scholarly journals Hyperextension Malunion of the Distal Humerus - Chevron Osteotomy: A Case Report

2020 ◽  
Vol 13 (62) (2) ◽  
pp. 65-72
Author(s):  
Radu Dan Necula ◽  
Bogdan Radu Necula ◽  
Daniel Balogh-Ungureanu
Keyword(s):  
Case Report ◽  
Range Of Motion ◽  
Distal Humerus ◽  
Rotational Stability ◽  
Future Studies ◽  
Chevron Osteotomy ◽  
Humerus Shaft ◽  
Multiple Interventions

"Treatment of hyperextension malunions of the distal humerus is done by osteotomy, several types being described in the literature. The aim of the paper is to highlight the possibility of using Chevron-type osteotomy in sagittal malunions of the distal humerus shaft. The patient presented in this case report has suffered multiple interventions after a 13C1 AO/OTA fracture of her right arm. When the malunion was identified her range of motion (ROM) was 40-90 degrees flexion. We have performed a supracondylar sagittal Chevron osteotomy at a 30 degrees angle open anteriorly. After the surgery, her ROM improved to 40-135 degrees flexion. The authors chose the Chevron osteotomy because it created an increased area (by 30%) of the interface between the two fragments and offers a good rotational stability. Unfortunately, information in the literature is limited and future studies must be done to endorse the usage of Chevron osteotomy in hyperextension malunion of the distal humerus."

scholarly journals Transverse olecranon osteotomy with Gigli saw: A fast and reliable technique

2021 ◽  
Vol 6 (1) ◽  
pp. 17-21
Author(s):  
Bulent Karslioglu
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Distal Humerus ◽  
Chevron Osteotomy ◽  
Elbow Fractures ◽  
Significant Difference ◽  
Transverse Osteotomy ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

Objective. Distal humerus fractures constitute of approximately 2% of all fractures and 30% of elbow fractures. Olecranon osteotomy provides excellent exposure of distal humerus and articular surface. In this study, we aimed to compare transverse osteotomy with gigli saw and classical chevron osteotomy techniques in terms of osteotomy duration and clinical results. Materials and Methods. 40 elbows of 40 patients with Type B intraarticular distal humerus fractures according to AO classification were included in our study. Patients were divided into 2 groups as transverse or chevron osteotomy groups. Patients were evaluated in terms of intraoperative osteotomy time, postoperative time to union, range of motion in the elbow joint and Quick Dash scores at 6th, 12th and 24th months. Results. The mean age of the patients was 45.6 years (19-62). 40% of the patients (8 patients) in the Chevron group had more than 2 mm stepping at articular surface, while this rate was 10% (2 patients) in the gigli saw group. Union was obtained in all patients for both techniques. There was no significant difference between the mean QuickDASH scores and range of motion of the elbow joints except flexion in both groups. Range of motion of flexion was statistically better in the gigli saw group (p<0.05). Conclusions. Transverse osteotomy technique significantly reduces osteotomy and fixation time and will not cause problems in fracture union. It may be preferred because it is simpler and faster to apply than chevron osteotomy and because intra-articular stepping is less common.

scholarly journals Using 3D Printing Technology for Corrective Biplanar Chevron Osteotomy with Customized Osteotomy Guide and Patient-Matched Monoblock Crosslink Plate in Treatment of Cubitus Varus Deformity: A Case Report and Technical Note

2020 ◽  
Author(s):  
Nithid Sri-utenc ◽  
Nachapan Pengrung ◽  
Korakod SrikonK ◽  
Chedtha Puncreobutr ◽  
Boonrat Lohwongwatana ◽  
...  
Keyword(s):  
Case Report ◽  
3D Printing ◽  
Varus Deformity ◽  
Distal Humerus ◽  
Study Patient ◽  
Lateral Condyle ◽  
Cubitus Varus ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Chevron Osteotomy

Abstract Background Cubitus varus deformity (CVD), a common complication after a supracondylar fracture of the distal humerus, is usually treated with corrective osteotomy. However, due to the complex anatomy of the distal humerus, conventional osteotomy techniques are sometimes unreliable and can result in an inaccurate correction, residual deformity, and lateral condyle prominence. Recently, medial three-dimensional (3D) printing technology has demonstrated potential benefits for the treatment of CVD by improving the accuracy of the osteotomy through the use of an osteotomy guide with or without a patient-mated plate. This study aimed to present an interesting CVD case involving a patient who was treated with corrective biplanar Chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3D printing technology. Methods A computer simulation was processed using images from computerized tomography(CT) scans of both upper extremities. The biplanar Chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus. Next, the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed. A simulation osteotomy for the real-sized bone model was created. Results The operation was performed using the posterior paratricipital approach and the k-wire position from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy. Our method helped successfully treat the CVD in the case study patient and significantly improved her radiographic and clinical outcomes with a satisfactory result. Conclusion This study showed that the treatment of CVD using 3D printing technology to create an innovative customized osteotomy guide and a patient-matched monoblock crosslink plate can help accurately assess and control the CVD correction. To the best of our knowledge, this case report introduces a new insight for the clinical application of 3D printing technology in the treatment of CVD.

