scholarly journals Bilateral fracture-dislocation of the calcaneus

2018 ◽  
Vol 12 (2) ◽  
pp. 164-169
Author(s):  
Mahmoud Beerens Abdul Ghani ◽  
Rui Dos Santos Barroco ◽  
Bruno Rodrigues de Miranda ◽  
Letícia Zaccaria Prates de Oliveira
Keyword(s):  
Literature Review ◽  
Rare Condition ◽  
Fracture Site ◽  
Fracture Dislocation ◽  
Flexor Hallucis Longus ◽  
Tarsal Bone ◽  
Level Of Evidence ◽  
Bilateral Fracture ◽  
Proper Diagnosis ◽  
Fracture Of The Calcaneus

The calcaneus is the most commonly fractured tarsal bone. However, locked fracture-dislocation of the calcaneus is a rare condition because of the bone and ligament stability between the calcaneus, talus, and cuboid. We report the unique features of a case of bilateral fracture-dislocation of the calcaneus, including open fractures, bilateral fibular dislocation, and bilateral interposition of the flexor hallucis longus tendon at the fracture site. A literature review identified only 19 cases of locked fracture-dislocation, but none of these cases involved the combination of injuries observed in this case. Fracture of the calcaneus may be associated with a variety of injuries requiring proper diagnosis and treatment. Level of evidence V; Therapeutic Studies; Expert Opinion.

scholarly journals Checkrein deformity treated through a forefoot approach

2019 ◽  
Vol 13 (4) ◽  
pp. 259-63
Author(s):  
Bruno Rodrigues de Miranda ◽  
Rui Dos Santos Barroco ◽  
Danilo Ryuko Cândido Nishikawa ◽  
Leticia Zaccaria Prates de Oliveira ◽  
Mahmoud Beerens Abdul Ghani
Keyword(s):  
Functional Outcomes ◽  
Callus Formation ◽  
Plantar Flexion ◽  
Metatarsophalangeal Joint ◽  
Scar Tissue ◽  
Flexion Contracture ◽  
Fracture Site ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Novel Approach

Checkrein deformity is characterized by flexible plantar flexion contracture of the interphalangeal joint and flexible extension contracture of the metatarsophalangeal joint of the hallux. It occurs due to entrapment of the flexor hallucis longus in the callus formation at the fracture site or within scar tissue on lower limb. Currently, there is still no consensus about the best surgical treatment for this deformity. The aim of this study is to report a case of a patient that was treated with a novel approach for the treatment of checkrein deformity of the hallux located in the forefoot, with satisfactory functional outcomes. Level of Evidence V; Therapeutics Studies; Expert Opinion.

scholarly journals Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199223
Author(s):  
Xiaolin Zhang ◽  
Hongmei Jiao ◽  
Xinmin Liu
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Respiratory Infections ◽  
Relevant Literature ◽  
Rare Condition ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Esophageal Diverticulum ◽  
Bronchoesophageal Fistula ◽  
Fatal Complications

Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

scholarly journals Bone Morphogenetic Protein in Scaphoid Nonunion: A Systematic Review

2021 ◽  
Author(s):  
Michael M. Polmear ◽  
Ashley B. Anderson ◽  
Paul J. Lanier ◽  
Justin D. Orr ◽  
Leon J. Nesti ◽  
...  
Keyword(s):  
Literature Review ◽  
Bone Morphogenetic Protein ◽  
Controlled Trial ◽  
Scaphoid Nonunion ◽  
Journal Articles ◽  
Level Of Evidence ◽  
Carpal Collapse ◽  
Morphogenetic Protein ◽  
Combination Of Methods

Abstract Background Scaphoid nonunion can lead to carpal collapse and osteoarthritis, a painfully debilitating problem. Bone morphogenetic protein (BMP) has been successfully implemented to augment bone healing in other circumstances, but its use in scaphoid nonunion has yielded conflicting results. Case Description The purpose of this study is to assess the outcomes and complications of scaphoid nonunion treated surgically with BMP. Literature Review A literature review of all available journal articles citing the use of BMP in scaphoid nonunion surgery from 2002 to 2019 was conducted. We included studies that used BMP as an adjunct to surgical treatment for scaphoid nonunions in both the primary and revision settings with computed tomography determination of union. Demographic information, dose of BMP, tobacco use, outcomes, and complications were recorded. A total of 21 cases were included from four different studies meeting inclusion criteria. Clinical Relevance The union rates were 90.5% overall, 100% for primary surgeries, and 77.8% for revision surgeries. Five patients (24%) experienced 11 complications, including four cases (19%) of heterotrophic ossification. Use of BMP in scaphoid nonunion surgery resulted in a 90.5% overall union rate but was also associated with complications such as heterotopic ossification. All included studies used BMP to augment bone graft, screw or wire fixation, or a combination of methods. The efficacy of BMP in scaphoid nonunion is unclear, and a sufficiently powered, randomized controlled trial is needed to determine optimal fixation methods, dosing, and morbidity of the use of BMP. Level of Evidence This is a Level IC, therapeutic interventional study.

