REMOVAL OF STUCK FEMUR INTERLOCKING NAIL BY LONGITUDINAL OSTEOTOMY OF FEMUR - A CASE REPORT

Introduction:Gerhard Kuntscher first introduced the technique of intramedullary nailing in 1940s . It is a clover leaf shaped hollow tubular nail for intramedullary fixation of long bones. This nailing system has been a technological breakthrough for femur fixation which can be both anterograde or retrograde. Case Report:A 34 year old Male patient resident of Shahapur brought by relatives to JJ hospital, with chief complaint of pain at left knee since 8 days. Patient had A/H/O RTA after fall from bike in 31/12/2012 with head injury with left shaft femur fracture. Patient was operated at JJH with left femur ILN. History of head injury operated in JJ hospital with no details known to patient. There was also history decreased vision in left eye since trauma. Discussion:Interlocking intramedullary nails are used as gold standard treatment in majority of tibial and femoral diaphyseal fractures. It can be removed in certain circumstances when it causes soft tissue irritation, prominent locking screws, implant failure, infection, nonunion, malunion etc. Conclusion:This study shows that in removal of stuck or bent femur interlocking nails in which all other closed techniques have failed, open longitudinal femoral osteotomy with retrograde hitting of the nail can effectively aid in successful removal of nail.

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Tumor Mimicking in Musculoskeletal System in Surabaya: A Case Series

Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya ◽

10.30651/jqm.v4i1.2652 ◽

2020 ◽

Vol 4 (1) ◽

pp. 111

Author(s):

Bayu Antara Hadi ◽

Mouli Edward

Keyword(s):

Chronic Osteomyelitis ◽

Case Series ◽

Clinical History ◽

Left Knee ◽

Diagnostic Modality ◽

Left Femur ◽

Papillary Carcinoma Thyroid ◽

Mass Size ◽

History Of ◽

One Year

ABSTRACTMusculoskeletal tumors are potential causes of heavy morbidity and economic burdens for patients. There are often cases suspected as musculoskeletal tumors based on a specific diagnostic modality because of overlapping features upon physical examination or a tumor-like appearance from the radiological examination, the more reason for triple diagnosis to be performed for an exact diagnosis. We report 5 cases of fractures tumor-mimicking lesions. The First patient, a patient with MRI revealing a primary malignant bone tumor, but with plain thorax x-ray and FNAB, the diagnosis was tuberculosis arthritis of the elbow. The second patient shows metastatic proses with plain radiographic, but from open biopsy, the diagnoses fall to chronic osteomyelitis. The third patient had a history of papillary carcinoma thyroid with pathological fracture of proximal of the left femur, but the biopsy shows a hypercalcemic state. The fourth patient, had mass size 20x15 cm at the thigh, but the biopsy shows Non-Specific Chronic Osteomyelitis. The fifth patient with progressive swelling of the left knee for one year, 10x10 cm in size, the biopsy showed no sign of malignancy but tuberculosis of left distal femur. In conclusion, standard comprehensive diagnosis steps consisting of clinical history, imaging, laboratory and histopathological examinations are crucial to differentiate tumor-mimicking lesions from neoplasms, thus ensuring proper treatment.Keywords: Tumour mimicking, osteosarcoma, chondroma, malignancy

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THE MISSING LINK IN THE HISTORY OF THE LOCKED INTRAMEDULLARY NAIL

Acta Ortopédica Brasileira ◽

10.1590/1413-785220212904246573 ◽

2021 ◽

Vol 29 (4) ◽

pp. 228-231

Author(s):

FLÁVIO PIRES DE CAMARGO ◽

GUILHERME PELOSINI GAIARSA ◽

OLAVO PIRES DE CAMARGO ◽

PAULO ROBERTO DOS REIS ◽

JORGE DOS SANTOS SILVA ◽

...

Keyword(s):

Standard Treatment ◽

Femoral Shaft ◽

Reference Level ◽

Intramedullary Nails ◽

Level Of Evidence ◽

Femoral Shaft Fractures ◽

Interlocking Nail ◽

Major Development ◽

The World ◽

History Of

ABSTRACT Femoral Shaft intramedullary nails were first described by the Aztecs in 16th century, but the modern use of intramedullary nails as the gold standard treatment for femoral shaft fractures began with Gerald Kuntcher in 1939. From the first Kuntcher’s study in 1939, to the creation of interlocking nail, a long and some minor developments were described around the world. However, a major development is missing: the first nail to have a rotational and vertical stability locking system was described by Flavio Godoy Moreira, but was never published on an indexed journal for the correct historical reference. Level of Evidence V, Therapeutics Studies, Expert Opinion.

