scholarly journals Total Talar Replacement with Ceramic Implant in Combination with Tibial Component of Ankle Endoprosthesis: A Case Report

2021 ◽  
Vol 27 (4) ◽  
pp. 111-119
Author(s):  
Vasilii V. Kuznetsov ◽  
Sergei M. Gudi ◽  
Liliya K. Skuratova ◽  
Igor A. Pakhomov

Background. Surgical treatment of patients with talus posttraumatic aseptic necrosis and its consequences usually includes tibiotalocalcaneal arthrodesis with various foot joints according to additional indications. This type of surgical treatment has number of significant disadvantages: traumatic surgical technique, permanent loss of movement in functionally significant joints, high risk of non-union, high frequency of residual deformities, the need for long periods of limb immobilization. The question arises: how to overcome the existing disadvantages and improve the results of talus posttraumatic aseptic necrosis treatment? A potential solution to this problem is the total talus endoprosthetics. Clinical case. A 64-year-old patient came to the clinic complaining of pain and deformity of the right foot and ankle area. After the examination, talus posttraumatic aseptic necrosis was diagnosed. The patient underwent ankle joint arthroplasty using total talus ceramic endoprosthesis in combination with the tibial component of the ankle joint endoprosthesis, a course of rehabilitation treatment was performed. Results. The VAS and AOFAS scales indicators showed a significant improvement both in the pain decrease (from 75 mm before surgery to 10 mm after), and in the functional state according to AOFAS by 2.2 times (from 36 to 80 points 20 months after surgery). By the last follow-up the patient could take more than 8000 steps a day. Conclusion. Considering the good clinical result achieved, the ankle joint arthroplasty using total talus ceramic endoprosthesis in combination with the tibial component of the ankle joint endoprosthesis can be considered a promising method of treatment of this severe pathology.

Author(s):  
A. I. Snetkov ◽  
G. N. Berchenko ◽  
A. R. Frantov ◽  
S. Yu. Batrakov ◽  
R. S. Kotlyarov ◽  
...  

Case report for the 18 years old female patient with a giant cell tumor of the distal articular end of the right tibia is presented. The surgical intervention included segmental resection of the articular end of the right tibia and substitution of the defect with the custom-made ankle endoprosthesis. The follow up period made up 4 years. The range of motion in the right ankle joint was satisfactory, no relapse occurred and the implant components were stable. 


2017 ◽  
Vol 24 (4) ◽  
pp. 56-61
Author(s):  
A. I Snetkov ◽  
G. N Berchenko ◽  
Anton R. Frantov ◽  
S. Yu Batrakov ◽  
R. S Kotlyarov ◽  
...  

Case report for the 18 years old female patient with a giant cell tumor of the distal articular end of the right tibia is presented. The surgical intervention included segmental resection of the articular end of the right tibia and substitution of the defect with the custom-made ankle endoprosthesis. The follow up period made up 4 years. The range of motion in the right ankle joint was satisfactory, no relapse occurred and the implant components were stable.


2013 ◽  
Vol 127 (6) ◽  
pp. 614-618 ◽  
Author(s):  
Y W Kim ◽  
M-J Baek ◽  
K H Jung ◽  
S K Park

AbstractObjective:We report two extremely rare cases of symptomatic nasopharyngeal branchial cleft cyst treated by powered instrument assisted marsupialisation.Methods:Case report and literature review concerning nasopharyngeal branchial cleft cyst and surgical treatment methods.Results:The first case was a two-year-old boy with a 1 × 2 cm, cystic, oropharyngeal mass, who also had severe snoring and sleep apnoea. The second case was a 56-year-old man with right nasal obstruction and a sensation of fullness in the right ear. In both cases, we performed endoscopic marsupialisation using a powered instrument. There was no recurrence in either case over two years of follow up.Conclusion:Powered instrument marsupialisation is a simple, effective and less invasive technique for the treatment of nasopharyngeal branchial cleft cyst.


