International Journal of Case Reports in Orthopaedics

Journal Information
ISSN / EISSN : 2707-8345 / 2707-8353
Published by: AkiNik Publications (10.22271)
Total articles ≅ 112
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Gyneshwar Tank, Sumit Agarwal, Kalom Jamoh
International Journal of Case Reports in Orthopaedics, Volume 4, pp 09-13; https://doi.org/10.22271/27078345.2022.v4.i2a.115

Abstract:
Osteochondroma is the most common form of benign bone tumors. Chondrosarcoma is a rare malignant bone tumor that may be primary or secondary. We report the case of a 19-year-old man with low grade chondrosarcoma secondary to malignant transformation of osteochondroma of the right distal femur. Here we discuss osteochondroma, chances of malignancy secondary to osteochondroma, chondrosarcoma, work up done in our case, histopathological features to differentiate osteochondroma from low grade chondrosarcoma, as well as treatment options that have shown significant benefits in patient’s outcomes.
LaTrice Johnson, Sabrina Aaron, Regan Burgess, Rolanda Willacy, Damirez Fossett
International Journal of Case Reports in Orthopaedics, Volume 4, pp 21-23; https://doi.org/10.22271/27078345.2022.v4.i2a.118

Abstract:
Acute transverse myelitis (ATM) is an inflammatory disease of the spinal cord, characterized by rapid onset of bilateral neurological symptoms. The term myelitis refers to inflammation of the spinal cord, which often leads to demyelination. The clinical finding of a pattern of altered sensation is often a horizontal band-like sensation at the dermatomal level of the lesion, with sensory changes below. The symptoms usually develop over hours to days; they typically present as muscle weakness, ascending paralysis, and autonomic dysfunction. Recovery is variable, but often prolonged over many months, and can lead to a wide range of deficits.1 Our report reviews a unique case of transverse myelitis in a patient with Lyme disease. A 27 year old male presented to the emergency department with past medical history of diabetes mellitus and hyperlipidemia with a week long history of fever to 102℉, non-productive cough, nausea, and decreased motor function and sensation in the bilateral lower extremities. Strength was intact in bilateral biceps, triceps, and wrists, but diminished in bilateral hips, knees, and ankles. Sensation to light touch was diminished from the level of T8 and below, fine touch sensation diminished from the level of T10 and below, and there was diminished proprioception in bilateral toes. There was intact pain sensation in all extremities and hyperreflexia in bilateral upper extremities. An MRI was obtrained which demonstrated cervical syrinx with expansion of the spinal cord and resultant cervical stenosis with cord compression indicating need for surgical intervention. A posterior cervical decompressive laminectomy at levels C4-C7 and posterior thoracic decompressive laminectomy at level T1 were scheduled, with a subsequent lumbar puncture. Serum findings were significant for elevated Lyme disease antibody titer (7.89) and antibody reaction to 8 borrelial proteins. After detection of Lyme disease, the patient was started on antibiotics. Over the course of the hospital stay, motor function continually improved with the aid of physical therapy. Sensation also significantly improved. Lyme disease may not always be identifiable with CSF collection from lumbar puncture, and as a result the etiology of ATM may go unknown. Guillain-Barre syndrome is a common differential which has a similar presentation. However, the treatment consists of plasmapheresis and immunoglobulin. This is an important distinction in order to to provide the appropriate treatment modalities to the patient.
Ranjith Kumar, Narender Saini, Ds Meena
International Journal of Case Reports in Orthopaedics, Volume 4, pp 14-16; https://doi.org/10.22271/27078345.2022.v4.i2a.116

