RESUMEN
Infection in a clavicle fracture is uncommon, but remains a challenging problem. A paucity of soft tissue coverage often combined with significant displacement and interfragmentary movement add complexity to an already difficult situation for effective infection treatment. External fixation in principle offers a means of achieving fracture stability, while the infection is being eradicated. We present the case of a closed clavicle fracture, initially treated conservatively, that presented 5â weeks later with infection. The fracture was definitively treated with external fixation using a locking plate positioned superficially to the skin, plus negative pressure wound therapy and subsequent secondary closure and antibiotic therapy. This case illustrates a novel method of treatment in this unusual presentation that was well tolerated by the patient and resulted in a good clinical outcome.
Asunto(s)
Clavícula/lesiones , Fijación Interna de Fracturas/métodos , Fracturas Cerradas/cirugía , Terapia de Presión Negativa para Heridas/métodos , Infección de la Herida Quirúrgica/cirugía , Adulto , Placas Óseas , Humanos , Masculino , Resultado del TratamientoRESUMEN
Protrusio acetabuli is an uncommon complication of total hip arthroplasty, which results in intrapelvic implant migration after erosion of medial acetabular wall. We present a case of severe prosthetic migration with the formation of haematoma and impingement on iliac vessels leading to thrombosis and subsequent pulmonary embolus. This is the first reported case of protrusio acetabuli as a cause of pulmonary embolus.
Asunto(s)
Artroplastia de Reemplazo de Cadera/efectos adversos , Migración de Cuerpo Extraño/complicaciones , Prótesis de Cadera/efectos adversos , Pelvis , Embolia Pulmonar/etiología , Acetábulo , Anciano , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/etiología , Femenino , Migración de Cuerpo Extraño/diagnóstico por imagen , Humanos , Arteria Ilíaca , Vena Ilíaca , Imagen Multimodal , Falla de Prótesis/efectos adversos , Embolia Pulmonar/diagnóstico por imagen , Reoperación , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Groin pain post-total hip arthroplasty (THA) is of concern for the patient and the surgeon, especially when there is no history of any traumatic event. Obvious concern centres on complications from the prosthesis. The use of multiple imaging modalities allow for accurate diagnosis of groin pain. Atraumatic iliopsoas rupture is rare and has only been reported once before in the setting of THA. We present the case of 53-year old female with atraumatic rupture of the iliopsoas tendon that presented with severe groin pain and limited flexion. We discuss the clinical presentation, radiological features and follow-up of the patient. We also discuss the relevant published literature on the topic. This is a rare phenomenon but should be consider in patients with groin pain post-THA, especially after prosthesis complications have been ruled out.
Asunto(s)
Artroplastia de Reemplazo de Cadera/efectos adversos , Ingle/patología , Dolor/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Músculos Psoas/diagnóstico por imagen , Traumatismos de los Tendones/diagnóstico por imagen , Tendones/diagnóstico por imagen , Antiinflamatorios no Esteroideos/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Dolor/etiología , Modalidades de Fisioterapia , Complicaciones Posoperatorias/fisiopatología , Músculos Psoas/patología , Traumatismos de los Tendones/fisiopatología , Traumatismos de los Tendones/terapia , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We report a case of a 73-year-old lady with transitional cell carcinoma and no evidence of metastatic disease presenting with gradual weight loss, pretibial swelling and painful weightbearing. Investigations revealed a lesion of the right tibial diaphysis. The radiological and clinical appearance was that of primary osteosarcoma. Biopsy results revealed metastatic transitional cell carcinoma of the tibia. Intramedullary nailing was performed which relieved pain on weightbearing. The patient declined radiotherapy and was started on a palliative care regimen. This case illustrates the importance of histological diagnosis in the treatment of diaphyseal lesions.
Asunto(s)
Neoplasias Óseas/secundario , Carcinoma de Células Transicionales/secundario , Osteosarcoma/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía , Anciano , Biopsia con Aguja , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/cirugía , Carcinoma de Células Transicionales/cirugía , Diagnóstico Diferencial , Femenino , Fijación Intramedular de Fracturas/métodos , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética/métodos , Osteosarcoma/diagnóstico , Tomografía de Emisión de Positrones/métodos , Radiografía , Medición de Riesgo , Tibia/diagnóstico por imagen , Tibia/patología , Tibia/cirugía , Resultado del TratamientoRESUMEN
We present a 23-year-old man who sustained an isolated fracture of the lateral process of the talus (LPT) in a head-on vehicle collision at a combined speed of 200 km/h. The driver of the other vehicle sustained fatal injuries at the scene. The LPT was openly reduced and fixed with successful outcome at 3 months. This case is unusual in the method of injury, in particular in relation to the isolated relatively minor injury sustained.