scholarly journals Case Report: Treatment of Femoral Non-union With Rib and Iliac Crest Autografts and rhBMP-2 in a Cat

2021 ◽  
Vol 8 ◽  
Author(s):  
Cheng-Shu Chung ◽  
Lee-Shuan Lin ◽  
Yi-Min Teo
Keyword(s):  
Case Report ◽  
Iliac Crest ◽  
Plate Fixation ◽  
Fracture Site ◽  
Bone Morphogenetic Protein 2 ◽  
Intact Male ◽  
Fixation Failure ◽  
Absorbable Collagen Sponge ◽  
Non Union ◽  
First Case

A 5-year-old, intact male Bengal cat weighing 5.2 kg was referred for the fixation failure of a right femoral fracture. Multiple surgical revisions failed, and atrophic non-union was diagnosed. The cat was then admitted for a final revision surgery using locking plate fixation in conjunction with rib and iliac crest autografts and recombinant human bone morphogenetic protein 2 (rhBMP-2). The fracture site was debrided and stabilized before filling the defect with 1.8 cm of rib bone autograft. The residual space in the defect was then filled with an iliac crest autograft. Finally, a 3 ×5 cm absorbable collagen sponge soaked with 0.5 mL of 0.2 mg/mL rhBMP-2 solution was placed around the defect. No significant complications were noted postoperatively. Bone healing was noted 2 months postoperatively, and it continued for 12 months. Although mild lameness remained, the cat's ambulatory function and quality of life were good. To the authors' knowledge, this is the first case report of a clinical transplantation of a rib segment as an autograft in combination with rhBMP-2 in a cat with a large bone defect.

Late onset venous thoracic outlet syndrome following clavicle non-union fracture: A case report

Vascular ◽  
2014 ◽  
Vol 23 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Daniel J Wong ◽  
Tammy M Holm ◽  
George SM Dyer ◽  
Jonathan D Gates
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Thoracic Outlet Syndrome ◽  
Late Onset ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Vascular Complications ◽  
Non Union ◽  
Clavicle Fractures

A 59-year-old woman was admitted three times over a six-month period with recurrent upper extremity deep venous thrombosis (UEDVT). It was determined that this patient was suffering from an unusual presentation of Paget-Schröetter syndrome secondary to a 20-year-old non-union of a midshaft clavicle fracture. Following thrombolysis the patient underwent resection and plate fixation of the clavicle fracture non-union. Despite the anatomic proximity of the subclavian vessels to the clavicle, vascular complications from fracture are rare. Treatment of midshaft clavicle fractures is often non-operative. Non-union rates are generally less than 10%, and easily treated secondarily without complication. Clavicular pseudo-arthroses from trauma have been implicated in the development of the thoracic outlet syndromes, however, onset 20 years after fracture has never before been reported.

scholarly journals Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus

2021 ◽  
Vol 8 (5) ◽  
pp. 72
Author(s):  
Jae-Eun Hyun ◽  
Yeong-Hun Kang ◽  
Cheol-Yong Hwang
Keyword(s):  
Mycophenolate Mofetil ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Oral Prednisolone ◽  
Intact Male ◽  
Strong Reaction ◽  
Dermoepidermal Junction ◽  
Tacrolimus Ointment ◽  
First Case ◽  
Continuous Use

A 6-year-old, intact male miniature Pinscher dog had erosive lesions on perilabial, peripenial and perianal mucocutaneous areas, which were exacerbated by ulcerations, crusts, with pain while defecating and urinating. The lesions were symmetrical, and no systemic signs were observed. Histopathological evaluation showed parakeratotic hyperkeratosis, ulceration and cell-rich lymphoplasmacytic interface dermatitis with basal keratinocyte apoptosis. Immunohistochemistry revealed strong reaction in the dermoepidermal junction against goat-canine IgG and mild-to-moderate reaction against goat-canine IgA, IgM and C3. Based on these findings, the dog was diagnosed with mucocutaneous lupus erythematosus (MCLE). Oral prednisolone 1 mg/kg twice daily, mycophenolate mofetil (MMF) 18.3 mg/kg twice daily and 0.1% tacrolimus ointment were prescribed as initial treatment. The lesions showed remarkable improvement within 4 weeks, but the dog exhibited polyuria, polydipsia and hepatomegaly with high dosage of prednisolone. Hence, the dosage of prednisolone was gradually tapered for 9 weeks and discontinued, but MMF and tacrolimus were continued. No new lesion or associated side effect was observed while reducing the MMF dose to 10 mg/kg twice daily and with continuous use of tacrolimus ointment after steroid discontinuation. In conclusion, this case report emphasizes the usefulness of MMF and tacrolimus as steroid-sparing agents in the treatment of dogs with MCLE. To the best of our knowledge, this is the first case report of MCLE that was successfully managed long-term with MMF and tacrolimus.