scholarly journals Digital Storytelling in Older Adults With Typical Aging, and With Mild Cognitive Impairment or Dementia: A Systematic Literature Review

2021 ◽  
pp. 073346482110154
Author(s):  
Adriana Maria Rios Rincon ◽  
Antonio Miguel Cruz ◽  
Christine Daum ◽  
Noelannah Neubauer ◽  
Aidan Comeau ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Digital Storytelling ◽  
Level Of Evidence ◽  
Form Of Life ◽  
Self Confidence ◽  
Care Partners

The rates of dementia are on the rise as populations age. Storytelling is commonly used in therapies for persons living with dementia and can be in the form of life review, and reminiscence therapy. A systematic literature review was conducted to examine the range and extent of the use of digital technologies for facilitating storytelling in older adults and their care partners, and to identify the processes and methods, the technologies used and their readiness levels, the evidence, and the associated outcomes. Eight electronic databases were searched: Medline, EMBASE, PsycINFO, CINAHL, Abstracts in Social Gerontology, ERIC, Web of Science, and Scopus. We included 34 studies. Mild cognitive impairment or dementia represented over half of medical conditions reported in the studies. Overall, our findings indicate that the most common use of digital storytelling was to support older adults’ memory, reminiscence, identity, and self-confidence; however, the level of evidence of its effectiveness was low.

scholarly journals Arthroscopic Posterior Ankle Ligament Anatomy

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110006
Author(s):  
Richard D. Ferkel ◽  
Cory Kwong ◽  
Randall Farac ◽  
Mark Pinto ◽  
Nader Fahimi ◽  
...  
Keyword(s):  
Distal Tibia ◽  
Case Series ◽  
Ankle Arthroscopy ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Tibiofibular Ligament ◽  
Ankle Ligament

Background: The purpose of this article is to document the normal arthroscopic appearance of the posterior ankle capsular and ligamentous structures, and variations in their anatomical relationships. Methods: 102 ankle arthroscopy videotapes were evaluated retrospectively for the configuration of the posterior capsuloligamentous structures. Based on these observations, the variations in the appearance and position of the posterior tibiofibular ligament (PTFL) and transverse (tibiofibular) ligament (TTFL) were documented. In addition, differences in the appearance of the flexor hallucis longus (FHL) were also noted. Results: All patients had evidence of both a PTFL and TTFL, which formed a labrum or meniscus-like addition to the posterior distal tibia. No patients demonstrated disruption of the PTFL; 3 had tears of the TTFL. We noted 4 distinct patterns of the PTFL and the TTFL. Thirty-four patients (33%) had a gap of ≥2 mm between the 2 ligamentous structures. Thirty-three (32.4%) had a gap <2 mm between the PTFL and TTFL. Twenty-six (25.5%) had a confluence of the 2 ligaments without a gap. Nine (9%) demonstrated a sizable gap between the 2 ligaments, and the TTFL appeared as a “cord-like” structure. Conclusion: To our knowledge, this is the first article to describe the variations in the arthroscopic normal posterior capsuloligamentous structures and FHL of the ankle. Level of Evidence: Level IV, case series.