2021 ◽  
Vol 25 (1) ◽  
pp. 61-67
Author(s):  
M. N. Sukhov ◽  
A. G. Narbutov ◽  
I. P. Lyvina ◽  
I. A. Bryzzheva ◽  
M. V. Isaeva ◽  
...  

Introduction. Neuroblastoma is the most common malignant embryonic extracranial solid tumor in childhood having a high mortality rate. While treating neuroblastoma, it is extremely important to follow international protocols with their staging systems and groups of risk. Surgical treatment is a compulsory approach, but in some cases it is extremely difficult, and it involves significant risks. However, in some cases, radical removal of the tumor can cure patients without chemotherapy.Material and methods. The article presents a clinical case of 14-month-old child with neuroblastoma of stage 3 and difficult anatomical location after 2 courses of polychemotherapy by NB-2004 protocol. The child had subradical resection of an extensive tumor in the retroperitoneal space and nephrectomy on the right. The authors also describe specific moments during surgery, problems which their faced during child’s treatment as well as follow-up examinations in the postoperative period.Results. Follow-up examinations did not reveal any signs of disease recurrence. Catamnesis lasted for 56 months. The child is in a good state; she is active, attends a nursery school.Conclusion. The discussed case demonstrates that a successful radical surgical removal of neuroblastoma of difficult anatomic location may have good outcomes without adjuvant postoperative therapy.


2007 ◽  
Vol 135 (7-8) ◽  
pp. 401-406
Author(s):  
Aleksandar Mikic ◽  
Biljana Obrenovic-Kircanski ◽  
Mladen Kocica ◽  
Mile Vranes ◽  
Vesna Lackovic ◽  
...  

Introduction Cardiac myxomas are the most frequent primary tumors of the heart in adults, and they can be found in each of four cardiac chambers. Although biologically benign, due to their unfavorable localization, myxomas are considered "functionally malignant" tumors. Diagnosis of cardiac myxoma necessitates surgical treatment. Objective To analyze: 1) the influence of localization, size and consistency of cardiac myxomas on preoperative symptomatology; 2) the influence of different surgical techniques (left, right, biatrial approach, tumor basis solving) on early, and late outcomes. Method From 1982 to 2000, at the Institute for Cardiovascular Diseases, Clinical Center of Serbia, there were 46 patients with cardiac myxomas operated on, 67.4% of them women, mean age 47.1?16.3 years. The diagnosis was made according to clinical presentation, electrocardiographic and echocardiographic examinations and cardiac catheterization. Follow-up period was 4-18 (mean 7.8) years. Results In 41 (89.1%) patients, myxoma was localized in the left, while in 5 (10.9%), it was found in the right atrium. Average size was 5.8?3.8 cm (range: 1?1 cm to 9?8 cm) and 6?4 cm (range: 3?2 cm to 9?5 cm) for the left and right atrial myxomas, respectively. A racemous form predominated in the left (82.6%) and globous in the right (80%) atrium. Fatigue was the most common general (84.8%) and dyspnoea the most common cardiologic symptom (73.9%). Preoperative embolic events were present in 8 patients (4 pulmonary, 4 systemic). In our series: 1) different localization, size and consistency had no influence on the preoperative symptomatology; 2) surgical treatment applied, regardless of different approaches and basis solving, resulted in excellent functional improvements (63.1% patients in NYHA III and IV class preoperatively vs. 6.7% patients postoperatively) and had no influence on new postoperative rhythm disturbances (8.7% patients preoperatively vs. 24.4% patients postoperatively); 3) early (97.8%), and late survival rates (91.3%) were excellent; 4) there were no relapses during the follow-up period. Conclusion Localization, size and consistency had no influence on the preoperative symptomatology. Excellent survival rate with significant functional improvement, rare postoperative complications and no recurrences, justify the applied strategies of surgical approach and tumor basis solving in our series.


