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Beijing, China

The authors report a case of a 47-year-old professional driver with an acute, simultaneous tear of patellar tendon and anterior cruciate ligament (ACL). The patient was treated in two stages. Acute patellar tendon repair and delayed (6-month postinjury) ACL reconstruction was performed. The authors discuss the possible mechanism of injury and the rationality of the two-stage surgical treatment. Source

Kerr H.-L.,Orthopaedics | Jackson R.,Kings Mill Hospital | Kothari P.,Kings Mill Hospital
Journal of Foot and Ankle Surgery | Year: 2010

This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1° ± 3.5° to 10.0° ± 3.2° and 32.1° ± 9.9° to 16.4° ± 7.9°, respectively, and these differences were statistically significant (P < .001). The mean first to second metatarsal sagittal plane length ratio was unchanged by the osteotomy (P > .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 ± 11.6 to 86.4 ± 11.6, and this difference was statistically significant (P < .0001). Of the 35 patients (36 operated feet), 20 (57.1%) were extremely satisfied, 10 (28.6%) were satisfied, and 5 (14.3%) were unsatisfied with the results of the surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus. © 2010 American College of Foot and Ankle Surgeons. Source

Trojian T.H.,Orthopaedics | Trojian T.H.,University of Connecticut
Clinics in Sports Medicine | Year: 2013

Thigh contusions are common injuries in sports, and the thigh is a very common location for sports-related muscle contusions. Treatment starts with placement of the knee in 120 of flexion for 24 hours. Nonsteroidal anti-inflammatory drugs can be detrimental to the healing if used for more than 48 to 72 hours, and glucocorticosteroids should be avoided. Early treatment with knee flexion to 120 degrees is very important, and is followed by range-of-motion exercises and advancement of activity. Early proper treatment is the key to success. Complications of myositis ossificans and compartment syndrome need to be considered. © 2013 Elsevier Inc. Source

Connolly S.,Orthopaedics
The Journal of trauma | Year: 2010

BACKGROUND: The aim of this study was to assess the outcome of immediate plate osteosynthesis in the surgical treatment of open humeral shaft fractures. METHODS: In a Level I trauma center and teaching hospital, we reviewed 53 patients with open humeral diaphyseal fractures who were treated with immediate open reduction and plate fixation from April 1988 to August 1998. Forty-six patients were available for adequate follow-up and assessment. All fractures were treated with a standard protocol that included irrigation and debridement, intravenous antibiotics, and immediate open reduction and plate fixation. Patients were assessed to determine whether bone grafts were needed during surgery, whether bone union was achieved, the state of the radial nerve, and postoperative complications. No quantitative functional outcomes were assessed, because this was beyond the scope of the study. It was hypothesized that immediate plate osteosynthesis would achieve safe and acceptable clinical results. RESULTS: The 46 patients with adequate final follow-up were assessed at a mean time of 37.5 weeks (13-156 weeks). All fractures united primarily in satisfactory angulation <5 degrees in coronal and sagittal planes. There were 6 delayed unions with a mean time to union of 42.5 weeks (30-72 weeks). The remaining 40 patients united at a mean of 18.4 weeks (12-26 weeks). No patient required subsequent surgery to obtain union of the fracture. Complications were rare, with no deep infections, nonunions, or iatrogenic nerve injuries. Complications included amputation in three patients and dysesthesia in one patient. Two patients had implants removed because of discomfort. CONCLUSIONS: Immediate plate osteosynthesis for open humeral shaft fractures has been shown to produce excellent results regarding bone union and absence of deep infections and is a safe technique in the management of these injuries. Source

Vijay V.,Indraprastha Apollo Hospital | Vaishya R.,Orthopaedics
Foot | Year: 2015

Painful lytic lesions of the foot raise a diagnostic dilemma for the foot surgeon. The localization of the lytic lesion in the mid foot is rare and isolated involvement of the calcaneo-cuboid (C-C) joint is even rarer. Early diagnosis is imperative in the mid foot to avoid rapid disease spread due to multiple venous interconnections. The diagnostic possibilities include infection, tumor (primary and metastasis), inflammatory arthritis, foreign body prick among others. The clues to rule out other differential diagnoses of lytic lesions can be history and examination, both clinical and radiographic but the gold standard for final diagnosis remains biopsy and histo-pathological examination. We describe two cases of lytic lesion around the calcaneo-cuboid joint and discuss the diagnostic dilemma. The lesions were diagnosed as tubercular in nature after histo-pathological examination of open biopsy. Both cases had complete resolution of lytic lesions and had fair functional outcome after completing the course of anti-tubercular therapy. Tuberculosis (TB) is making a worldwide resurgence due to the epidemic of HIV. In order to control this global epidemic of TB, it is important to know about all the possible presentations of the disease, including rare ones. Tuberculosis if diagnosed early in the disease course, when the pathology is localized, can result in good to fair results in the foot if adequately managed by anti-tubercular therapy. Level of evidence: V. © 2015 Elsevier Ltd. Source

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