scholarly journals Arthroscopic treatment for posteromedial talar process fracture (Cedell fracture): a case report

2021 ◽  
Vol 15 (3) ◽  
pp. 273-277
Author(s):  
Carla Fernandes Martins ◽  
Patrícia Alexandra Nunes Gomes ◽  
Paulo Jorge Reino dos Santos Felicíssimo
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Ankle Sprain ◽  
Subtalar Joint ◽  
Surgical Techniques ◽  
Ankle Pain ◽  
Level Of Evidence ◽  
Rare Injury ◽  
Fracture Reduction And Fixation ◽  
Good Access

Fracture of the posteromedial talar process (Cedell fracture) is a rare injury and is easily misdiagnosed as a simple ankle sprain. Suspicion should be heightened if specific mechanisms of injury are present, and, in these cases, a CT scan should be performed. Significant ankle pain and disability can result if these injuries are not identified and treated properly. Few cases have been described in the literature, and the efficacy of surgical techniques and approaches for fractures of the posterior talar process remains controversial. We report a 56-year-old man with an acute posteromedial talar fracture treated arthroscopically. This approach provides good access to the posterior ankle compartment, subtalar joint, and extraarticular structures, which may allow fracture reduction and fixation under arthroscopic visualization. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Pseudo Os Trigonum Sign: Missed Posteromedial Talar Facet Fracture

2003 ◽  
Vol 24 (8) ◽  
pp. 642-649 ◽  
Author(s):  
A. Ylenia Giuffrida ◽  
Sheldon S. Lin ◽  
Nicholas Abidi ◽  
Wayne Berberian ◽  
Avril Berkman ◽  
...  
Keyword(s):  
Ct Scan ◽  
Subtalar Joint ◽  
Articular Surface ◽  
Cast Immobilization ◽  
Rare Injury ◽  
Joint Dislocation ◽  
Os Trigonum ◽  
Subtalar Dislocation ◽  
Subtalar Arthritis ◽  
Facet Fracture

Background: Posteromedial talar facet fracture (PMTFF) is a rare injury, sparsely reported in the literature. This article proposes that PMTFF is often left undiagnosed by orthopaedic surgeons and suggests the routine application of advanced radiographic studies (i.e., CT scan) in the recognition of PMTFF. It also evaluates nonoperative management of PMTFF. Methods: After obtaining Institutional Review Board approval, the medical records over a 5-year period (1997–2001) were retrospectively reviewed from the foot and ankle service of a level 1 trauma center, identifying all cases of PMTFF. Charts were reviewed for relevant data. Results of treatment were assessed during follow-up physical examination. Results: Six cases of PMTFF were identified over a 5-year period. All injuries were associated with medial subtalar joint dislocation. Four of six (66%) patients were not initially diagnosed with PMTFF, but instead misdiagnosed as an os trigonum. The remaining two patients had an established diagnosis of PMTFF at the time of initial treatment. All had short leg cast immobilization for medial subtalar dislocation. CT evaluation yielded additional diagnoses in all six patients. All six patients showed a PMTFF. Five patients (83%) revealed persistent subtalar joint subluxation. Five of six (83%) patients required at least one additional procedure as a result of an undiagnosed or nonoperatively treated PMTFF. Four patients underwent subtalar joint fusion, and one patient underwent tibiotalar calcaneal fusion secondary to concomitant ankle/subtalar arthritis. The patient who did not undergo recommended fusion continued to be symptomatic. Conclusions: Diagnosis of PMTFF necessitates a heightened clinical suspicion, especially when a medial subtalar joint dislocation is present. Proper imaging studies, such as coronal CT scan, should be performed after any subtalar dislocation. Timely treatment, in the form of open reduction and internal fixation for large fragments involving the articular surface or surgical excision for smaller fragments, is recommended in order to restore proper anatomy and function of the subtalar joint. This study verifies the significant morbidity associated with an undiagnosed or nonoperatively treated PMTFF.