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Cognitive reserve in neuropsychiatry

Psychological Medicine ◽

10.1017/s0033291706007501 ◽

2006 ◽

Vol 36 (8) ◽

pp. 1053-1064 ◽

Cited By ~ 159

Author(s):

J. H. BARNETT ◽

C. H. SALMOND ◽

P. B. JONES ◽

B. J. SAHAKIAN

Keyword(s):

Bipolar Disorder ◽

Cognitive Function ◽

Head Injury ◽

Cognitive Reserve ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Neuropsychiatric Disorders ◽

Future Studies ◽

Cognitive Failure ◽

History Of

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.

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Cutibacterium acnes sternoclavicular joint osteomyelitis in an otherwise healthy 55-year-old man

BMJ Case Reports ◽

10.1136/bcr-2021-241778 ◽

2021 ◽

Vol 14 (7) ◽

pp. e241778

Author(s):

Sean Yaphe ◽

Kemal Bahcheli

Keyword(s):

Unusual Case ◽

Left Knee ◽

Sternoclavicular Joint ◽

Joint Injection ◽

Cutibacterium Acnes ◽

History Of ◽

Haematogenous Spread ◽

Body Joint ◽

Full Body

Sternoclavicular joint osteomyelitis is extremely rare, with only 225 reported cases in the last 45 years. We present an unusual case in an otherwise healthy 55-year-old man with a history of well-controlled type 2 diabetes mellitus and hypertension. He presented to the emergency department after a week of left knee pain that worsened to full-body joint pain with left sternoclavicular swelling. He was started on antibiotics with multiple washouts of the left knee and treated for septic arthritis. By MRI and CT, he was found to have left sternoclavicular joint osteomyelitis and abscess and underwent debridement and resection. We believe that the initial joint injection resulted in haematogenous spread to the left sternoclavicular joint, stressing the importance of a sterile field for joint procedures.

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Esophageal Injury Secondary to Severely Embedded Denture: A Case Report

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v5i3.289 ◽

2021 ◽

Vol 5 (3) ◽

pp. 362

Author(s):

Santiyamadhi Subramanyan ◽

Komathi Ramachandran ◽

Ing Ping Tang

Keyword(s):

Case Report ◽

Open Surgery ◽

Foreign Bodies ◽

Health Sciences ◽

Esophageal Injury ◽

Review Of The Literature ◽

Surgical Extraction ◽

History Of ◽

Successful Removal ◽

Esophageal Foreign Bodies

The incidence of esophageal impacted denture is proportionately increasing as there is increasing number of people wearing denture in current days. Impacted denture has to be removed as soon as possible because the delay can lead to complications. The successful removal of impacted denture in the esophagus in a patient is reported, with a review of the literature. A 52-year-old Malay lady complained of dysphagia with no history of foreign body ingestion. Following unsuccessful attempts of removal via a rigid esophagoscope, open surgery was performed. Without further delay, the impacted denture was removed by cervical esophagotomy, and the patient recovered uneventfully. Esophageal foreign bodies are usually removed by endoscopy. However, in situations where this appears potentially hazardous, such as with impacted denture, open surgical extraction that is promptly performed is a safer option.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 362-365

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Study of management of diaphyseal fracture shaft femur by intramedullary interlocking nail

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20192109 ◽

2019 ◽

Vol 5 (4) ◽

pp. 588

Author(s):

Ayush Tiwari ◽

Sarabjeet Singh Kohli ◽

Manish Kokne

Keyword(s):