scholarly journals A Case Report of Proximal Migration of Fibular Head with Intact Peroneal Nerve in a Post-Operative Infected Tibia Gap Non-union Managed by Ilizarov Technique

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Spandan R Koshire ◽  
Rajesh R Koshire ◽  
Ajay M Wankhade
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Fracture Site ◽  
Bony Union ◽  
Ilizarov Technique ◽  
Fibular Head ◽  
Non Union ◽  
Wound Debridement ◽  
Proximal Migration

Introduction: We hereby present a rare case of proximal fibular head migration associated with Ilizarov technique for infected tibia gap non-union due to follow-up failure in post-operative management during the coronavirus disease (COVID) pandemic. Case Report: A 45-year-old male patient had undergone primary external fixation with wound debridement for a compound tibia shaft fracture Grade 3 A Gustilo class which later on with a healed external wound with a discharging sinus at the fracture site was confirmed to be infected non-union and subsequently managed by Ilizarov ring fixation over an antibiotic coated intramedullary nail and local gentamycin beads after a necrotic bone fragment of around 6 cm was excised. Post-operative protocol of compression and distraction was initiated and the patient educated regarding the same before discharge. As the world over was hit by the COVID pandemic and the lockdown limited all possible movements in our country, the patient could not follow up for monitoring the Ilizarov limb lengthening procedure. He presented to us after 4 months after the relaxation of lockdown with radiological union at the docking site but with a shortening of about 3 cm. Vigorous knee range physiotherapy failed to improve range beyond 90° which prompted us to check X-ray the knee joint and revealed the complication of proximal fibular head migration of 4 cm but with no neurodeficit and currently the patient is being managed with full weight mobilization with the help of crutch and shoe raise and an improved knee range till 100° of flexion with no pain tenderness or any other complaints. Conclusion: Having knowledge of this possible rare complication and the need for follow-up and monitoring with the importance of patient education makes practicing orthopedic surgeons equipped to handle and anticipate such undesirable complications. Keywords: Bony union, fibula migration, fibula resection, Ilizarov technique, infected non-union.

DISCOSPONDYLITIS IN A 7-MONTH-OLD FRENCH BULLDOG: A CASE REPORT

2019 ◽  
Vol 45 (03) ◽  
pp. 91-96
Author(s):  
Chung-Chao Chen ◽  
Shu-Fang Yang ◽  
Shei-Wen Lee ◽  
Heng-Leng Yang ◽  
Feng-Yi Hsieh ◽  
...  
Keyword(s):  
Case Report ◽  
Pain Perception ◽  
Complete Blood Count ◽  
Old French ◽  
Intact Male ◽  
Normal Limits ◽  
First Case ◽  
Staphylococcus Epidermis ◽  
Bacteria Culture ◽  
French Bulldog

A 7-month-old, intact, male French bulldog presented for paraplegia for two days, and persistent fever and diarrhea for seven days. Complete blood count and biochemical profiles were within normal limits. Radiography and computed tomography (CT) revealed destructive endplate lesions between T11 and T12. Surgery of intervertebral disc (IVD) curettage was performed because the dog was beginning to lose deep pain perception. Staphylococcus epidermis was isolated from blood culture and specimens of the IVD. After surgery, intravenous and oral antibiotics were continued for three weeks. The dog regained ambulatory status one month after surgery. Diagnosis of discospondylitis of T11 and T12 was confirmed according to CT and positive bacteria culture. To our knowledge, this case is the youngest dog confirmed with discospondylitis managed successfully, and the first case report of discospondylitis in a French bulldog. Aggressive surgical treatment is highly recommended in young dogs with rapidly progressive neurologic deficits from discospondylitis.

