedures in the low mobility older Indian population. Although there are numerous complications associated with the procedure, we want to study the types and management of peri-prosthetic fractures in patients treated with hip hemi-arthroplasty.</p><p class="abstract"><strong>Methods:</strong> A total of 26 patients were included in the study. A retrospective analysis of the radiological cum clinical diagnosis and management of peri-prosthetic fractures was performed. All patients were followed up till 1.5 years post-operatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to Vancouver classification of peri-prosthetic fractures, 10 fractures were classified as type A, 7 as type B1, 3 as type B2, 4 as type B3 and 2 as type C. Fractures were managed either by Open Reduction with Internal Fixation (ORIF) or Revision hemi-arthroplasty. Fractures type AG, B1 and C were managed with ORIF and type B2 and B3 fractures were managed with revision hemi-arthroplasty using longer stem.</p><p class="abstract"><strong>Conclusions:</strong> As evident in our study, majority of fractures occurred intra-operatively, a thorough evaluation of pre-operative x-rays of both hips should be done along with special focus on anatomical variations. Correct diagnosis based on radiological and intraoperative findings followed by appropriate treatment are of paramount importance in the management of peri-prosthetic fractures.</p>

scholarly journals Possible factors for ankle fractures

2010 ◽  
Vol 67 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Dejan Tabakovic ◽  
Radovan Manojlovic ◽  
Marko Kadija ◽  
Mihailo Ille ◽  
Goran Turkovic ◽  
...  
Keyword(s):  
Body Weight ◽  
Significant Risk ◽  
Ankle Fractures ◽  
Type B ◽  
Physical Exercises ◽  
Appropriate Treatment ◽  
Fracture Body ◽  
Type C ◽  
Fracture Types

Background/Aim. Classification of ankle fractures is commonly used for selecting an appropriate treatment and prognosing an outcome of definite management. One of the most used classifications is the Danis-Weber classification. To the best of our knowledge, in the available literature, there are no parameters affecting specific types of ankle fractures according to the Danis-Weber classification. The aim of this study was to analyze the correlation of the following parameters: age, body weight, body mass index (BMI), height, osteoporosis, osteopenia and physical exercises with specific types of ankle fractures using the Danis-Weber classification. Methods. A total of 85 patients grouped by the Danis-Weber classification fracture types were analyzed and the significance of certain parameters for specific types of ankle fractures was established. Results. The proportion of females was significantly higher (p < 0.001) with a significantly higher age (59.9 years, SD ? 14.2) in relation to males (45.1 years, SD ? 12.8) (p < 0.0001). Type A fracture was most frequent in the younger patients (34.2 years, SD ? 8.6), and those with increased physical exercises (p = 0.020). In type B fracture, the risk factor was osteoporosis (p = 0.0180), while in type C fracture, body weight (p = 0.017) and osteoporosis (p = 0.004) were significant parameters. Conclusion. Statistical analysis using the Danis-Weber classification reveals that there are certain parameters suggesting significant risk factors for specific types of ankle fractures.

scholarly journals A New Classification of Endodontic-Periodontal Lesions

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid S. Al-Fouzan
Keyword(s):  
Differential Diagnosis ◽  
Periodontal Disease ◽  
Periodontal Diseases ◽  
Correct Diagnosis ◽  
Clinical Classification ◽  
New Classification ◽  
Appropriate Treatment ◽  
Simultaneous Existence ◽  
Endodontic Disease

The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

scholarly journals An Aggressive Urothelial Carcinoma in a Horseshoe Kidney- A Case Report

2020 ◽  
Author(s):  
Sana Fathima ◽  
Sulata Manjunath Kamath
Keyword(s):  
Renal Mass ◽  
Indian Population ◽  
Index Case ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Horseshoe Kidney ◽  
Urothelial Carcinomas ◽  
Appropriate Treatment ◽  
Radiologic Imaging ◽  
Poorly Differentiated

