Acetabular Migration of Lag Screw of Intramedullary Nail Used as Treatment for Intertrochanteric Fracture. Case Study

2021 ◽  
Vol 23 (6) ◽  
pp. 433-443
Author(s):  
Wojciech Koniec
Keyword(s):  
Hip Joint ◽  
Intramedullary Nail ◽  
Bone Union ◽  
Postoperative Course ◽  
Screw Insertion ◽  
Acetabular Fossa ◽  
Restorative Treatment ◽  
Modular Stem ◽  
Mechanical Procedure ◽  
The Right

Most trochanteric fractures of the femur are classified as low-energy fractures as they are seen in people with decreased mechanical properties of bone tissue. The treatment is assumed to provide biomechanical fixation with the possibility of dynamization between bony fragments to stimulate the biological processes of bone union. The aim of the study was to analyze a complication presenting as migration of the cervical screw of an intra­medullary nail towards the hip joint acetabulum and present the therapeutic management of this complication. The case report concerned a 74-year-old patient with an AO/OTA type 31 A2.2 fracture of the trochanteric massif of the right femur treated with the Gamma3 intramedullary nail. An assessment of changes over time of the radiological appearances on A-P images after the surgery showed migration of the cervical screw towards the acetabulum and displacement of the major trochanter fracture. Extensive destruction of the acetabular fossa made biologic restorative treatment impossible. A total hip joint prosthesis with a modular stem and MDM articulation was implan­ted and the trochanter was fixed with a "hook" plate with a "cable system". The postoperative course was uneventful. Failure to perform axial radiographs in the preoperative and postoperative period made it impossible to objectively determine the type of fracture and the quality of screw insertion into the femoral neck, and assessment limited to A-P images turned out to be deceptive. The wandering of the screw towards the acetabulum led to extensive destruction of the acetabular fossa. The decision to stop biological treatment, which, if properly performed, stimulates bone union, and perform the mechanical procedure of endoprosthesoplasty was fully prognostically justified. The early and late postoperative course was not complicated.

scholarly journals Concomitant Partial Achilles Tendon Rupture and Lateral Luxation of the Superficial Digital Flexor Muscle Tendon in a Dog

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e37-e40
Author(s):  
Hélène Dosseray ◽  
Claire Deroy-Bordenave
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Simultaneous Occurrence ◽  
Flexor Muscle ◽  
Screw Insertion ◽  
Superficial Digital Flexor Tendon ◽  
Fixation Screw ◽  
Pelvic Limb ◽  
The Right

AbstractThe aim of this study was to report a posttraumatic partial Achilles tendon (AT) rupture associated with lateral luxation of the superficial digital flexor tendon (SDFT) in a Whippet. This article is a brief communication. A Whippet was presented with posttraumatic plantigrade stance and non-load-bearing lameness of the right pelvic limb. The objective findings consisted in partial AT rupture and SDFT lateral luxation. Surgical treatment ensued: tenorrhaphy of the torn tendons and calcaneo-tibial screw insertion for tarsal immobilization, followed by suturing of the SDFT retinaculum. A casting bandage was employed for additional immobilization. Nonetheless, a bandage complication prompted the premature removal of the fixation screw and casting wrap. Complete functional recovery was achieved by the 20th postoperative week. The simultaneous occurrence of SDFT luxation and partial AT tear has not been reported in the literature before. The long-term postoperative functional outcome was highly satisfactory.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

Ganglion Cyst in Acetabular Fossa of the Hip Joint - Case Report -

2011 ◽  
Vol 23 (3) ◽  
pp. 225
Author(s):  
Ui Seoung Yoon ◽  
Hak Jin Min ◽  
Jin Soo Kim ◽  
Hyun Seok Oh ◽  
In Hwa Chung ◽  
...  
Keyword(s):  
Case Report ◽  
Hip Joint ◽  
Ganglion Cyst ◽  
Acetabular Fossa