Abstract:
Penetrating trauma is an injury caused by a foreign object piercing the skin and damaging the underlying tissues and results in an open wound. The most common cause of such trauma are gun shots, explosive devices and stab wounds. These penetrating injuries if neglected can result in various complications like neurovascular compromise, flexor or extensor tendon injuries, ischemic changes, infection and it can even go for compartment syndrome. Here we report a case of accidental penetrating injury to forearm by wooden stick and the proper timely intervention in removing it and make limb salvageable. We have removed it by supraclavicular block with the tourniquet and proper lazy S incision and so that preserving the neurovascular structures which was just close to it along with repairing the flexor muscles of the forearm. We report here a case with accidental penetrating injury to forearm by wooden stick. A 35year-old male patient presented with history of pain and swelling in his right forearm occurs after an accident. There was an entry wound on radial side of forearm around 3×4 cm and an exit wound of 3×3 cm with wooden stick in situ. A detail history and careful examination is needed.
Tjm Wetzels
International Journal of Case Reports in Orthopaedics, Volume 4, pp 04-08; https://doi.org/10.22271/27078345.2022.v4.i2a.114

Abstract:
Fingertip injuries are frequently seen and there are many treatment options. Small defects with limited exposure of the bone can be treated conservatively with healing by secondary nature. Good results can be achieved with standard dressings or a semi-occlusive dressing. With larger defects, surgical treatment is needed. Local advancement flaps can be used when there is sufficient local tissue. If this is not present, a pedicle flap or tissue transfer is needed. The non-microsurgical refixation of the amputated part as a composite graft yields excellent results in children. It is, however, not frequently used in adults, due to the less favourable results. In this case report, an Allen type III fingertip amputation was successfully treated by non-microsurgical re-fixation of the amputated fingertip. At final follow up, 18 months after injury, there was a satisfactory aesthetic and functional result. Although smaller in size, the fingertip resembled the other fingers with normal nail growth. Sensibility had recovered moderately and cold intolerance was present. However, the patient was very satisfied with the result and did not experience any limitations during daily activities.In conclusion, the use of a composite graft in Allen type III fingertip injuries is a viable option in selected cases.
Rushikesh Vilas Ghongade, Chaitanya Chikhale, Ganesh Pundkar, Rajendra Baitule
International Journal of Case Reports in Orthopaedics, Volume 4, pp 01-03; https://doi.org/10.22271/27078345.2022.v4.i2a.113

Abstract:
Giant cell tumor is a relatively rare neoplasm. In GCT the axial skeleton is extremely rarely involved. Most GCT arises in the meta-epiphyseal ends of the long bones. Peak incidence is between 30 to 40 years of age. GCT is usually classified as benign, but shows aggressive behavior and occasionally undergo transformation to malignancy. The patients with GCT in the spine often complain of the lower back pains, as the tumors primarily involve the sacrum. We report a case of an adolescent female complaining of the upper back pain with a sudden weakness of the lower extremities, later diagnosed with the GCT of the D8 vertebra. The present patient was operated using posterior lateral approach of spine and proper rehabilitation was done. Subsequent follow up revealed improvement in carrying out her daily activities.
Hendawy Ahmed, Al Sawafi Saleh
International Journal of Case Reports in Orthopaedics, Volume 4, pp 17-20; https://doi.org/10.22271/27078345.2022.v4.i2a.117

Abstract:
In situ fixation of SCFE is the widely accepted treatment for both stable and unstable SCFE. Prophylactic fixation of the contralateral hip remains controversial. There is still no agreement about the removal of the screws in the absence of implant-related symptoms.The case A case of a slipped capital femoral epiphysis SCFE in an adolescent with Dravet Syndrome after a seizure attack. To the best of our knowledge, this is the first report worldwide about the presentation of SCFE in Dravet syndrome.Dravet syndrome is severe myoclonic epilepsy in infancy. Cases of SCFE after epileptic fit need more studies and long-term follow-up to understand the pathophysiology and consequences of treatment.Lessons learntThis rare case needs more follow-up till adulthood. Possible complications and further management are challenging culprits. Children presented with SCFE after epileptic fit, withdraw special attention. However, there is a lack of knowledge in the literature about their natural history & long-term follow-up.
Chandan Shetty
International Journal of Case Reports in Orthopaedics, Volume 4, pp 163-166; https://doi.org/10.22271/27078345.2022.v4.i1c.112

