RESUMEN
Introduction: There is a paucity of literature regarding a neglected shoulder dislocation, as it is unusual to miss it clinically due to the apparent deformity. Nevertheless, in some cases, particularly those who receive primary treatment from a local bonesetter, they may present with a neglected shoulder dislocation. In the absence of comprehensive studies, health-care professionals have to resort to lower-tier evidence and practical experience to guide their treatment decisions. Therefore, most of the treatment recommendations are based on level four studies and the literature for recurrent dislocation of the shoulder. Case Report: We have described three cases of neglected anterior dislocation of the shoulders in two patients, which were managed by open reduction, Latarjet procedure, remplissage, and rotator cuff repair. Both of our patients after 1-year follow-up had a painless joint with an improved functional range of motion. This case discussion contributes to understanding the approach to treating these patients. Conclusion: Recurrent shoulder joint instability with bone loss in the younger and older age groups has to be managed differently. Based on this case report involving individuals older than 50 years, it can be inferred that the approach to managing neglected locked shoulder dislocations with off-track lesions is with open reduction and fixation with Latarjet procedure, coupled with RCR and remplissage, has yielded adequate joint stability and favorable post-operative outcomes.
RESUMEN
Introduction: Securing stable internal fixation for fractures in osteoporotic intra-articular distal femur proves to be a demanding task due to thin cortices, a wide medullary canal, diminished bone stock, and fracture comminution. No singular therapeutic approach has successfully tackled all facets of this injury. Consequently, we now introduce a pioneering fixation method in our report, aiming to offer a holistic solution to the intricate challenges associated with this scenario. Case Report: A 60-year-old female presented with an intra-articular distal femur fracture, and underwent a combination fixation of distal femur plate and intramedullary interlocking nailing. The patient was rehabilitated with active knee range of motion on post-operative day 7 and has now attained full knee range of motion. Conclusion: The utilization of anatomical plates with locking mechanisms, in tandem with intramedullary interlocking nailing, holds promise for the secure stabilization and fixation of osteoporotic distal femur fractures, potentially leading to an expedited recovery process.
RESUMEN
Introduction: The femoral neck system (FNS) represents an emerging fixation system designed for the management of femoral neck fractures. This innovative system combines the mechanical benefits of compression and anti-rotation properties in internal fixation. Biomechanical studies have demonstrated the superior axial and rotational stability of the FNS implant when compared to traditional cannulated screws and dynamic hip screw. Despite these promising mechanical advantages, there is currently a limited body of literature addressing the factors contributing to FNS failure. A thorough assessment of the safety and outcomes associated with this novel implant is essential. Case Report: In this context, we present three cases wherein FNS failure occurred, aiming to elucidate the potential causes behind these failures, and had to undergo either an implant removal or bipolar hemiarthroplasty. Conclusion: While considering the femoral neck system as the implant of choice, we should consider the age, injury to surgery time, and the location of the fracture line. However, we cannot conclusively ascertain whether age contributes independently to the risk of failure.
RESUMEN
Introduction: Distal pole of patella avulsion fracture with tibial tuberosity avulsion has been frequently reported as a bifocal patellar tendon injury. However, an osteochondral lateral patella facet fracture with a longitudinal split in the patella tendon in addition to these avulsion fractures has never been documented previously. Hence, we now report this trifocal patellar tendon injury. Case Report: An adolescent with a trifocal patella tendon injury underwent a fixation with a combination of transosseous pull- through sutures, suture tape, and knotless anchor. The patient was rehabilitated with gradual increase in 30° of knee flexion weekly and has now attained full knee range of motion. Conclusion: Fixation of the small avulsion fracture can be challenging using conventional methods such as cannulated cancellous screws especially in an immature skeleton as it can crush the fragments. Suture tape, transosseous tunnels, and knotless suture anchors have more flexibility, they avoid the physis and provide adequate strength in such situations compared to metallic implants.