Psoriasis Vulgaris Caused by Ceramic Inserts Used in Total Hip Replacement

2012 ◽  
Vol 16 (6) ◽  
pp. 448-450 ◽  
Author(s):  
Fujio Higuchi ◽  
Daisuke Tsuruta ◽  
Yumiko Ishibashi ◽  
Kazuko Imamura ◽  
Tokiko Shimoyama ◽  
...  
Keyword(s):  
Nous Avons ◽  
Total Hip Replacement ◽  
Hip Joint ◽  
Hip Replacement ◽  
Nuclear Factor Κb ◽  
Total Hip ◽  
First Case ◽  
The Right ◽  
Ceramic Insert ◽  
Psoriatic Lesions

Background: Ceramics are inorganic nonmetallic materials and are used as bioinert components in joint replacement surgeries. Ceramics are known to be low allergenic. We experienced a ceramic-induced psoriasis. Objective: We report a first case of possible ceramic-induced psoriasis caused by a ceramic insert. Methods: A 55-year-old female received an implanted ceramic-on-ceramic total hip replacement for osteoarthritis of the right hip joint. Following surgery, she developed psoriatic lesions, which continued for 10 years. We suspected that psoriasis was caused by a ceramic insert and removed it surgically. Results: When the ceramic insert was replaced with a polyethylene-on-metal hip joint, the psoriatic lesions completely disappeared. Conclusion: The pathogenesis of psoriasis is still an enigma, although deregulation of nuclear factor κB signaling and resulting abnormal cytokine secretion are speculated to be involved. Ceramics may affect these signaling events and cause the onset of psoriasis. Renseignements de base: Les céramiques sont des matériaux non métalliques inorganiques et sont utilisées comme composants bio-inertes dans les arthroplasties. Les céramiques sont reconnues pour être peu allergisantes. Nous avons observé un psoriasis provoqué par la céramique. Objectif: Nous exposons un premier cas possible de psoriasis provoqué par la céramique causé par un implant en céramique. Méthodes: Une femme de 55 ans a reçu une prothèse céramique-sur-céramique implantée lors d'une arthroplastie totale de la hanche pour traiter l'arthrose de l'articulation de la hanche droite. Après la chirurgie, elle a développé des lésions psoriasiques dont la manifestation s'est poursuivie pendant 10 ans. Nous avons soupçonné que le psoriasis était causé par l'implant en céramique, et nous l'avons enlevé chirurgicalement. Résultats: Une fois l'implant en céramique remplacé par une prothèse articulaire en polyéthylène-sur-métal, les lésions psoriasiques ont disparu complètement. Conclusion: La pathogenèse du psoriasis demeure une énigme, bien qu'on suppose que la dérégulation de la voie de signalisation NF-κB et que la sécrétion anormale de cytokines résultante soient impliquées. Les céramiques peuvent affecter ces événements de signalisation et provoquer l'apparition du psoriasis.

scholarly journals Ligamentum teres reconstruction with labrum and capsule repair after posterior acetabular wall fracture: a case report

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. i41-i45
Author(s):  
Jacek Mazek ◽  
Maciej Gnatowski ◽  
Antonio Porthos Salas ◽  
Marcin Domżalski ◽  
Rafał Wójcicki ◽  
...  
Keyword(s):  
Hip Joint ◽  
Hip Dislocation ◽  
Ligamentum Teres ◽  
Hip Instability ◽  
Post Traumatic ◽  
The Right ◽  
Capsule Repair ◽  
Acetabular Wall

Abstract The aim of this case study is to present arthroscopic treatment of recurrent hip instability after acute post-traumatic posterior hip dislocation with a fracture of the posterior acetabular wall. A male patient aged 35 suffered a dislocation of the right hip joint with a fracture of the posterior acetabular wall due to an accident. The fracture was stabilized during emergency surgery with a locking compression plate, and the patient was released home in a hip brace. Multiple dislocations of the hip joint followed with the implant being confirmed as stable. Decision was made to qualify the patient for a right hip arthroscopy. During the surgery, ligamentum teres was reconstructed using gracilis and semitendinous muscle grafts, followed by the labrum and joint capsule repair, where the surgery that stabilized the acetabular wall fracture had damaged them. There were no complications following the procedure. Short-term follow-up of 3 months demonstrates the patient has a stable hip, reduced pain and has returned to pre-injury activities.