Fifth Metatarsal Jones Fractures in the Athlete

2017 ◽  
Vol 39 (2) ◽  
pp. 250-258 ◽  
Author(s):  
David A. Porter
Keyword(s):  
Screw Fixation ◽  
Nonoperative Treatment ◽  
Fracture Site ◽  
Medullary Canal ◽  
Return To Sports ◽  
Stress Reactions ◽  
Current Standard ◽  
Level Of Evidence ◽  
Metatarsal Fractures ◽  
Intramedullary Screw

Fifth metatarsal fractures, otherwise known as “Jones” fractures, occur commonly in athletes and nonathletes alike. While recent occurrence in the popular elite athlete has increased public knowledge and interest in the fracture, this injury is common at all levels of sport. This review will focus on all three types of Jones fractures. The current standard for treatment is operative intervention with intramedullary screw fixation. Athletes typically report an acute episode of lateral foot pain, described as an ache. Radiographic imaging with multiple views of the weightbearing injured foot are needed to confirm diagnosis. If these images are inconclusive, further magnetic resonance imaging (MRI) or computed tomography (CT) is used. Nonoperative treatment is not commonly used as the sole treatment, except when following reinjury of a stable screw fixation. While screw selection is still controversial, operative treatment with intramedullary screw fixation is the standard approach. Technical tips on screw displacement are provided for Torg (types I, II, III) fractures, cavovarus foot fractures, recurrent fractures, revision surgery, occult fractures/high-grade stress reactions, and Jones’ variants. Excellent clinical outcomes can be expected in 80% to 100% of patients when using the intramedullary screw fixation to “fit and fill” the medullary canal with threads across the fracture site. Most studies show the timing for return to sports with optimal healing to be seven to twelve weeks after fixation. Level of Evidence: Level V, expert opinion.

scholarly journals Management of Isolated Capitate Nonunion: A Case Series and Literature Review

2018 ◽  
Vol 07 (05) ◽  
pp. 419-423 ◽  
Author(s):  
Rishabh Jethanandani ◽  
Schneider Rancy ◽  
Keith Corpus ◽  
Jeffrey Yao ◽  
Scott Wolfe
Keyword(s):  
Literature Review ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Relevant Literature ◽  
Case Series ◽  
Rare Condition ◽  
Vascular Supply ◽  
Autogenous Bone ◽  
Rare Injury ◽  
Autogenous Bone Grafting

Background Isolated capitate nonunion is rare. No consensus on the appropriate treatment for this condition exists. Case Description We reported two cases of capitate fracture nonunion presenting several months after untreated high-impact wrist trauma. Treatment was delayed as both patients' nonunions were missed on conventional radiographs. Both were ultimately diagnosed with advanced imaging and successfully treated with internal fixation and autogenous bone grafting. The relevant literature pertaining to capitate nonunion was reviewed. Literature Review Immobilization and internal fixation with bone grafting for capitate nonunion have been described in the literature. Loss of vascular supply and progression to avascular necrosis is a concern after capitate nonunion. Clinical Relevance We present two cases and review the literature on the diagnosis and treatment of this rare injury to guide management. Internal fixation with autogenous bone grafting could play a role in management for this rare condition.

Predisposing Factors for Posttraumatic Osteoarthritis After Malleolus Fracture Fixation in Patients Younger Than 50 Years

2021 ◽  
pp. 107110072110500
Author(s):  
Jong Seok Beak ◽  
Yeong Tae Kim ◽  
Sung Hyun Lee
Keyword(s):  
Risk Factors ◽  
Articular Surface ◽  
Binary Logistic Regression ◽  
Ankle Fractures ◽  
Fracture Dislocation ◽  
Posttraumatic Arthritis ◽  
Level Of Evidence ◽  
Posttraumatic Osteoarthritis ◽  
Posterior Malleolus

Background: The purpose of this study was to identify the risk factors for posttraumatic osteoarthritis (OA) after surgery for ankle fractures in patients aged ≤50 years. Methods: We performed a retrospective review of consecutive patients who underwent surgery for ankle fractures and were followed up for a minimum period of 5 years. The patients were assigned to 2 groups according to the presence of advanced OA at the last follow-up. Binary logistic regression was used to model the correlation between risk factors and OA. Functional outcomes were assessed using the Foot and Ankle Outcome Score. Results: The data of 332 patients who met the inclusion criteria were included in the analysis. The overall rate of posttraumatic arthritis was 27.7% (nonarthritis group: 240 patients, arthritis group: 92 patients). The arthritic change was significantly affected by BMI (95% confidence interval [CI] 1.29-19.76; adjusted odds ratio [OR] ≥ 30, 6.56), fracture-dislocation injury (CI 1.66-11.57; adjusted OR, 4.06), posterior malleolus (PM) fracture (CI 1.92-12.73, adjusted OR > 25% of the articular surface, 5.72), and postoperative articular incongruence (CI 1.52-18.10; adjusted OR, 7.21). The mean scores of the arthritis group were lower than those in the nonarthritis group ( P < .05). Conclusion: Obesity, fracture-dislocation injury, concomitant large PM fracture, and articular incongruence were risk factors of posttraumatic OA after surgery for ankle fractures. Surgeons should be aware that accurate reduction is critical in patients with ankle fractures with associated large PM fractures, especially those with obesity or severe initial injuries such as fracture-dislocation. Level of Evidence: Level III, case control study.