2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Tatiana Tarules Azzi ◽  
Leandro Cabral Zacharias ◽  
Sérgio Luis Gianotti Pimentel

The Shaken Baby Syndrome (SBS) is characterized by subdural hematomas (SH), retinal hemorrhages (RH), and multiple fractures of long bones without external evidence of head trauma. Subinternal limiting membrane (ILM) hemorrhage, also known as macular schisis, is a characteristic finding of this entity. There is no guideline on the right time to indicate surgical treatment. This report describes an abused child with massive sub-ILM hemorrhage, which showed spontaneous absorption after less than two months of follow-up. Due to the possible spontaneous resolution, we suggest an initial conservative treatment in cases of sub-ILM hemorrhage related to SBS.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sanjay Kumar Saroj ◽  
Satendra Kumar ◽  
Yusuf Afaque ◽  
Abhishek Kumar Bhartia ◽  
Vishnu Kumar Bhartia

Background, Aims, and Objectives. Congenital diaphragmatic hernia typically presents in childhood but in adults is extremely rare entity. Surgery is indicated for symptomatic and asymptomatic patients who are fit for surgery. It can be done by laparotomy, thoracotomy, thoracoscopy, or laparoscopy. With the advent of minimal access techniques, the open surgical repair for this hernia has decreased and results are comparable with early recovery and less hospital stay. The aim of this study is to establish that laparoscopic repair of congenital diaphragmatic hernia is a safe and effective modality of surgical treatment.Materials and Methods.A retrospective study of laparoscopic diaphragmatic hernia repair done during May 2011 to Oct 2014. Totaln=13(M/F: 11/2) cases of confirmed diaphragmatic hernia on CT scan, 4 cases Bochdalek hernia (BH), 8 cases of left eventration of the diaphragm (ED), and one case of right-sided eventration of the diaphragm (ED) were included in the study. Largest defect found on the left side was 15 × 6 cm and on the right side it was 15 × 8 cm. Stomach, small intestine, transverse colon, and omentum were contents in the hernial sac. The contents were reduced with harmonic scalpel and thin sacs were usually excised. The eventration was plicated and hernial orifices were repaired with interrupted horizontal mattress sutures buttressed by Teflon pieces. A composite mesh was fixed with nonabsorbable tackers. All patients had good postoperative recovery and went home early with normal follow-up and were followed up for 2 years.Conclusion.The laparoscopic repair is a safe and effective modality of surgical treatment for congenital diaphragmatic hernia in experienced hands.


Author(s):  
Yong-Cheol Hong ◽  
Ki-Jin Jung ◽  
Hee-Jun Chang ◽  
Eui-Dong Yeo ◽  
Hong-Seop Lee ◽  
...  

Septic ankle arthritis is a devastating clinical entity with high risks of morbidity and mortality. Prompt treatment is necessary because delayed or inadequate treatment can lead to irreversible damage that may occur on the articular surface, resulting in cartilage erosion, infective synovitis, osteomyelitis, joint deformity, and pain and joint dysfunction. An aggressive surgical approach is required when a joint infection causes severe limb-threatening arthritis. A 58-year-old woman visited our clinic with increasing pain in the right ankle, which had been present for the previous 2 months. She complained of discomfort in daily life due to deformity of the ankle; limping; and severe pain in the ankle even after walking a little. The patient reported a history of right-ankle injury while exiting a bus in her early 20s. Plain radiographs of the right ankle joint revealed that the medial malleolus was nearly absent in the right ankle joint on the anteroposterior view, and severe varus deformity was observed with osteoarthritic changes because of joint space destruction. Magnetic resonance imaging revealed diffuse synovial thickening of the destroyed tibiotalar joint with joint effusion. Hybrid 99mTc white blood cell single-photon emission computed tomography/computed tomography showed increased uptake along the soft tissue around the ankle joint; uptake was generally low in the talocrural and subtalar joints. A two-stage operation was performed to remove the infected lesions and correct the deformity, thus enabling limb salvage. The patient was nearly asymptomatic at the 6-month follow-up, with no discomfort in her daily life and nearly normal ability to carry out full functional activities. She had no complications or recurrent symptoms at the 1-year follow-up. We have described a rare case of a staged limb salvage procedure in a patient with chronic septic arthritis sequelae. For patients with severe joint deformity because of septic ankle sequelae, staged arthrodesis is a reliable method to remove infected lesions, solve soft tissue problems, correct deformities, and maintain leg length.


