Letter Regarding: Talar Osteonecrosis After Subchondroplasty for Acute Lateral Ligament Injuries: Case Series.
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ABSTRACT:
SUBMITTER: Guzman J
PROVIDER: S-EPMC8697215 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC8697174 | biostudies-literature
Project description:Talar osteonecrosis is a well-described phenomenon following talar neck fracture, but is a rarely described complication after procedures about the foot and ankle. Here we describe the clinical course of 5 cases of talar osteonecrosis following injection of calcium phosphate into the talus (subchondroplasty) with or without acute lateral ligament repair after acute lateral ankle ligament injuries performed at an outside institution. Practitioners should be aware of this potentially devastating complication. Future research is indicated to determine the safety and efficacy of subchondroplasty for the talus.Level of evidenceLevel V, case series.
| S-EPMC8697153 | biostudies-literature
Project description:Facial skin wounds are common problems seen and treated by emergency centers around the world. Among all wounds, cat and dog bites are frequently seen. Human bite injuries are both deceptive and difficult in their presentation and management. The injuries have a disfiguration effect with possible psychological impact on the patient. The aim of this paper is to compare experience with human bites of the face in our surgical unit, with other similar trials in term of reasons for the circumstances of injuries, age, and sex of the patients, site of injury, pan-time between consultation and treatment, incidence of infection and surgical management. Data in terms of age, gender distribution, circumstances of injury, location of injuries, evolution of surgical management and complications were recorded. We report here a series of 10 cases of human bite wounds to the face, admitted to our department, and treated with different reconstruction procedures.
| S-EPMC7840440 | biostudies-literature
Project description: Not available
| S-EPMC8564926 | biostudies-literature
Project description:Background and objectivesRenal infarction is an arterial vascular event that may cause irreversible damage to kidney tissues. This study describes the clinical characteristics of patients with renal infarction according to underlying mechanism of vascular injury.Design, setting, participants, & measurementsThis study retrospectively identified 94 patients with renal infarction diagnosed between 1989 and 2011 with the aim of highlighting potential correlations between demographic, clinical, and biologic characteristics and the etiology of renal infarction. Four groups were identified: renal infarction of cardiac origin (cardiac group, n=23), renal infarction associated with renal artery injury (renal injury group, n=29), renal infarction associated with hypercoagulability disorders (hypercoagulable group, n=15), and apparently idiopathic renal infarction (idiopathic group, n=27).ResultsClinical symptoms included abdominal and/or flank pain in 96.8% of cases; 46 patients had uncontrolled hypertension at diagnosis. Laboratory findings included increase of lactate dehydrogenase level (90.5%), increase in C-reactive protein level (77.6%), and renal impairment (40.4%). Compared with renal injury group patients, this study found that cardiac group patients were older (relative risk for 1 year increase=1.21, P=0.001) and displayed a lower diastolic BP (relative risk per 1 mmHg=0.94, P=0.05). Patients in the hypercoagulable group had a significantly lower diastolic BP (relative risk=0.86, P=0.005). Patients in the idiopathic group were older (relative risk=1.13, P=0.01) and less frequently men (relative risk=0.11, P=0.02). Seven patients required hemodialysis at the first evaluation, and zero patients died during the first 30 days.ConclusionsThis study suggests that the clinical and biologic characteristics of patients can provide valuable information about the causal mechanism involved in renal infarction occurrence.
| S-EPMC3586969 | biostudies-literature
Project description:Background: With the progress of modernization, treadmill hand injury in pediatric population is taking on a global trend in recent years. The purpose of this study was to investigate the epidemiology and clinical features in a developing country, thereby providing some experience in the treatment and prevention of this particular type of injury. Methods: A 5-year retrospective review of patients with treadmill hand injury in Burn and Plastic Surgery ward at Children' Hospital of Chongqing Medical University was conducted. Demographics, injury details, therapy performed, length of hospital stay, complications, and outcome were analyzed. Results: Forty-six patients were surveyed, with a mean age of 3.5 ± 2.0 years old, including 24 males and 22 females. Injuries (77.8%) occurred between dinner to bedtime, and 95.7% happened indoors. Fingers were the most vulnerable part, of which the middle finger, ring finger, and index finger were the top three ones. The mean body surface area (BSA%) was 0.3 ± 0.2, but at least in deep dermal. Dressing changes, full-thickness skin grafts (FTSG), and Negative Pleasure Wound Therapy (NPWT) assisted FTSG were performed. The scar contracture, as the most severe complication, occurred in 26 patients, of which 22 originally received dressing changes at the time of injury. Conclusion: Treadmill hand injury in children should be highly regarded. Compared with conservative dressing changes, surgical intervention from a professional team may achieve more satisfactory prognosis and fewer complications. A prevention strategy based on "Time-Space-Person" was summarized according to its epidemiological characteristics, may help to decrease the incidence of this specific type of injury theoretically.
