RESUMEN
Anterior shoulder dislocations following an epileptic event are considered rare. An extremely rare case of a 41 year old female suffering from bilateral anterior shoulder dislocation with concomitant greater tuberosities fractures after an epileptic seizure is presented. The patient presented to the out-patient orthopaedic clinic due to persistent pain and restriction of shoulders movement, 4 weeks after an epileptic seizure. Clinical examination and radiological evaluation established the diagnosis of bilateral anterior shoulder dislocation with concomitant greater tuberosities fractures. Closed reduction was performed under general anesthesia. There are 12 such cases in the literature, including the present one. Thirty percent of these cases had a delayed diagnosis. It is of paramount importance to have a high clinical suspicion for myoskeletal injuries and especially for shoulder dislocations following an epileptic episode, even in the absence of a traumatic event.
Asunto(s)
Convulsiones , Luxación del Hombro , Fracturas del Hombro , Adulto , Femenino , Humanos , Convulsiones/complicaciones , Luxación del Hombro/complicaciones , Fracturas del Hombro/complicacionesRESUMEN
BACKGROUND: Graft choice for anterior cruciate ligament (ACL) reconstruction is of critical importance. Various grafts have been used so far, with autografts long considered the optimal solution for the treatment of ACL-deficient knees. Limited data are available on the long-term survivorship of synthetic grafts. PURPOSE: To compare the functional outcome and survivorship of ACL reconstructions performed using the LARS (ligament augmentation and reconstruction system) ligament and the ABC (active biosynthetic composite) purely polyester ligament. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The results of 72 patients who underwent primary arthroscopic ACL reconstruction with the LARS ligament and 31 cases with an ABC purely polyester ligament were reviewed. The mean follow-up periods for the LARS and ABC groups were 9.5 and 5.1 years, respectively. A survivorship analysis of the 2 synthetic grafts was performed using the Kaplan-Meier method with a log-rank test (Mantel-Cox, 95% CI). Lysholm, Tegner activity, Knee injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) scores as well as laxity measurements obtained using a KT-1000 arthrometer were recorded for all intact grafts, and a Mann-Whitney U test was used for comparison reasons. RESULTS: The rupture rates for LARS and ABC grafts were 31% (95% CI, 20%-42%) and 42% (95% CI, 25%-59%), respectively. For intact grafts, the mean Lysholm score was good for both groups (90 for the LARS group and 89 for the ABC group), with the majority of patients returning to their preinjury level of activities, and the mean IKDC score was 90 for the LARS group and 86 for the ABC group. CONCLUSION: The rupture rates of both LARS and ABC grafts were both high. However, the LARS ligament provided significantly better survivorship compared with the ABC ligament at short- to midterm follow-up (95% CI).
RESUMEN
We report a case of lipomatosis of the sciatic nerve, also known as lipofibromatous hamartoma. A male, 26-year-old, presented with gait impairment, leg pain, and foot drop compatible with sciatic nerve's compression. The preoperative magnetic resonance imaging (MRI) revealed diffuse thickening of the proximal third of the sciatic nerve with adipose tissue interspersed among the nerve fascicles. Internal neurolysis was performed with microsurgical techniques under high magnification. The patient was followed up for a period of 34 months. He significantly recovered, and there was no clinical recurrence of the tumor.