Rehabilitation, initiated after the surgery, included a phased increment in knee range of motion (ROM) and weight-bearing. Subsequent to five months of postoperative rehabilitation, he regained the ability to independently move his knee yet experienced residual stiffness, prompting the need for arthroscopic adhesiolysis. The patient's six-month follow-up assessment demonstrated no pain and a return to their normal activities, including a knee range of motion of 5 to 90 degrees.
This article showcases a singular and uncommon type of Hoffa fracture, absent from existing classifications. Management of implants and the associated post-operative rehabilitation poses a significant hurdle due to a lack of consensus on the ideal course of action. For achieving the optimal post-operative knee function, the ORIF approach presents the best possible outcome. In order to stabilize the sagittal fracture component, a buttress plate was applied in our surgical procedure. Soft-tissue and/or ligamentous injury may complicate post-operative rehabilitation. The morphology of the fracture is crucial for determining the optimal choices for the approach, technique, implant, and rehabilitation protocol. Close monitoring and rigorous physiotherapy are critical to maintaining a full long-term range of motion, ensuring patient satisfaction and enabling a successful return to pre-injury activity.
A unique and rare Hoffa fracture subtype, not depicted in existing classifications, is the focus of this article. Management of implants and the subsequent rehabilitation process are fraught with difficulty, as no single approach is widely considered optimal. Optimal post-operative knee function is best achieved with the ORIF procedure. IMT1 Our approach involved utilizing a buttress plate to stabilize the fracture component in the sagittal plane. IMT1 Complications in post-operative rehabilitation can arise from soft-tissue and/or ligamentous injury. The morphological features of the fracture dictate the selection of the appropriate surgical approach, implant, technique, and post-operative rehabilitation program. Thorough physiotherapy, consistently followed up, is essential to maintain a substantial long-term range of motion, ensuring patient contentment and a successful return to normal activity.
The global COVID-19 pandemic's initial and subsequent effects have had widespread repercussions on many people. Steroid-related complications, particularly femoral head avascular necrosis (AVN), arose as a consequence of employing high-dose steroids in the treatment.
This case study illustrates bilateral femoral head avascular necrosis (AVN) in a patient with sickle cell disease (SCD) due to COVID-19 infection, with no prior history of steroid use.
This report showcases a case where COVID-19 infection potentially led to avascular necrosis (AVN) of the hip joint in a sickle cell disease (SCD) patient, prompting further research and heightened awareness.
Through this case report, we hope to raise awareness regarding a possible association between COVID-19 infection and avascular necrosis of the hip in patients suffering from sickle cell disease.
Wherever fatty tissue is concentrated, fat necrosis can potentially arise. The aseptic saponification of the fat by the action of lipases leads to this. In most cases, the affected area is the breast.
The orthopedic outpatient department's records show a 43-year-old female patient presenting with a history of a mass on each buttock. In the patient's history, a year prior, a surgical excision of an adiponecrotic mass from their right knee was recorded. The three masses presented themselves concurrently. A left gluteal mass was surgically excised via ultrasonography. The pathology report, generated from the excised mass, confirmed the diagnosis of subcutaneous fat necrosis.
Fat necrosis, a condition, may also manifest in the knee and buttocks, its origin unexplained. The diagnostic process frequently benefits from both imaging procedures and biopsies. One must possess a profound understanding of adiponecrosis in order to differentiate it from other serious conditions, including cancer, that it can mimic.
Fat necrosis, an enigmatic condition, can be found in the knee and buttocks. Imaging examinations and biopsies can aid in the process of diagnosis. Differentiating adiponecrosis from other grave conditions, particularly cancer, requires a comprehensive understanding of adiponecrosis.
Unilateral radiculopathy is the classic indication of foraminal stenosis. Instances of bilateral radiculopathy where foraminal stenosis is the only contributing factor are uncommon. Five patients presenting with bilateral L5 radiculopathy, solely caused by L5-S1 foraminal stenosis, are presented. A detailed exploration of both clinical and radiological characteristics follows.