scholarly journals Irreducible anteromedial radial head fracture-dislocation: value of pre-operative magnetic resonance imaging

2020 ◽  
pp. 20200111
Author(s):  
Lee Kai Lim ◽  
Joey Beh
Keyword(s):  
Radial Head ◽  
Radial Head Fracture ◽  
Rare Condition ◽  
Fracture Dislocation ◽  
Imaging Findings ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Rare Presentation ◽  
Sustained Reduction ◽  
Surgical Journal

We describe a case of an anteromedial fracture-dislocation of the radial head in an adult patient, which was initially irreducible using closed means, and remained challenging to reduce despite open surgery. Further advanced CT/MRI revealed entrapment of the radial head due to the interposition of the brachialis tendon posteriorly, thereby preventing sustained reduction. While three other cases of irreducible anteromedial radial head dislocation due to the brachialis tendon have been reported in the English surgical literature, none of the imaging findings have been described in the radiological literature. Only one other case published in a surgical journal briefly demonstrated pre-operative MRI imaging. We would like to share the value of pre-operative MRI in this rare presentation, which would be helpful in diagnosing not only cases with interposition of the brachialis tendon, but potentially other types of soft tissue interposition which also limit closed reduction. To the best of the authors’ knowledge, this would be the first report on the imaging findings in a radiological journal. Awareness of this phenomenon would assist radiologists in the diagnosis and management of this rare condition.

scholarly journals USE OF FLUNARIZINE AS A PREVENTIVE FOR VESTIBULAR MIGRAINE CRISES IN COMPARISON WITH OTHER DRUGS: SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Author(s):  
Lara Estupina Braghieri ◽  
Paula Lopes ◽  
Osmar Person ◽  
Fernando Junior ◽  
Priscila Bogar
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Vestibular Migraine ◽  
Moderate Degree ◽  
Level Of Evidence ◽  
Grade Method ◽  
Episodic Vertigo ◽  
Preventive Drug

INTRODUCTION: Vestibular migraine is the main cause of episodic vertigo and the second most common cause of dizziness in adults. Treatment for vestibular migraine encompasses the prevention of crises and the control of acute symptoms. Flunarizine works by preventing the contraction of labyrinthine vessels and altering blood flow, thus preventing symptoms. Due to the high prevalence of the disease, its negative impacts on individual health and increased expenditure on public health, preventive pharmacological and non-pharmacological treatment must be implemented early. PURPOSE: To evaluate the efficacy of Flunarizine as a preventive for migraine and vestibular crises compared to other preventive drugs. MATERIAL AND METHODS: Scientific articles were searched in the databases using the terms (vestibular migraine OR migrainous vertigo) AND (flunarizine) AND (prophylaxis). Subsequently, a systematic literature review and meta-analysis was performed, including 3 randomized clinical trials comparing flunarizine and other preventive drugs in terms of efficacy and safety for preventing migraine vertigo attacks. The studies were analyzed using a ROB table, analysis using the GRADE method and meta-analysis. RESULTS: Qualitatively, the analysis showed that flunariniza was positive for decreasing the frequency of vertigo in cases of vestibular migraine, with a moderate degree of evidence, a relative risk of 0.34 and a confidence interval of 0.15 to 0.76. CONCLUSIONS: There are few studies available in the scientific literature on the use of flunarizine in vestibular migraine, many of which are heterogeneous among themselves, mainly in the way of evaluating and monitoring patients, carried out mainly through subjective methods. The meta-analysis showed a positive result for flunarizine as a preventive drug for the studied population. Furthermore, in all the studies analyzed, no serious side effects resulting from the use of the medication were reported, which makes it safe for patients to use. Flunarizine is a good drug for the prevention of vestibular migraine, especially in reducing the number of attacks, with a good level of evidence.

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