2020 ◽  
Author(s):  
linyuan zhang ◽  
zhiqing liu ◽  
yueting wang ◽  
chao yu ◽  
jian tang ◽  
...  

Abstract Background: Posterior pilon fracture (PPF) is a serious ankle injury caused by combined vertical and rotational trauma. Surgical treatment includes buttress plate (BP), anteroposterior screw (APS) and posteroanterior screw (PAS) fixation. This study aimed to compare the therapeutic effects after PPF internal fixation with BPs and APSs. Methods: From January 2015 to June 2018, 37 patients with PPFs underwent surgical treatment in our institution. The patients were divided into the BP (11 patients) and APS (26 patients) groups according to the internal fixation method. Bone healing time and postoperative complications were recorded. At the last follow-up, American Orthopedic Foot and Ankle Society (AOFAS) scores, visual analog scale (VAS) scores and Burwell-Charnley scores were used to evaluate ankle joint function, ankle joint pain, and fracture reduction on imaging, respectively. Results: No significant difference in bone healing time was found between the two groups (P > 0.05). Local necrosis of the posterolateral incision and chronic ankle pain occurred in 1 case each in the BP group. Chronic ankle joint pain occurred in 4 cases in the APS group. Two cases of soft tissue irritation were caused by screws that were too long. Local numbness of the posterolateral incision occurred in 1 case. At the last follow-up, no significant difference in VAS scores between the two groups at rest (P = 0.477), but a significant difference during exercise was noted (P = 0.033). AOFAS scores were better in the BP group than those in the APS group (P = 0.002). According to the Burwell-Charnley scoring system, 11 cases were anatomically reduced in the BP group. In the APS group, anatomical reduction was achieved in 19 cases and fair in 7 cases. Conclusion: Compared with APSs, BPs resulted in better reduction, ankle joint functional recovery and complication rates. BPs are recommended for internal fixation of PPFs.


2020 ◽  
Vol 19 (2) ◽  
pp. 90-96
Author(s):  
Sushil Rana Magar ◽  
Pankaj Chand ◽  
Bishnu Babu Thapa ◽  
Ritesh Sinha ◽  
Rajesh Pratap Shah ◽  
...  

Introduction: Stress fracture of neck of femur is known to occur in athletes and soldiers. From treatment perspective, this is still an unsolved fracture. The purpose of this study is to critically analyse the functional outcome of surgical treatment of stress fracture of neck of femur in military recruits performed by the same surgical team. Methods: This is a retrospective study of surgically treated femoral neck stress fracture from 1st December 2012 to 1st December 2013. All fractures were fixed with three 6.5 mm cancellous lag screws with washers. For failure of primary fixation or non-union, osteosynthesis with fibular strut graft was performed. Patients were evaluated at six weeks, 12 weeks, six months, 12 months and then yearly for three years. Functional outcome was evaluated by using Harris Hip Score at six months and at final follow-up. The outcome was followed up for six years up to Dec 2019. Results: There were eight males and one female patient. Mean age of patient was 20.7 years (Range, 19-23 years). Average follow-up period was 67.6 months (range 6-81). Lag screw fixation was done in five cases after closed reduction and in four cases after open reduction. Osteosynthesis with fibular graft was done in two cases. In six cases, fracture united at a mean duration of 9.8 months (Range 6-20). In three cases there was non-union of the fracture with added  infection in one case. Avascular necrosis of femoral head developed in two cases. Conclusions: Successful surgical treatment of stress fracture of neck of femur requires anatomical reduction and stable interfragmentary compression with lag screws.


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