Chronic Subtalar Instability Due to Insufficiency of the Calcaneofibular Ligament: A Case Report

2002 ◽  
Vol 23 (12) ◽  
pp. 1135-1137 ◽  
Author(s):  
Kazuo Kamada ◽  
Shohei Watanabe ◽  
Haruyasu Yamamoto
Keyword(s):  
Case Report ◽  
Ankle Sprain ◽  
Subtalar Joint ◽  
Clinical Findings ◽  
Calcaneofibular Ligament ◽  
Chronic Instability ◽  
Stress Radiograph ◽  
Subtalar Instability

Calcaneofibular ligament insufficiency in isolation is an uncommon cause of chronic instability of the subtalar joint. We report one case of chronic subtalar instability due to calcaneofibular ligament insufficiency after an ankle sprain. It was diagnosed with clinical findings and stress radiograph, and successfully treated with proximal advancement of the elongated calcaneofibular ligament.

scholarly journals All-On-Four Protocol With Immediate Load on Short Implants in an Atrophic Mandible: A Case Report with a 4-Year Follow-Up

2018 ◽  
Vol 12 (1) ◽  
pp. 1004-1011
Author(s):  
Enéias Carpejani Rosa ◽  
Tuanny Carvalho de Lima Do Nascimento ◽  
Aline Monise Sebastiani ◽  
Rafaela Scariot ◽  
Tatiana Miranda Deliberador ◽  
...  
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Surgical Techniques ◽  
Masticatory Function ◽  
Facial Esthetics ◽  
Short Implants ◽  
Computer Tomography Scan

Purpose: Edentulism has been demonstrated to have negative social and psychological effects on individuals that include adverse impacts on facial and oral esthetics, masticatory function and speech abilities, that when combined, are translated into significant reductions in patients’ quality of lives. It is well-known that immediate placement of implants is a challenging surgical procedure that requires proper treatment planning and surgical techniques. Therefore, the present study describes a 4-year follow-up case report where short implants were placed in an atrophic mandibule and were loaded with the utilization of an all-on-four prosthetic protocol. Case report: A 54 year-old woman dissatisfied with her oral and facial esthetics, masticatory function and speech ability came to the implantology clinic of the Positivo University seeking for oral rehabilitation treatment. After detailed physical and clinical examination, a Computer Tomography scan (CT-scan) was performed to determine the patient’s bone ridge density, dimensions and eligibility for the placement of dental implants. The CT-scan results have indicated the presence of an extremely atrophic mandibular bone ridge. The CT-scan was also used as an aid during the final restoration treatment planning in terms of vertical dimension of occlusion, masticatory function, and stabilization of the lower denture. An all-on-four protocol supported by short implants was then treatment-planned to reduce time, costs and morbidity, and also to achieve superior immediate esthetic results and masticatory function. To reconstruct the patient’s atrophic edentulous mandibule, 4 short implants, including 2 distally tilted, were placed with a final torque of 45 Ncm. Results: Following the development and implementation of a complex treatment plan, the patient displayed stable soft and hard tissues at 4-year postoperative follow-up assessment, demonstrating the effectiveness of the all-on-four technique supported by short implants. Conclusion: Within the limits of this study, the present case report demonstrated that the all-on-four prosthetic protocol with immediate loading on short implant was effective in an atrophic mandible over a 4-year follow-up.

scholarly journals Pediatric Posterior Cruciate Ligament Avulsion Fracture of the Tibial Insertion: Case Report and Review of the Literature

2017 ◽  
Vol 03 (03) ◽  
pp. e134-e138 ◽  
Author(s):  
Yannick Hurni ◽  
Vincenzo De Rosa ◽  
Jorge Gonzalez ◽  
Mario Mendoza-Sagaon ◽  
Flurim Hamitaga ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Cruciate Ligament ◽  
Avulsion Fracture ◽  
Pediatric Population ◽  
Cruciate Ligament ◽  
Correct Diagnosis ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Rare Injury ◽  
Tibial Insertion

Background Posterior cruciate ligament (PCL) avulsion fracture of the tibial insertion is a very rare injury in children. In addition to performing an attentive clinical examination, radiologic studies are fundamental for its correct diagnosis and treatment. Its management may be either conservative or operative. So far, only a few cases treated conservatively have been reported in the pediatric population, with controversial results. Methods We prospectively collected and reviewed clinical and radiographic data of an 11-year-old boy with avulsion fracture of the tibial insertion of the PCL. In addition, we performed a systematic review of the literature available to date. Results We decided to treat the avulsion fracture in a conservative way. The patient has been followed with accurate clinical and radiological follow-up controls until complete recovery. Conclusion Posterior cruciate avulsion fracture is a very rare finding in children, and no definitive indications for its appropriate management exist. With this report, we demonstrate that these fractures can be treated conservatively in selected cases with good results, avoiding potential surgical-related complications. Study Design This is a case report (level of evidence V).