scholarly journals Acute right upper extremity ischemia resulting from true aneurysmof right brachial artery: A case report

2020 ◽  
Vol 12 (4) ◽  
pp. 337-340
Author(s):  
Niki Tadayon ◽  
Sina Zarrintan ◽  
Seyed Mohammad Reza Kalantar-Motamedi
Keyword(s):  
Case Report ◽  
Upper Extremity ◽  
Ct Angiography ◽  
Brachial Artery ◽  
Artery Aneurysm ◽  
True Aneurysm ◽  
Postoperative Course ◽  
Run Off ◽  
The Right ◽  
Extremity Ischemia

We report a case of 66-year-old woman with true aneurysm of the right brachial artery. She presented with acute upper extremity ischemia. The hand was cold and parenthesized and distal pulses were absent. CT angiography (CTA) revealed a 20*25 mm true brachial artery aneurysm. The aneurysm was thrombosed without distal run-off. We excised the aneurysm and reestablished the arterial flow by a reverse saphenous interposition graft. The postoperative course was uneventful.

scholarly journals An isolated pilomatricoma of the leg: a rare location – A Case Study

2021 ◽  
pp. 28
Keyword(s):  
Head And Neck ◽  
Lower Limbs ◽  
Surgical Removal ◽  
Skin Tumour ◽  
Postoperative Course ◽  
Hair Matrix ◽  
Rare Location ◽  
The Right

Pilomatricoma is a rare, benign skin tumour arising from the hair matrix. The usual locations are the head and neck. Localization in the lower limbs is exceptional. The diagnosis of certainty is histological. Treatment is complete surgical removal to avoid recurrence. We report in this article the case of a rare localization of a pilomatricoma on the right leg, in a 25-year-old patient operated with complete surgical removal. The postoperative course was simple and without recurrence after 2 months of follow-up.

scholarly journals Treatment of an extensive acetabular defect in a patient with aseptic instability of a total hip arthroplasty

2020 ◽  
Vol 27 (3) ◽  
pp. 60-66
Author(s):  
Hovakim A. Aleksanyan ◽  
Hamlet A. Chragyan ◽  
Sergey V. Kagramanov ◽  
Nikolay V. Zagorodniy
Keyword(s):  
Acetabular Component ◽  
Hip Joint ◽  
Revision Arthroplasty ◽  
Acetabular Defect ◽  
Total Arthroplasty ◽  
Total Endoprosthesis ◽  
Reconstructive Operations ◽  
Fresh Frozen ◽  
Joint Revision ◽  
The Right

The aim of the study is to demonstrate, using a clinical example, the possibility of treating a patient with a severe acetabular defect by performing a one-stage revision arthroplasty using an individual design. Materials and methods. A 45-year-old female patient was admitted with complaints of pain, limitation of movement in the right hip joint, and gait disturbance. From anamnesis at the age of 5 years, reconstructive operations of the hip joints were performed. In 1991, CITO performed primary total arthroplasty of the right hip joint with an endoprosthesis from ESKA Implants. In 1998, due to the instability of the acetabular component of the total endoprosthesis of the right hip joint, revision arthroplasty was performed, and the cup was placed with a cement fixation. In 2001, for left-sided dysplastic coxarthrosis, primary total arthroplasty of the left hip joint was performed. In 2012, due to the instability of the total endoprosthesis of the left hip joint, revision arthroplasty was performed using an ESI anti-protrusion ring (ENDOSERVICE) with a cement cup and a Zweimller-type femoral component; the femur defect was repaired using a fresh frozen cortical graft. In October 2019, instability of the total endoprosthesis of the right hip joint was revealed, for which revision endoprosthetics was performed using an individual acetabular component. Results. The HHS index before revision arthroplasty was 21 points, after 1 month after surgery 44 points, after 3 months after surgery 65, after 6 months 82. Quality of life was assessed according to the WOMAC scale: before surgery 73 points, after 1 month after surgery 54 points, after 3 months 31, after 6 months 15 points. At the time of the last consultation, the patient moves with a cane, lameness persists, associated with scar reconstruction and atrophy of the gluteal muscles. Conclusion. The use of individual structures allows to restore the support ability of the lower limb and the function of the hip joint in the case of an extensive defect of the pelvic bones of the pelvic discontinuity type.

