scholarly journals Intraosseous uric acid tumor without joint involvement: case report

2021 ◽  
Vol 15 (2) ◽  
pp. 167-170
Author(s):  
Elcio Valloto Junior ◽  
Valter Penna ◽  
Vinícius Medina Guimarães ◽  
Vinícius Dino Pozzebon ◽  
Mariana Oliveira de Araújo
Keyword(s):  
Unusual Case ◽  
Bone Cyst ◽  
Postoperative Outcome ◽  
Joint Involvement ◽  
Medial Malleolus ◽  
Level Of Evidence ◽  
Previous Diagnosis ◽  
Gouty Tophus ◽  
Therapeutic Study ◽  
Histopathologic Findings

We report an unusual case of extra-articular gouty tophus in the left medial malleolus. A 33-year-old man with a previous diagnosis of chronic gout presented with mild, non-disabling ankle pain associated with gout attacks. Imaging and histopathologic findings were inconclusive. The tumor was surgically resected, and the cavity was filled with methyl methacrylate. Histopathology confirmed the diagnosis in a sample collected intraoperatively. Giant cell tumor and bone cyst were ruled out. The patient had a good postoperative outcome. Level of Evidence V; Therapeutic Study; Expert Opinion.

Range of Motion after the Sauvé–Kapandji and Darrach Procedures without Extensor Tendon Rupture

2020 ◽  
Author(s):  
Tomoyuki Kato ◽  
Taku Suzuki ◽  
Makoto Kameyama ◽  
Masato Okazaki ◽  
Yasushi Morisawa ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
The Mean ◽  
Therapeutic Study ◽  
Loss Of Motion

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.

Preliminary Report of Arthroscopically Assisted Sauvé–Kapandji Procedure for Distal Radioulnar Joint Arthritis

2021 ◽  
Author(s):  
Yukio Abe ◽  
Youhei Takahashi ◽  
Kenzo Fujii
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Kirschner Wire ◽  
Distal Radioulnar Joint ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Advantages And Disadvantages ◽  
Arthroscopically Assisted ◽  
Therapeutic Study

Abstract Background The arthroscopically assisted Sauvé–Kapandji (S-K) procedure has been described as a safe and promising technique for distal radioulnar joint (DRUJ) arthrodesis. Our purpose was to investigate the advantages and disadvantages of the arthroscopically assisted S-K procedure. Methods Eight patients underwent an arthroscopically assisted S-K procedure. All patients were diagnosed as DRUJ osteoarthritis (OA), including six primary DRUJ OA, one OA following a distal radius fracture, and one rheumatoid arthritis (RA). Arthroscopy was performed in neutral forearm rotation with vertical traction. The surface of the DRUJ was debrided through arthroscopy to expose the subchondral surface, and the DRUJ was fixed with a cannulated screw and Kirschner wire (K-wire) with zero or minus ulnar variance in the same posture. Bone graft was not performed. Results Bone union was achieved at 2 to 3.5 months postoperatively. At an average of 17-month follow-up, the pain intensity on 10-point numerical rating scale (NRS) decreased from 10 preoperatively to 0.4 postoperatively, average range of pronation significantly improved from 77 degrees to 89 degrees, and average grip strength as a percentage of contralateral side improved from 76 to 104%. Conclusion Satisfactory outcomes were achieved with the arthroscopically assisted S-K procedure. Advantages of this procedure included the ability to achieve union without bone grafting, preservation of the extensor mechanism integrity, and easy reduction of the ulnar head due to its wrist positioning. No major complications were encountered. Disadvantages included its required use of arthroscopic technique and potential contraindication for cases with severe deformity at the sigmoid notch. Level of Evidence This is a Level IV, therapeutic study.

scholarly journals Gouty tophus: Unusual case of nasal lump

2021 ◽  
Vol 16 (10) ◽  
pp. 2904-2907
Author(s):  
Wai Hung Lester Shiu ◽  
Hei Man Joyce Cheng ◽  
Yuet Tin Chan ◽  
Chi Yeung Chu ◽  
Wai Kuen Kan
Keyword(s):  
Unusual Case ◽  
Gouty Tophus

scholarly journals Hyaluronic acid injections in post-enucleation or evisceration socket syndrome: a case series