| S-EPMC7928388 | biostudies-literature
Project description:IntroductionThis paper describes a novel technique developed by the senior author to address acute acromioclavicular joint (ACJ) dislocations and certain distal clavicle fractures.MethodsThe procedure employs a four strand, single tunnel, double endobutton repair performed entirely percutaneously, without any arthroscopic guidance or deep surgical dissection.ResultsWe present the preliminary results from our series of 6 consecutive patients performed over a period of 18 months. The mean length of surgery was 36min (range 32-40) and the mean correction of coracoclavicular (CC) distance achieved was 12.6?mm (range 10.3-14.1). There was no restriction of movement in any of the patients post-operatively and their average QuickDASH scores at final follow-up was 4.2 (range 0-6.8).ConclusionResults in the present series were at least comparable to those for other techniques, validating percutaneous treatment as a solution for acute ACJ dislocations.
| S-EPMC6494760 | biostudies-literature
Project description:ObjectivesTo determine the diagnostic value of ultrasonography for complete discontinuity of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL) and the anterior inferior tibiofibular ligament (AITFL).MethodsAll acute ankle injuries in adult athletes (> 18 years old) presenting to the outpatient department of a specialised Orthopaedic and Sports Medicine Hospital within 7 days post-injury were assessed for eligibility. Using ultrasonography, one musculoskeletal radiologist assessed the ATFL, CFL and AITFL for complete discontinuity. Dynamic ultrasound measurements of the tibiofibular distance (mm) in both ankles (injured and contralateral) were acquired in the neutral position (N), during maximal external rotation (Max ER), and maximal internal rotation (Max IR). MR imaging was used as a reference standard.ResultsBetween October 2017 and July 2019, 92 acute ankle injuries were included. Ultrasound diagnosed complete discontinuity of the ATFL with 87% (CI 74-95%) sensitivity and 69% (CI 53-82%) specificity. Discontinuity of the CFL was diagnosed with 29% (CI 10-56%) sensitivity and 92% (CI 83-97%) specificity. Ultrasound diagnosed discontinuity of the AITFL with 100% (CI 74-100%) sensitivity and 100% (CI 95-100%) specificity. Of the dynamic measurements, the side-to-side difference in external rotation had the highest diagnostic value for complete discontinuity of the AITFL (sensitivity 82%, specificity 86%; cut-off 0.93 mm).ConclusionsUltrasound has a good to excellent diagnostic value for complete discontinuity of the ATFL and AITFL. Therefore, ultrasound can be used to screen for injury of the ATFL and AITFL. Compared with ultrasound, dynamic ultrasound has inferior diagnostic value for complete discontinuity of the AITFL.Key points• Ultrasound has a good to excellent diagnostic value for complete discontinuity of the anterior talofibular ligament (ATFL) and anterior inferior tibiofibular ligament (AITFL). • Ultrasound can be used to screen for injury of the ATFL and AITFL. • Compared with ultrasound, dynamic ultrasound has inferior diagnostic value for complete discontinuity of the AITFL.
| S-EPMC7979658 | biostudies-literature
Project description:There are few data relating to sirolimus overdose in the medical literature. Our objectives were to describe all cases of overdose with sirolimus reported to Swiss, German and Austrian Poisons Centres between 2002-2013.An observational case-series analysis was performed to determine circumstances, magnitude, management and outcome of sirolimus overdose.Five cases of acute sirolimus overdose were reported--three in young children and two in adults. Four were accidental and one was with suicidal intent. Two patients developed symptoms probably related to sirolimus overdose: mild elevation of alkaline phosphatase, fever and gastroenteritis in a 2.5-year-old male who ingested 3 mg, and mild changes in total cholesterol in an 18-year-old female after ingestion of 103 mg. None of these events were life-threatening. Serial blood concentration measurements were performed starting 24 h after ingestion of 103 mg in a single case, and these followed a similar pharmacokinetic time-course to measurements taken after dosing in the therapeutic range.Acute sirolimus overdose occurred accidentally in the majority of cases. Even large overdoses appeared to be well-tolerated, however children might be at greater risk of developing complications. Further study of sirolimus overdose is needed.
| S-EPMC4447358 | biostudies-literature
Project description:IntroductionAnkle arthrodesis is one of the managements for a significantly unstable Charcot ankle. Some of the methods of internal fixation for ankle arthrodesis include the use of intramedullary nails, screws, and plates. Ankle arthrodesis using intramedullary nails has become more popular. However, studies evaluating the use of plate fixation, particularly double posterior lateral plating, are limited. We report the clinical and radiological outcomes of double posterior lateral plating ankle arthrodesis in three diabetic Charcot ankle patients.Presentation of caseThree patients, aged 73, 67, and 65 years old, complained of ankle pain and with a history of type 2 diabetes mellitus. The physical examination revealed swelling and erythema without a sign of active infection. The radiological examination showed ankle deformity, and the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scores were 5, 10, and 0, respectively. All patients were diagnosed with a diabetic Charcot ankle and underwent ankle arthrodesis using double posterior lateral plating. Four months and six months follow up revealed talus union, improved ankle deformity, and improved AOFAS Ankle-Hindfoot scores to 70, 76, and 73, respectively.DiscussionVarious methods of ankle arthrodesis are retrograde intramedullary nails, screws, and plates. In this report, we opt for plate fixation because it allows for stable internal fixation, adequate compression, high angular stability, and a lower irreversible deformation in osteoporotic bone.ConclusionDouble posterior lateral plating ankle arthrodesis provided satisfactory clinical and radiological outcomes. This method can be an alternative for patients with Charcot ankle requiring ankle arthrodesis.
| S-EPMC8091877 | biostudies-literature