Intramedullary Insertion of the Patellar Tendon, a Rare Anatomical Variant, Its Sequelae, and Surgical Management

Knee dislocation with concomitant multiligament injury is a rare and devastating injury. We report the successful repair of a rare case of open knee dislocation with concomitant multiligament injury and patellar tendon rupture of an 18-year-old male due to a motorcycle accident. The patient presented with an open wound running parallel to the knee joint line and patellar tendon rupture with full exposure of the cartilage of the distal femur. Staged surgical management including the application of a ring-type external fixator with a hinged joint, lateral collateral ligament repair, medial collateral ligament reconstruction using autogenous hamstring tendon, and joint release was performed. Range of movement was recovered to 0 degrees of knee extension and 80 degrees of knee flexion, and extension lag was negative. The Lysholm score of the patient was recovered to 92. The patient was able to return to work in the construction field 2 years after sustaining the injury. The patient had no complaint of pain and was able to resume construction work, even though reconstruction of the anterior cruciate ligament and posterior cruciate ligament was not performed. The application of a hinged ring-type external fixation device might play a key role in early range of movement restoration and to maintain the reduced position and acceptable recovery of the posterior cruciate ligament injury without the need for reconstructive surgery. This report is the first to describe the safety and effectiveness of staged surgical management for the repair of open knee dislocation with concomitant multiligament injury and patellar tendon rupture. However, further studies with longer follow-up periods will be needed to observe the development of osteoarthritis or weakness of the knee. Staged surgical management is a safe and effective procedure for repairing an open knee dislocation with concomitant multiligament injury and patellar tendon rupture.

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An Unusual Case of Bony Styloid Processes That Extend to the Hyoid Bone

Case Reports in Otolaryngology ◽

10.1155/2015/780870 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Shekhar K. Gadkaree ◽

Christopher G. Hyppolite ◽

Aisha Harun ◽

Ryan H. Sobel ◽

Young Kim

Keyword(s):

Surgical Management ◽

Laryngeal Cancer ◽

Clinical Finding ◽

Hyoid Bone ◽

Unusual Case ◽

Pharyngeal Arch ◽

Imaging Findings ◽

Anatomical Variant ◽

Relative Contribution ◽

Rare Malformation

The embryological origin of the hyoid bone is a point of uncertainty, with controversy surrounding the relative contribution of the second pharyngeal arch to hyoid development. We encountered a 52-year-old male with bilateral bony styloid extension to the lesser cornu of the hyoid bone during the workup of a patient with laryngeal cancer. This embryological malformation clearly supports the hypothesis that the second pharyngeal arch gives rise to the lesser cornu and demonstrates an unusual clinical finding that may be encountered by otolaryngologists. We demonstrate the imaging findings and surgical management of this unusual anatomical variant and review the embryological basis for this rare malformation.

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Crossed doubled patellar tendon: A rare anatomical variant with potential clinical significance

Radiology Case Reports ◽

10.1016/j.radcr.2021.07.033 ◽

2021 ◽

Vol 16 (10) ◽

pp. 3034-3038

Author(s):

Ziyu Xian ◽

Sayed Ali

Keyword(s):

Clinical Significance ◽

Patellar Tendon ◽

Anatomical Variant

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Surgical Management of Tendinopathy of the Main Body of the Patellar Tendon in Athletes

Clinical Journal of Sport Medicine ◽

10.1097/00042752-199904000-00002 ◽

1999 ◽

Vol 9 (2) ◽

pp. 58-61 ◽

Cited By ~ 22

Author(s):

Nicola Maffulli ◽

Peter M. Binfield ◽

William J. Leach ◽

John B. King

Keyword(s):

Surgical Management ◽

Patellar Tendon ◽

Main Body

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Surgical Management of Acute Patellar Tendon Rupture

Techniques in Knee Surgery ◽

10.1097/btk.0b013e3181b57f73 ◽

2009 ◽

Vol 8 (3) ◽

pp. 194-200 ◽

Cited By ~ 2

Author(s):

R. Cole Beavis ◽

F. Alan Barber

Keyword(s):

Surgical Management ◽

Patellar Tendon ◽

Tendon Rupture ◽

Patellar Tendon Rupture

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Surgical Management of Patients With 22q11.2 Deletion Syndrome

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig5-2019-0004 ◽

2019 ◽

Vol 4 (5) ◽

pp. 857-869

Author(s):

Oksana A. Jackson ◽

Alison E. Kaye

Keyword(s):

Surgical Management ◽

Preoperative Evaluation ◽

Preoperative Assessment ◽

22Q11.2 Deletion Syndrome ◽

Deletion Syndrome ◽

22Q11.2 Deletion ◽

Surgical Decision ◽

Obstructive Sleep ◽

Spine Abnormalities ◽

Speech Assessment

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.

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