2021 ◽  
Author(s):  
Renata Migliardi ◽  
Alessandra Modugno ◽  
Fabrizio Chirico ◽  
Nicola Zerbinati ◽  
Giovanni Francesco Nicoletti ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Case Series ◽  
Outpatient Setting ◽  
Level Of Evidence ◽  
Upper Eyelid ◽  
Filler Injection ◽  
Tear Trough Deformity ◽  
Vasovagal Response ◽  
Superior Sulcus ◽  
Therapeutic Study

Abstract Background One of the primary goals of enucleation and evisceration surgery is the restoration of an adequate orbital volume through the use of appropriately sized alloplastic or autogenous tissues. In patients inadequately treated, post-enucleation or evisceration socket syndrome occurs. Fillers are an ideal alternative for eyelid and eyebrow arcade volume enhancement since their injection is easily performed in an outpatient setting avoiding several complications. The aim of this study is to report the use of hyaluronic acid (HA) fillers to treat volume deficits of the upper and lower eyelids, projecting the brow arcade and reducing the asymmetry. Methods Thirteen patients (2 male, 11 female, mean age 32.7 years) were treated from June 2012 to May 2020. Non-surgical treatment by HA filler injection for aesthetic rehabilitation of deep superior sulcus, inferior tear trough deformity, and scleral show was performed. Results No complications as orbital-ache and/or vasovagal response were reported during the injections. Minor complications such as light swelling at the site of injection, self-resolved within 2 days, were recorded. Stable results were observed at follow-ups. In two cases, two successive treatments were required at 3 and 6 years from the first injection. Conclusions Hyaluronic acid fillers offer a versatile and safe method for replacing soft tissue lost from the upper eyelid/brow complex in cases of post-enucleation or evisceration socket syndrome. Level of evidence: Level IV, therapeutic study.

scholarly journals Breast softness in patients randomised to postmastectomy breast reconstruction with an expander prosthesis or DIEP flap

2021 ◽  
Author(s):  
Linda Tallroth ◽  
Håkan Brorson ◽  
Nathalie Mobargha ◽  
Patrik Velander ◽  
Stina Klasson ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Subjective Evaluation ◽  
Objective Evaluation ◽  
Applanation Tonometry ◽  
Diep Flap ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Delayed Breast Reconstruction ◽  
Level I ◽  
Therapeutic Study

Abstract Background Objectively measured breast softness in reconstructed breasts and its relation to patients’ subjective satisfaction with breast softness has not yet been investigated. The aim of this study was to evaluate breast softness in patients 1 year following delayed breast reconstruction with an expander prosthesis (EP) or deep inferior epigastric perforator (DIEP) flap, using objective and subjective methods. Methods Seventy-three patients were randomised to breast reconstruction with an EP or DIEP flap between 2012 and 2018. Of these, 69 completed objective evaluation at a mean of 25 (standard deviation, SD 9.4) months following breast reconstruction. Objective evaluation included measurements of breast volume, jugulum-nipple distance, clavicular-submammary fold distance, ptosis and Baker scale grading. Breast softness was assessed with applanation tonometry. Subjective evaluation was performed using the BREAST-Q questionnaire. Results Objectively, DIEP flaps were significantly softer than EP breast reconstructions. Non-operated contralateral breasts were significantly softer compared with reconstructed breasts. In the subjective evaluation, the median score on the question (labelled 1.h) “How satisfied or dissatisfied have you been with the softness of your reconstructed breast (s)?” was higher in the DIEP flap group corresponding to greater satisfaction in this group. A fair correlation was found between the applanation tonometry and the patient-reported satisfaction with the reconstructed breast’s softness (rs = 0.37). Conclusions In terms of breast softness, breast reconstructions with DIEP flaps result in more satisfied patients. Concerning applanation tonometry as an objective tool for softness assessment, future studies on interobserver agreement are warranted. Level of evidence: Level I, therapeutic study

scholarly journals BEHAVIOR OF CORTISOL, CK AND LACTATE IN A SESSION OF VARIABLE RESISTANCE

2018 ◽  
Vol 24 (4) ◽  
pp. 268-272 ◽  
Author(s):  
Álvaro Huerta Ojeda ◽  
Luis Chirosa Ríos ◽  
Rafael Guisado Barrilao ◽  
Ximena Huerta Ojeda
Keyword(s):  
Creatine Kinase ◽  
Serum Cortisol ◽  
Repeated Measure ◽  
Level Of Evidence ◽  
Muscular Injury ◽  
Creatine Kinase Mb ◽  
Quasi Experimental ◽  
Complex Training ◽  
Therapeutic Study ◽  
Post Stress