scholarly journals Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096648
Author(s):  
Yu Wang ◽  
Jie Liu
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
Distal Humerus ◽  
Left Lobe ◽  
Pathological Examination ◽  
Hypoechoic Mass ◽  
Brown Tumors ◽  
Restricted Mobility ◽  
The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

scholarly journals True Symphalangism of All Bilateral Proximal Interphalangeal Joints with Multi-carpal Coalition and Hypoplasia of the Ulnar Styloid Process

2021 ◽  
Author(s):  
Hao Yu ◽  
Chongjie Li
Keyword(s):  
Case Report ◽  
Range Of Motion ◽  
Styloid Process ◽  
Genetic Condition ◽  
Ulnar Styloid ◽  
Wrist Motion ◽  
First Case ◽  
Distal Interphalangeal ◽  
Carpal Coalition ◽  
Ulnar Styloid Process

AbstractSymphalangism is a rare genetic condition characterized by ankylosis of the proximal interphalangeal (PIP) or/and distal interphalangeal (DIP) joints. The patient presented with fused bilateral PIP joints and poor flexion, and an unsatisfactory range of motion (ROM) in the metacarpophalangeal (MP) and DIP joints. Concomitantly, multi-carpal coalition, proximal carpal malalignment, and ulnar styloid process abnormality were also observed in radiographs obtained at diagnosis. Rehabilitation training of the MP and DIP joints and a wrist supporter were recommended to achieve MP and DIP functional motion and restrict dramatic wrist motion. This is the first case report of symphalangism with multi-carpal coalition and abnormality of the ulnar styloid process to the best of our knowledge.

scholarly journals Temporal gliosarcoma: case report and review of literature

2015 ◽  
Vol 22 (1) ◽  
pp. 112-116
Author(s):  
Amit Agrawal ◽  
Vissa Shanthi ◽  
Baddukonda Appala Ramakrishna ◽  
Kuppili Venkata Murali Mohan
Keyword(s):  
Case Report ◽  
Median Survival ◽  
Glial Cells ◽  
Primary Tumor ◽  
Clinical Presentation ◽  
Spindle Cell ◽  
Review Of Literature ◽  
Future Studies ◽  
Aggressive Tumor ◽  
The Brain

Abstract First characterized by Stroebe, the gliosarcomas are highly malignant and rare primary tumor of the brain composed of neoplastic glial cells in association with spindle cell sarcomatous elements (biphasic tissue patterns). In spite of being recognized as two different pathologies studies have not shown any significant differences between gliosarcoma and glioblastoma with regard to age, sex, size, clinical presentation, and median survival. In summary, gliosarcoma is an aggressive tumor with a propensity to recur and re-grow with poor outcome. Future studies are needed to understand the true pathology of these biphasic tumors.

Fracture of the Medial Epicondylar Apophysis of Distal Humerus with Subluxation of the Radial Head: A Case Report

2003 ◽  
Vol 16 (2) ◽  
pp. 304
Author(s):  
Han Yong Lee ◽  
Kee Won Rhyu ◽  
Jin Young Jeong ◽  
Joo Hyoun Song ◽  
Hae Seok Koh ◽  
...  
Keyword(s):  
Case Report ◽  
Radial Head ◽  
Distal Humerus

scholarly journals STUDY OF THE FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF INTRA-ARTICULAR DISTAL HUMERUS FRACTURE (AO/OTA TYPE C) IN ADULTS

2020 ◽  
pp. 1-3
Author(s):  
Ravindra Prasad ◽  
L B Manjhi
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Surgical Management ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Joint Surface ◽  
Distal Humerus Fracture ◽  
Complex Anatomy ◽  
Type C

Introduction: Distal humerus fracture in adults particularly complete articular (AO/OTA Type C) remain some of the most difficult injuries to manage. Complex anatomy of distal humerus combined with multifragmented fracture, sparse soft tissue cover with adjacent neurovascular structures poses great difficulty for treatment. Goal of treatment is to obtain a painless, stable and mobile elbow joint through a systematic approach. Aim: to study the functional outcome of surgical management of complete articular distal humerus fracture in adults. Method: a prospective study comprising of 20 patients treated surgically with open reduction and internal fixation using Orthogonal plating (dorsolateral and medial 3.5mm LCP) through trans olecranon approach. Result: Mean age of patients was 36.6 years (range 19 to 58 years) with male dominance, most fractures were of type 13C1 (AO/OTA). RTA accounts for most common mode of injury, majority of them being left sided. Mean operative time was 130 minutes. Complications included one case of superficial infection, 3 cases of ulnar neuropathy and non-union in 2 cases. Mean range of motion of elbow was 89 degree. Functional outcome assessed using Mayo Elbow Performance Score (MEPS) shown Excellent result in 12 cases, good to fair results in 6 and poor result in 2 cases. Conclusion: Anatomical restoration of joint surface and rigid internal fixation with bicolumnar orthogonal plating allowing early range of motion is the key for obtaining good functional results in complete articular distal humerus fractures. However, outcomes do deteriorate with increasing fracture complexity.

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