Two of the five patients were male, and the remaining three were female, having an average age of 69 years. Four patients, having previously undergone surgery, were at the L4-5 level. The postoperative period witnessed an improvement in the symptoms of all patients. A certain time elapsed before patients began experiencing pain and a deficiency of sensation in both legs. Two patients experienced a secondary surgical procedure; nevertheless, no positive change in their symptoms occurred. Over a period of three years, a patient who did not have surgery was treated non-surgically. Before their initial visit to our hospital, all patients had been experiencing symptoms affecting both lower limbs. These patients exhibited neurological signs indicative of bilateral L5 radiculopathy. In the pre-operative assessment, the average score on the Japanese Orthopedic Association (JOA) scale was 13 out of a possible 29 points. Bilateral foraminal stenosis at the L5-S1 level was ascertained by means of a three-dimensional magnetic resonance imaging or computed tomography procedure. One patient benefited from a posterior lumbar interbody fusion, while four patients had bilateral lateral fenestrations performed, following the Wiltse approach. The surgery brought about a quick and full recovery from the neurological symptoms. Following two years of observation, the average JOA score amounted to 25 points.
Foraminal stenosis pathology may be underappreciated by spine surgeons, especially when patients also exhibit bilateral radiculopathy. To correctly diagnose bilateral foraminal stenosis at the L5-S1 level, one must possess a firm grasp of the symptomatic lumbar foraminal stenosis's clinical and radiological features.
Patients with bilateral radiculopathy could present a situation where the pathology of foraminal stenosis might be overlooked by spine surgeons. To correctly diagnose bilateral foraminal stenosis at the L5-S1 level, one must be well-versed in the clinical and radiological aspects of symptomatic lumbar foraminal stenosis.
This paper showcases a delayed presentation of deep peroneal nerve symptoms following total hip arthroplasty (THA), which successfully resolved after seroma removal and a decompression of the sciatic nerve. Although THA-related hematoma formation causing deep peroneal nerve symptoms has been noted in the medical literature, no instances of seroma-induced similar symptoms have been previously reported.
A 38-year-old woman who had undergone a straightforward primary total hip replacement exhibited paresthesia in the lateral leg and foot drop beginning on postoperative day seven. Subsequent ultrasound imaging identified a fluid collection that was compressing the sciatic nerve. Seroma evacuation and sciatic nerve decompression were performed on the patient. In the postoperative clinic at the 12-month mark, the patient had successfully regained active dorsiflexion and experienced only slight instances of paresthesia restricted to the dorsal lateral region of their foot.
Operative treatment initiated early in patients with diagnosed fluid collections and an escalation in neurological impairment can produce positive outcomes. This case stands out due to the absence of any similar reported cases of seroma formation causing deep peroneal nerve palsy.
Intervention through surgery, performed promptly on patients with diagnosed fluid buildup and worsening neurological conditions, can produce favorable results. This case is exceptional, with no prior reports of seroma formation leading to deep peroneal nerve palsy.
Elderly patients exhibiting bilateral femoral neck stress fractures represent a relatively uncommon clinical scenario. The difficulty in diagnosing these fractures often stems from inconclusive radiographs. Early diagnosis, facilitated by a high index of suspicion, and subsequent management can minimize the occurrence of further complications in this age range. We present three elderly patients with differing underlying causes for their fractures within a detailed case series, discussing the chosen treatment options.
These case series document three elderly patients with bilateral neck of femur fractures, each showcasing a distinct set of predisposing factors. Risk factors identified in these patients included Grave's disease, or primary thyrotoxicosis, as well as steroid-induced osteoporosis and renal osteodystrophy. Biochemical testing for osteoporosis in these patients uncovered marked deviations in vitamin D, alkaline phosphatase, and serum calcium. One patient's care included the execution of hemiarthroplasty and osteosynthesis, accomplished by means of percutaneous screw fixation on the opposite side. The patients' prognosis was meaningfully improved through the careful management of osteoporosis, coupled with dietary modifications and lifestyle changes.
Simultaneous bilateral stress fractures in the elderly, while infrequent, are preventable with the right focus on managing their underlying risk factors. Given the occasional inconclusive radiographic results in these fracture scenarios, a high degree of suspicion should remain. IMT1 Due to advancements in diagnostic tools and surgical approaches, a positive prognosis is often anticipated when intervention is provided expeditiously.
Simultaneous bilateral stress fractures in the elderly are unusual, and their occurrence can be prevented by appropriately addressing the associated risk factors.