ABSTRACT Introduction: Complex Training (CT) has been used to achieve Post-activation Potentiation (PAP) of physical capabilities and, in doing so, improve the sports performance of athletes. However, few studies have considered alterations in serum Cortisol, Metabolic Creatine Kinase (MB-CK), Total Creatine Kinase (Total-CK), and Lactate concentrations ([La]) resulting from this training method. Objective: This study determined the behavior of the following blood serum substances in a CT session: Cortisol, MB-CK, Total CK and [La]. Method: Ten military athlete volunteers aged 28.5 ± 4.8 years; 66.2 ± 2.8 kg, 171.4 ± 3.7 cm, 22.6 ± 1.2 kg/m2; 11.3 ± 2.9% of fat tissue took part in the study. The study had a quasi-experimental, intrasubject design. The variable measurements were: Cortisol, MB-CK, Total-CK, and [La], measured before physical exercise and 24 hours post-stress. The CT session consisted of: four series of five repetitions at 30% of 1RM, plus four repetitions at 60% of 1RM, plus three throws of a 575 g projectile, 15 seconds apart. The statistical analysis was carried out through repeated measure ANOVA for Lactate and a Wilcoxon Matched Pairs t-Test for Cortisol, MB-CK and Total-CK. Results: There was no evidence of alterations in the indicators for fatigue ([La] p = 0.36), and muscular injury (Cortisol p = 0.16; MB-CK p = 0.23; Total-CK p = 0.64) after the training sessions. Conclusion: Variables for muscular injury showed no evidence of alterations 24 hours after the CT sessions, hence confirming that the workload did not generate significant post-stress muscular injury. Level of Evidence I; Therapeutic Study: Investigating Treatment Results.

scholarly journals Posterior malleolar fractures. New classification and treatment algorithm

2020 ◽  
Vol 14 (3) ◽  
pp. 254-259
Author(s):  
Diego Yearson ◽  
Ignacio Melendez ◽  
Federico Anain ◽  
Santiago Siniscalchi ◽  
Juan Drago
Keyword(s):  
Posterior Approach ◽  
Treatment Algorithm ◽  
Case Series ◽  
Fracture Pattern ◽  
Joint Surface ◽  
Medial Malleolus ◽  
New Classification ◽  
Level Of Evidence ◽  
Malleolar Fractures ◽  
Posterior Malleolus

Objective: This study proposes a new classification of posterolateral malleolar fractures and a treatment algorithm. Methods: We divided the posterolateral malleolus, which we considered as the posterior malleolus, from the posteromedial one, which we considered as being part of the medial malleolus fracture. The experience with 77 patients treated from February 2017 to February 2020 was assessed. All of them were assessed by frontal and profile radiographies and computed tomography (CT). Among the parameters to classify these fractures, we believe the most determining ones are fracture size, followed by presence of fracture displacement. Results: Fractures were divided into those whose posterior fragment was 25% smaller than the tibial joint surface and those that compromised more than 25% of this joint. The first group underwent syndesmotic opening and was subclassified into 1A (stable fractures), which do not require surgical treatment, and 1B (unstable), which require syndesmotic stabilization. The second group, which comprised the larger fractures, was subclassified into 2 A (non-displaced fractures, or with a displacement below 2 mm), which underwent percutaneous osteosynthesis, 2B (displaced fractures), and 2C (comminuted fractures), which underwent open reduction and internal fixation using a posterior approach. Conclusion: The classifications published so far are anatomic or descriptive, but none of them proposes a therapeutic algorithm for each type of fracture. We believe it will be helpful for its interpretation and decision-making on the need to perform a posterior approach, prioritizing the anatomical reduction of the joint fragment and resolution of syndesmotic instability linked to each fracture pattern using the most simple and effective method. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals ASSESSING PSYCHOSOCIAL DISTRESS IN BONE METASTASES TREATED WITH ENDOPROSTHESIS