Evidence of horseshoe kidney in Indian population is 1 in 600-800 individuals. Horseshoe kidney is predisposed to complications by virtue of its ectopic position, malrotation and associated vascular and ureteral anomalies. Incidence of Renal Cell Carcinoma (RCC) in a horseshoe kidney is same as that in general population. Other pelvic tumours, transitional tumours, Wilms tumour and carcinoids show a greater frequency. High grade urothelial carcinomas are quite rare with a few case reports available. An index case of 75 yeal old male presented with renal mass in an incidentally diagnosed horseshoe kidney on radiologic imaging. The case has been highlighted due to its poorly differentiated tumour morphology and aggressive nature. Further, immunohistochemistry was done to arrive at a correct diagnosis for appropriate treatment. The tumour cells showed positivity for Cytokeratin 7 (CK 7) and CK 5/6. They were negative for p63, PAX-8 (Paired-box gene 8). Also, it is technically difficult to excise large-sized renal mass in an anomalous kidney.

scholarly journals Postarthroscopy Osteonecrosis of the Knee: Current Concepts

Joints ◽  
2017 ◽  
Vol 05 (04) ◽  
pp. 229-236 ◽  
Author(s):  
Francesco Di Caprio ◽  
Renato Meringolo ◽  
Maria Navarra ◽  
Massimiliano Mosca ◽  
Lorenzo Ponziani
Keyword(s):  
Severe Disease ◽  
Correct Diagnosis ◽  
Special Focus ◽  
Rare Form ◽  
Correct Treatment ◽  
Actual Knowledge ◽  
Appropriate Treatment ◽  
Therapeutic Algorithm ◽  
Arthroscopic Knee ◽  
End Stage

AbstractKnee osteonecrosis is a severe disease rapidly leading to end-stage osteoarthritis, which was classified into three categories: spontaneous, secondary, and postarthroscopy. To understand postarthroscopy osteonecrosis of the knee, all the three types of knee osteonecrosis have to be deepened. This article reviewed spontaneous and secondary osteonecroses of the knee, with special focus upon postarthroscopy osteonecrosis, which is a rare form, affecting patients operated for arthroscopic knee surgery, most commonly for meniscectomy. Due to its rarity, patients and surgeons are often unprepared for this complication. A correct diagnosis is essential for appropriate treatment, and also to determine if a preexisting osteonecrosis was present, avoiding medicolegal sequelae, although many authors agree that osteonecrosis (both spontaneous and postarthroscopy) represent unpreventable and unpredictable conditions. In spontaneous osteonecrosis, the treatment is defined according to the size and the degree of the lesion, whereas in postarthroscopy osteonecrosis, the size of the lesion has no prognostic value, and therefore, the choice of the correct treatment is based more on the timing of the diagnosis. A diagnostic and therapeutic algorithm was outlined on the basis of the actual knowledge.

Endoscopic Anatomy of the Tensor Fold and Anterior Attic

2017 ◽  
Vol 158 (2) ◽  
pp. 358-363 ◽  
Author(s):  
Bin Li ◽  
Phi Doan ◽  
Robert R. Gruhl ◽  
Alessia Rubini ◽  
Daniele Marchioni ◽  
...  
Keyword(s):  
Anatomical Variations ◽  
Ossicular Chain ◽  
Type B ◽  
Cadaver Dissection ◽  
Tegmen Tympani ◽  
Before And After ◽  
Horizontal Type ◽  
Type C ◽  
Temporal Bones

Objectives The objectives of the study were to (1) study the anatomical variations of the tensor fold and its anatomic relation with transverse crest, supratubal recess, and anterior epitympanic space and (2) explore the most appropriate endoscopic surgical approach to each type of the tensor fold variants. Study Design Cadaver dissection study. Setting Temporal bone dissection laboratory. Subjects and Methods Twenty-eight human temporal bones (26 preserved and 2 fresh) were dissected through an endoscopic transcanal approach between September 2016 and June 2017. The anatomical variations of the tensor fold, transverse crest, supratubal recess, and anterior epitympanic space were studied before and after removing ossicles. Results Three different tensor fold orientations were observed: vertical (type A, 11/28, 39.3%) with attachment to the transverse crest, oblique (type B, 13/28, 46.4%) with attachment to the anterior tegmen tympani, and horizontal (type C, 4/28, 14.3%) with attachment to the tensor tympani canal. The tensor fold was a complete membrane in 20 of 28 (71.4%) specimens, preventing direct ventilation between the supratubal recess and anterior epitympanic space. We identified 3 surgical endoscopic approaches, which allowed visualization of the tensor fold without removing the ossicles. Conclusions The orientation of the tensor fold is the determining structure that dictates the conformation and limits of the epitympanic space. We propose a classification of the tensor fold based on 3 anatomical variants. We also describe 3 different minimally invasive endoscopic approaches to identify the orientation of the tensor fold while maintaining ossicular chain continuity.