scholarly journals Preoperative Assessment of the Feasibility of Pedicle Screw Insertion at the Proximal Thoracic Curve in Lenke Type 2 Idiopathic Scoliosis

2019 ◽  
Vol 10 (3) ◽  
pp. 261-265
Author(s):  
Yuki Taniguchi ◽  
Yoshitaka Matsubayashi ◽  
So Kato ◽  
Takashi Ono ◽  
Yasushi Oshima ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Preoperative Assessment ◽  
Japanese Patients ◽  
Minimal Distance ◽  
Screw Insertion ◽  
The Right

Study Design: Retrospective cohort study. Objectives: To investigate the feasibility of inserting pedicle screws in the proximal thoracic (PT) curve in Lenke type 2 idiopathic scoliosis, using post-myelography computed tomography (CT). Methods: Post-myelography CT images of 46 Japanese patients, 10 to 30 years old, who underwent surgery for Lenke type 2 idiopathic scoliosis were analyzed. A new parameter “SAPS” (space available for pedicle screw) was introduced, which defines the minimal distance between the lateral cortex of the pedicle and the spinal cord, with a SAPS <4.5 mm being “unacceptable.” All 460 pedicles (T2 through T6) were analyzed. Pedicle diameter was classified according to the Akazawa grading system. Results: Most pedicles on the right side at T3 (84.8%) and T4 (97.8%) were unacceptable. The unacceptable rate was 58.7% and 15.2% on the right side at T5 and T6, respectively. A larger Cobb angle of the PT curve was associated with a greater incidence of unacceptable SAPS at these levels. For a Cobb angle of the PT curve >40°, most right T5 pedicles were unacceptable. On the left side, most pedicles from T2 to T5 were acceptable. When T5 was the caudal end vertebra of the PT curve, the left T6 pedicles had an unacceptable SAPS in some cases. When the width of the pedicle channel was ≥2 mm (Akazawa grade 1 or 2), all pedicles from T2 to T6, on both sides, were acceptable. Conclusions: Post-myelography CT enabled us to clearly demonstrate the feasibility of inserting pedicle screws in the PT region.

Hip Joint Control of PGO for Paraplegics

2006 ◽  
Vol 326-328 ◽  
pp. 735-738 ◽  
Author(s):  
Sung Jae Kang ◽  
Jei Cheong Ryu ◽  
Gyoo Suk Kim ◽  
Mu Seong Mun
Keyword(s):  
Hip Joint ◽  
Joint Control ◽  
Hip Joints ◽  
Driving System ◽  
Air Supply ◽  
Air Muscle ◽  
The Right ◽  
And Control ◽  
Flexion And Extension

In this study, we developed a fuzzy-logic-controlled PGO (Power Gait Othosis) that controls the flexion and extension of each PGO joint using bio-signals and an FSR sensor. The PGO driving system works to couple the right and left sides of the orthosis by specially-designed hip joints and pelvic section. This driving system consists of the orthosis, sensor, and control system. An air supply system for muscle action is composed of an air compressor, 2-way solenoid valve (MAC, USA), accumulator and pressure sensor. The role of this system is to provide constant “air muscle” with compressed air at the hip joint. With the output signal of the EMG and foot sensors, air muscles assist the flexion of the hip joint during the PGO gait.

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