2019 ◽  
Vol 27 (5) ◽  
pp. 257-260
Author(s):  
Lucas Santiago ◽  
Pedro Reggiani Anzuatégui ◽  
José Paulo Agner Ribeiro ◽  
Maurício Carrilho Filon ◽  
Glauco José Pauka Mello ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Psychosocial Distress ◽  
Distress Thermometer ◽  
Preoperative Period ◽  
Level Of Evidence ◽  
Psychosocial Screening ◽  
Early Improvement ◽  
Therapeutic Study ◽  
Cancer Network

ABSTRACT Objective: To compare preoperative and early postoperative levels of psychosocial distress in patients undergoing bone metastasis treatment with endoprosthesis, evaluating its impact on quality of life. Methods: Thirteen patients undergoing endoprosthetic treatment of bone metastasis were assessed at two time points: preoperatively and 30 days postoperatively. The tool used was the Distress Thermometer, a questionnaire for psychosocial screening developed by the National Comprehensive Cancer Network. Distress is considered moderate or severe if the patient scores 4 or higher. Results: The most frequent problems in the preoperative period were “bathing and dressing”. At 30 days, “fatigue” and “nervousness” prevailed. There was a significant improvement in distress when preoperative and 30-day assessments were compared. Conclusion: The surgical treatment of bone metastasis with endoprosthesis results in an early improvement of psychosocial distress as measured by the Distress Thermometer. Level of evidence II, Prospective and comparative therapeutic study.

scholarly journals An Unusual Case of Aneurysmal Bone Cyst Involving Both Middle and Posterior Fossa Skull Base

2016 ◽  
Vol 05 (02) ◽  
pp. 114-116
Author(s):  
Hrushikesh Kharosekar ◽  
Vernon Velho ◽  
Shonali Valsangkar
Keyword(s):  
Skull Base ◽  
Posterior Fossa ◽  
Aneurysmal Bone Cyst ◽  
Unusual Case ◽  
Bone Cyst

Single- vs 2-Screw Lag Fixation of the Medial Malleolus in Unstable Ankle Fractures

2019 ◽  
Vol 40 (7) ◽  
pp. 790-796 ◽  
Author(s):  
Jessica Mandel ◽  
Omar Behery ◽  
Rajkishen Narayanan ◽  
Sanjit R. Konda ◽  
Kenneth A. Egol
Keyword(s):  
Ankle Fracture ◽  
Fragment Size ◽  
Smoking Status ◽  
Medial Malleolus ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Initial Injury ◽  
American Society ◽  
Fixation Points ◽  
American Society Of Anesthesiologists

Background: The purpose of this study was to determine the efficacy of medial malleolar fixation with 1 vs 2 screws. Methods: Between April 2013 and February 2017, 196 patients who presented at 2 hospitals within one academic institution with an unstable rotational ankle fracture with a medial fracture and were treated operatively by a trained orthopedic surgeon were identified. These patients’ charts were reviewed and their injury, radiographic, surgical, and follow-up data recorded. Medial malleolus fragment size was assessed on the anteroposterior (AP) and lateral views of the initial injury radiograph. Functional outcome was assessed using Maryland Foot Score (MFS). Patients were grouped based upon the number of screws utilized to fox the medial malleolar fragment. Data were assessed using Fisher exact tests and independent t tests with SPSS, version 23. Results: Out of the 196 patients who met inclusion criteria, 47 patients (24%) were fixed with 1 medial malleolar screw and 149 patients (76%) were fixed with 2 screws. There were no differences among patients who received 1 vs 2 screws with regard to age, gender, body mass index, American Society of Anesthesiologists grade, or smoking status. The average malleolar fragment size was smaller in those treated with 1 screw on both the AP and lateral radiographic views than those with 2 screws ( P = .009, P = .001, respectively). There was no difference between groups in ankle dorsiflexion or plantarflexion at 1 year postoperation ( P = .451, P = .581). Patients who received 1 screw did not differ from those who received 2 screws with respect to Maryland Foot Scores ( P = .924). There was no difference in rate of revision surgery or need for hardware removal between groups ( P = .093). Furthermore, time to healing and postoperative complication rate did not differ between groups. Conclusion: The use of a single screw for medial malleolar fixation provided stable fixation to allow ankle fracture healing, without an increase in complications. This information is especially important in situations when the fragment is too small to accommodate multiple fixation points. Level of Evidence: Level III, retrospective case-control study.

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