Primary Treatment ◽

Rotational Stability ◽

Diaphyseal Fracture ◽

Flexion Deformity ◽

Interlocking Nail ◽

Medical College ◽

Diaphyseal Fractures ◽

Free Function ◽

Femur Shaft

Background: Aim of this study was to analyze the effectiveness of interlocking nail in management of femoral diaphyseal fractures with special reference to fracture anatomy, pattern and status of stability.Methods: This hospital based prospective study was done in the department of Orthopedics, MGM Medical College Navi Mumbai. A total of 41 patients who were admitted in our institute was included to evaluate management of diaphyseal fracture shaft femur by intramedullary interlocking nail from July 2015 to July 2017. They were asked to follow up at 6 weeks, 3 months and 6 months.Results: Most of the fractures (70.7%) were united in 16-20 weeks while 10 (24.4%) fractures were united in 10-15 weeks and 2 (4.9%) fractures were united in 21-25 weeks. The mean time to union was 16.87±3.09 weeks. In the present study, 26 out of 41 patients had excellent results (63.4%) with full, pain free, function of the extremity. 13 patients with good result (31.8%), 9 patients had flexion deformity 1200, 3 patients had shortening 2 cm, 2 patients had shortening 1 cm. Two patients with fair result (4.8%), both had flexion deformity and none had with poor result. So overall, we had 95.2% excellent to good and 4.8% fair results.Conclusions: Interlocking intramedullary nailing is the most effective ad successful method of definitive primary treatment, in most types of fractures of femur shaft. It provides strong fixation, rotational stability and earliest return to functional status, as rate of healing is good with nailing.

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Surgical Resection with Boyd Technique for Metastatic Ewing Sarcoma of the Bone Plus Docetaxel/Gemcitabine, Associated with Improved Outcomes in Tumor Activity

Advances in Hematology and Oncology Research ◽

10.33140/ahor.03.01.12 ◽

2020 ◽

Vol 3 (1) ◽

Keyword(s):

Ewing Sarcoma ◽

Distal Femur ◽

Medical Oncology ◽

Femur Fracture ◽

Improved Outcomes ◽

History Of ◽

Metastatic Activity ◽

History Of Epilepsy ◽

Histopathological Result

Ewing sarcoma is a malignant bone tumor that mainly affects children, adolescents and young adults with more than 1.5 cases per million worldwide. Approximately 20-25% of patients present metastatic disease at the diagnosis, that is often resistant to intensive therapy.We present the case of a 19-year-old male with history of epilepsy who started his condition with weight loss, increased volume, pain, swelling after receiving surgical treatment due to a left distal femur fracture, showing tomographic evidence of a 50-cm tumor with multiple lung lesions, so disarticulation was performed with the Boyd technique, obtaining histopathological result of Ewing’s Sarcoma, and was subsequently sent to the medical oncology service for follow-up and adjuvant treatment with significant clinical and radiological improvement in pulmonary metastatic activity.

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A clinical study on surgical management of diaphyseal fractures of tibia by intramedullary interlocking nail

National Journal of Clinical Orthopaedics ◽

10.33545/orthor.2019.v3.i3a.02 ◽

2019 ◽

Vol 3 (3) ◽

pp. 08-12

Author(s):

Syed Azher Hussain

Keyword(s):

Clinical Study ◽

Surgical Management ◽

Interlocking Nail ◽

Diaphyseal Fractures

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Association of post-traumatic communication of endocranium and nasal cavity with recurrent meningoencephalitis without rhinorrhea

Vojnosanitetski pregled ◽

10.2298/vsp1011945d ◽

2010 ◽

Vol 67 (11) ◽

pp. 945-948 ◽

Cited By ~ 1

Author(s):

Djula Djilvesi ◽

Petar Vulekovic ◽

Tomislav Cigic ◽

Zeljko Kojadinovic ◽

Vladimir Papic ◽

...

Keyword(s):

Case Report ◽

Head Injury ◽

High Resolution ◽

Ct Scans ◽

Direct Impact ◽

Skull Base Fracture ◽

Therapeutic Procedures ◽

History Of ◽

Post Traumatic ◽

Transnasal Endoscopic Surgery

Introduction. A gunshot head injury, characterized by a huge intensity of mechanical force, in addition to the direct tissue damage at the location of direct impact, may cause a skull and skull base fracture, distant from the the point of direct impact, which could be further complicated by creating a communication between endocranium and nasal/paranasal cavities. Such cases pose a great diagnostic and therapeutic challenge for every clinician. Case report. The patient is presented with the history of a perforating gunshot head injury six years ago, with recurrent attacks of meningoencephalitis subsequently, without rhinorrhea. By using high resolution CT scans, previous traumatic skull injury was verified and a fissure in the frontoethmoidal region, far from the point of direct impact, was detected. The patient underwent transnasal endoscopic surgery, in order to seal the communication on skull basis. The patient did not suffer from meningoencephalitis during the next two years. Conclusion. In the cases with late occurrence of posttraumatic meningoencephalitis with no signs of rhinorrhea, a possibility of an existing communication between intracranial and nasal cavities should be considered, as well. By applying modern diagnostic and therapeutic procedures such communication should be precisely located and sealed.

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