Abstract:
Introduction: Technical difficulties in managing a case of transcervical femur fracture in post-polio residual paralysis patient with dysplastic femur. Case Report: We present a case of a 66 year male with Post-Polio residual Paralysis walking with Hand to knee gait who sustained a transcervical Femur fracture. The difficulties faced in this case were narrow medullary canal, coxa valgus, dysplastic greater trochanter, hypoplastic lesser trochanter, Shallow acetabulum, inability to compare the length after insertion of trial implant with the opposite limb due to underdeveloped and shortened affected limb.Conclusion: We try to emphasise on the preoperative preparations that need to be done in terms of CT scan with pre operative estimation of canal diameter, keeping a back-up of an array of implants including CDH hip stems, technique of measuring the vertical and horizontal offset before neck osteotomy and extraction of the head and recreating the offset after implantation, increased anteversion of the hip to prevent dislocation due to shallow acetabulum, and proper closure of the capsule.
Tathagata Bose, Anirban Chatterjee, Vikash Kapoor, Ejaz Bari
International Journal of Case Reports in Orthopaedics, Volume 4, pp 132-135; https://doi.org/10.22271/27078345.2022.v4.i1b.105

Abstract:
Peroneal Intraneural Ganglion Cyst is a rare condition that only a few cases have been reported in the literature. A 55 years old middle aged Lady presented at our Outpatient Department with complaints of pain over lateral aspect of right knee and leg for the last 1 month. She also complained about the inability to extend the ankle and the toes for 1 week. No recent history of trauma was there. She has been complaining about tingling and Numbness over right foot for the last 1 month. Because of its radiological appearance and atypical clinical course, the lesion was diagnosed as Peroneal Intraneural ganglion Cyst. This 55 years old female patient, with no history of comorbidities, with above mentioned complaints, initially was managed elsewhere with conservative management. Referred to Orthopaedic surgeon for further management. After all necessary investigations, was planned for definitive management, which was Decompression of the Common peroneal nerve along with Neurolysis, Ganglion Cyst dissected and Disarticulation of proximal Tibio Fibular Joint.
Cory Kim, David Carrier
International Journal of Case Reports in Orthopaedics, Volume 4, pp 103-106; https://doi.org/10.22271/27078345.2022.v4.i1b.104

Abstract:
One of the most common causes of groin pain in older patients is hip joint arthritis. We present 2 patients in their 60’s with severe groin pain consistent with iliopsoas bursitis and mild hip joint arthritis. Co-existing iliopsoas bursitis in the setting of mild hip joint arthritis is a rare finding and this created diagnostic and therapeutic challenges. Medical records, imaging studies, and surgeries for 2 patients were reviewed. Both patients underwent ultrasound guided steroid aspirations and injections into both their iliopsoas bursa and hip joints yielding little benefit. Within several months both patients had radiographic progression of their degenerative arthritis leading to total hip replacement with relief of all symptoms. Coexisting iliopsoas bursitis and mild hip joint arthritis has not been widely reported in the literature. We propose that iliopsoas bursitis can be an early indicator for advancing hip osteoarthritis.
Mobeen Khalid Qureshi, Qaisar Akhlaq Choudhry
International Journal of Case Reports in Orthopaedics, Volume 4, pp 01-03; https://doi.org/10.22271/27078345.2022.v4.i1a.84

Abstract:
We present a case of a 54-year-old patient with high body mass index (BMI) who presented with a traumatic knee dislocation with an associated popliteal artery occlusion after the patient’s partner fell onto the affected patients’ leg. This led to the patient requiring an urgent reduction in the emergency department (ED), followed by external fixation in theatre with popliteal artery bypass. This case highlights the importance of early recognition of vascular compromise and early reduction in the ED followed by relevant imaging.
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