Cricoid Chondronecrosis: Case Report and Review of Literature

2020 ◽  
Vol 129 (7) ◽  
pp. 662-668
Author(s):  
Mark M. Mims ◽  
Andree A. Leclerc ◽  
Libby J. Smith
Keyword(s):  
Case Report ◽  
Endotracheal Intubation ◽  
Surgical Techniques ◽  
Upper Airway ◽  
Signs And Symptoms ◽  
Rare Entity ◽  
Level Of Evidence ◽  
Radiologic Findings ◽  
Short Period ◽  
History Of

Objective: Cricoid chondronecrosis is a rare entity that has significant consequences for patients. Reports of its occurrence are scattered in the literature and currently there is no comprehensive review to help guide providers. Methods: A case report from our institution is presented. A review of available literature is then provided with assessment of risk factors, signs and symptoms at presentation, laryngeal exam findings, radiologic findings, and surgical techniques. Results: Twenty-four cases of cricoid chondronecrosis were reviewed from the literature. Patient age ranged from 8 months to 76 years. A history of endotracheal intubation for various reasons was present in all but two cases, and duration of intubation ranged from 6 hours to 28 days. Patients presented with airway compromise in all but two cases—one asymptomatic patient with prior tracheostomy and another with dysphagia after radiation. Dysphonia (n = 6) and dysphagia (n = 3) were less commonly present. Subglottic stenosis (n = 19) was the most common exam finding followed by vocal fold impairment (n = 11). When CT scan findings were reported, fragmentation of the cartilage and/or hypodensity of the central lamina were described in all but one case. Interventions ranged from observation on antibiotics and steroids to surgical therapies including tracheostomy, dilation, and posterior cricoid split, with or without stent placement. Conclusions: Cricoid chondronecrosis is a serious, rare entity that can occur even after a short period of endotracheal intubation. Providers must have a high level of suspicion in patients that present with upper airway dyspnea with a history of prior intubation. Level of evidence: Level 4

Arthroscopic Subtalar Joint Arthrodesis: Topical Review

2021 ◽  
pp. 107110072110353
Author(s):  
Hesham Oshba ◽  
Raghda Hasan AboBakr Shaaban ◽  
Islam Abdelrahman ◽  
Nikolaos Gougoulias
Keyword(s):  
Subtalar Joint ◽  
Surgical Techniques ◽  
Case Series ◽  
Deformity Correction ◽  
Weighted Average ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Perioperative Morbidity ◽  
Improved Outcomes ◽  
Accelerated Rehabilitation

Background: Advances in foot and ankle arthroscopy over the last 2 decades have allowed for subtalar joint arthrodesis to be performed arthroscopically. The potential advantages of the arthroscopic technique include higher fusion rates, lower complications, reduced perioperative morbidity, and accelerated rehabilitation. Arthroscopic arthrodesis may, however, not be appropriate in the setting of complex deformity correction or the need for other open procedures. Methods: Surgical techniques of arthroscopic subtalar joint arthrodesis are described. Outcomes and complications associated with these procedures are presented, based on a comprehensive literature review. Thirteen Level IV studies of moderate quality were included. Results and Conclusion: Excellent arthrodesis union rates were achieved (average 96%, range 86%-100%), at a weighted average union time of 8.8 weeks (95% confidence interval 7.9-9.7). The overall complication rate was 21% (87/415 feet; range 10%-36.4%). Metal irritation was the most common complication (11.2%), followed by nerve injury (4.2%) and infection (0.9%). Similar fusion rates have been reported when comparing arthroscopic and open arthrodesis. Complication rates are also similar, excerpt for infection, which may be lower with arthroscopy. Three different approaches were used to access the subtalar joint with similar union and complication rates. There was no evidence that the use of bone graft or more than 1 screw improved outcomes. The superiority of arthroscopic subtalar fusion over open techniques cannot be demonstrated by the available studies. Level of Evidence: Level IV, case series.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

Multiple Cerebral Aneurysm - Case Report

2014 ◽  
Vol 21 (3) ◽  
pp. 279-282 ◽  
Author(s):  
C. Kakucs ◽  
I. St. Florian
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Scan ◽  
Cerebral Aneurysm ◽  
Internal Carotid ◽  
Neurological Status ◽  
Posterior Communicating Artery ◽  
Nuchal Rigidity ◽  
Angio Ct

Abstract This 41-years-old female presented with somnolence, confusion and nuchal rigidity. Preoperative angio-CT scan showed two aneurysm located on both internal carotid artery (ICA) at the site of posterior communicating artery (PComA). During surgery we discovered another dilatation on the origin of left ophtalmic artery that proves to be an infundibullum. We clipped the two communicating posterior aneurysm from the left side and the ophtalmic infundibullum was wrapped. Seven days after surgery the neurological status was improved and she was transferred to the Neurological department.

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