scholarly journals Stones in Dystopic Kidneys

2018 ◽  
Vol 1 (1) ◽  
pp. e17-e20
Author(s):  
Mohammed El Hadi ◽  
Nisha Ranga ◽  
Shabi Ahmad
Keyword(s):  
Urinary Tract ◽  
Correct Diagnosis ◽  
Anatomical Variations ◽  
Urinary Stone ◽  
Stone Disease ◽  
Renal Anomalies ◽  
Urinary Stone Disease ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Tract Infections

Congenital abnormalities of the urinary tract comprise a variety of structural and functional malformations, these can range from mild asymptomatic to complex and life threatening. Renal anomalies predispose individuals to many complications, including recurrent urinary tract infections, stones formation, and impaired renal function. The knowledge of those anatomical variations is essential to urologists and trainees to help make correct diagnosis and offer appropriate treatment. Our aim is to define the role and evaluate the outcomes of flexible uretero-renoscopy (fURS) as an accepted treatment modality for urinary stone disease in two dystopic kidneys managed in our hospital.

Classification of small type B/C follicles as primordial follicles in mature rats

Reproduction ◽  
2000 ◽  
pp. 43-48 ◽  
Author(s):  
S Meredith ◽  
G Dudenhoeffer ◽  
K Jackson
Keyword(s):  
Dna Synthesis ◽  
Granulosa Cells ◽  
Single Layer ◽  
Reliable Indicator ◽  
Type B ◽  
Primordial Follicles ◽  
Type C

In the present study, follicles were classified according to the morphology of their granulosa cells. Type B follicles contained only flattened granulosa cells; type B/C follicles had a mixture of flattened and cuboidal granulosa cells in a single layer, and type C follicles had a single layer of cuboidal granulosa cells. The primary objectives of the study were to determine whether 5-bromo-2-deoxyuridine incorporation into type B/C follicles was a marker for initiation of growth and how long type B/C follicles could remain at the same stage before transformation to type C follicles. Female Holtzman rats received bromo-deoxyuridine for 7 days. After the infusion (day minipumps were removed = day 0), rats were ovariectomized on days 0 (n = 9), 30 (n = 8), 90 (n = 8) and 150 (n = 9). The numbers of type B, B/C and C follicles within one ovary were determined using modified fractionator counting. Analysis over all times demonstrated that there were more (P < 0.0001) type B/C (941 +/- 61 per ovary) than type C (140 +/- 18 per ovary) or type B (159 +/- 19 per ovary) follicles. The numbers of type B and type C follicles did not differ from each other at any time. Only one of 34 rats evaluated had bromo-deoxyuridine-labelled type B follicles. On day 150, 57% of the bromo-deoxyuridine-labelled type B/C follicles remained from day 0. It is concluded that (1) DNA synthesis in granulosa cells of type B/C follicles is not a reliable indicator of impending growth; and (2) type B and type B/C follicles are both components of the pool of primordial follicles.

scholarly journals Neurological Complications of Cardiac Procedures

2021 ◽  
Author(s):  
Courtney M. Hrdlicka ◽  
Jeffrey Wang ◽  
Magdy Selim
Keyword(s):  
Cardiac Surgery ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Neurological Complications ◽  
Diagnostic Workup ◽  
Diagnosis And Management ◽  
Percutaneous Interventions ◽  
Cardiac Procedures ◽  
Appropriate Treatment ◽  
Periprocedural Stroke

AbstractNeurological complications after cardiac surgery and percutaneous cardiac interventions are not uncommon. These include periprocedural stroke, postoperative cognitive dysfunction after cardiac surgery, contrast-induced encephalopathy after percutaneous interventions, and seizures. In this article, we review the incidence, pathophysiology, diagnosis, and management of these complications. Improved understanding of these complications could lead to their prevention, faster detection, and facilitation of diagnostic workup and appropriate treatment.

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

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