scholarly journals Primary brain involvement of disseminated histiocytic sarcoma in a Rottweiler dog – histopathology, 18F-fluorodeoxyglucose positron emission tomography and 7 T-magnetic resonance imaging findings: a case report

2017 ◽  
Vol 62 (No. 11) ◽  
pp. 604-613
Author(s):  
BT Kang ◽  
D. An ◽  
HW Kim ◽  
Y. Jin ◽  
YD Son ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Positron Emission Tomography ◽  
Case Report ◽  
Magnetic Resonance ◽  
Histiocytic Sarcoma ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Intact Male ◽  
First Case ◽  
Positron Emission

An eight-year-old, intact male Rottweiler dog was presented due to anorexia, lethargy, ataxia and imbalance. Cerebellar and thyroid masses were identified using 0.3T magnetic resonance imaging. The <sup>18</sup>F-fluorodeoxyglucose uptakes of the masses were elevated on positron emission tomography and 7 T-magnetic resonance imaging fusion imaging. At 113 days after the initial presentation, new nodular lesions were observed in the skin, liver and spleen. Histopathology revealed multiple lesions of disseminated histiocytic sarcoma in the cerebellum, liver, spleen and skin, whereas the thyroid lesions were diagnosed as mixed medullary-follicular thyroid carcinoma. The primary site of the disseminated histiocytic sarcoma was found to be in the cerebellum. To our knowledge, this is the first case report to describe the imaging and histopathological findings of extracranial metastasis of a primary intracranial histiocytic sarcoma in a dog.

scholarly journals Reconstruction of Juxta-Articular Bone Defect in an Infected Fracture Distal Right Femur Using Autologous Fibular Strut and Iliac Crest Graft

2021 ◽  
Vol 10 (39) ◽  
pp. 3501-3504
Author(s):  
Nareshkumar Satyanarayan Dhaniwala ◽  
Khizar Khusrau Khan ◽  
Salahuddin Ahmed
Keyword(s):  
Bone Defect ◽  
Iliac Crest ◽  
Distal Femur ◽  
Fracture Site ◽  
Open Fractures ◽  
Iliac Crest Graft ◽  
Strut Graft ◽  
Non Union ◽  
Femur Fractures ◽  
Fibular Strut

Distal femur fractures are about 7 % of all femur fractures.1 Being complex in nature management of these fractures is difficult; management is still a challenge in this technically advanced era. Fibular strut graft is one of the useful and simple options to manage defects in distal femur fractures. High velocity injuries causing open fractures may lead to infection and non-union of fracture if proper debridement and antibiotics are not used as per established protocol. Antibiotics can be given mixed with polymethyl-methacrylate (PMMA) cement formed in beads at the open fracture site or coated over a nail.2 This causes slow release of antibiotics and helps in control of infection. Local infection, damaged soft tissue, ischemia over fracture site, stabilisation of fracture, the hardware used and patient’s co morbidities all play a role in union and infection control of open fractures. Early detection of infection is important to avoid non-union and related complications. Distal femur juxta-articular fracture may develop infection due to fractures and unstable fixation more commonly. This may result in cavity formation and complications like osteomyelitis often leading to bone destruction and sequestrum formation. Its management becomes a challenging task for an orthopaedic surgeon.3- 9 The reconstructive methods are autogenous cortical bone, cancellous bone, allograft, bone substitutes like synthetic bone blocks and bone granules. Free bone transfer is crucial in reconstructing massive defects in distal femur fracture due to properties of rapid healing and being hypertrophic.7-13 Fibula is the best available option for grafting in massive defects of femur due to its characteristics like mechanical strength, length, minimum morbidity, and resistance to infection.3,11,13 A single fibula strut graft can give up to 26 cm of graft. The case reported here is of a patient of juxta-articular bone defect in an infected previously operated fracture distal femur using autologous fibular strut and iliac crest graft

The first case report of Pembrolizumab inducing thyroiditis and hypophysitis

2020 ◽  
Author(s):  
Rahman Maraqa Sima Abdel ◽  
Robert McMahon ◽  
Anusha Pinjala ◽  
Gastelum Alheli Arce ◽  
Mohsen Zena
Keyword(s):  
Case Report ◽  
First Case
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