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Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg： a rare case and its management principles

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Chinese Journal of Traumatology 2011年第3期14卷 183-187页

作者： Ramesh Kumar Sen Sujit Kumar Tripathy Vibhu Krishnan tarun goyal Vanyambadi Jagadeesh Department of Orthopedics Postgraduate Institute of Medical Education and Research Chandigarh 160012 India

This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracturedislocations of the left hip （Pipkin＇s type IV） and knee （Moore II）joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin＇s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no insta-bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

关键词： Hip dislocation Knee dislocation Fractures bone

Limb length discrepancy after total knee arthroplasty: A systematic review and meta-analysis

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World Journal of Clinical Cases 2021年第2期9卷 357-371页

作者： Sujit Kumar Tripathy Siddharth Satyakam Pradhan Paulson Varghese Prabhudev Prasad Purudappa Sandeep Velagada tarun goyal Bijnya Birajita Panda Jagadeesh Vanyambadi Department of Orthopaedics All India Institute of Medical SciencesBhubaneswar 751019OdishaIndia Department of Orthopedics VA Boston Health careBostonMassachusetts 02130United States Department of Orthopaedics All India Institute of Medical SciencesBathinda 209201India Department of Ophthalmology SCB Medical CollegeCuttack 751019India Department of Orthopaedics Salford Royal NHS Foundation TrustSalford M68HDUnited Kingdom

BACKGROUND Limb length discrepancy(LLD)after total knee arthroplasty(TKA)has been considered as one of the reasons for the unsatisfactory ***,there is no consensus about the extent of LLD that can be considered as clinically *** To evaluate the incidence of radiographic LLD and its impact on functional outcome following *** All randomized-controlled trial and observational studies on LLD in TKA,published till 22nd June 2020,were systematically searched and *** primary outcome was“limb lengthening or LLD after TKA”.The secondary outcomes included“assessment of LLD in varus/valgus deformity”and“impact of LLD on the functional outcome”.RESULTS Of 45 retrieved studies,qualitative and quantitative assessment of data was performed from eight studies and six studies,*** studies(n=1551)reported the average limb lengthening of 5.98 *** LLD after TKA was ranging from 0.4±10 mm to 15.3±2.88 *** incidence of postoperative radiographic LLD was reported in 44%to 83.3%of *** was no difference in the preoperative and postoperative LLD(MD-1.23;95%CI:-3.72,1.27;P=0.34).Pooled data of two studies(n=219)revealed significant limb lengthening in valgus deformity than varus(MD-2.69;95%CI:-5.11,0.27;P=0.03).The pooled data of three studies(n=611)showed significantly worse functional outcome in patients with LLD of≥10 mm compared to<10 mm(standard MD 0.58;95%CI:0.06,1.10;P=0.03).CONCLUSION Limb lengthening after TKA is common,and it is significantly more in valgus than varus *** LLD(≥10 mm)is associated with suboptimal functional outcome.

关键词： Arthroplasty Knee Replacement Limb length Joint diseases Surgery

Multiple floating metatarsals： a unique injury

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Chinese Journal of Traumatology 2013年第2期16卷 110-112页

作者： Vivek Trikha tarun goyal Amit K. Agarwal Department of Orthopaedics Jai Prakash Narayan Apex Trauma Centre All India Institute of Medical Sciences New Delhi 110029 India

Concomitant dislocation of the tar- sometatarsal and metatarsophalangeal joints of foot is an extremely rare injury. Such injuries presenting in a single or adjacent dual rays have been described in few cases previously. We describe such an injury in adjacent three metatarsals of a polytrauma patient. These injuries are likely to be missed in the initial assessment of a polytrauma patient. These patients are at risk of an overlooked diagnosis but the consequences of missing this type of injury may be quite severe. This case is presented in view of its unique- ness along with possible mechanism of injury, the sequence of reduction and follow-up. Knowledge of such injury and its proper management may be useful to the trauma surgeons

关键词： Metatarsal bones Metatarsophalangealjoint Wounds and injuries

Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture

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Chinese Journal of Traumatology 2011年第2期14卷 104-106页

作者： Vivek Trikha tarun goyal Ram K. Jha Department of Orthopaedics Jai Prakash Narayan Apex Trauma Centre All india Institute of Medical Sciences New Delhi 110029 India

Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.

关键词： Trauma Hip dislocation Femoral neck fractures

Rare case of chronic Q fever myocarditis in end stage heart failure patient:A case report

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World Journal of Cardiology 2022年第9期14卷 508-513页

作者： Amandeep goyal tarun Dalia Poonam Bhyan Hassan Farhoud Zubair Shah Andrija Vidic Department of Cardiovascular Medicine University of Kansas Medical CenterKansas CityKS 66160United States Department of Internal Medicine Cape Fear Valley HospitalFayettevilleNC 28304United States School of Medicine University of Kansas Medical CenterKansas CityKS 66160United States

BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella *** is associated with significant morbidity and mortality if left *** studies have reported myocarditis in patients with acute Q *** present the first case of chronic myocarditis in an end-stage heart failure patient with chronic Q fever *** SUMMARY A 69-year-old male was admitted with dyspnea on exertion,hypotension and bilateral lower extremity edema for a few *** has a past medical history of ischemic cardiomyopathy with left ventricular ejection fraction of 25%,implantable cardioverter defibrillator in place,bioprosthetic aortic valve and mitral valve *** continued to have shortness of breath despite diuresis along with low grade *** infectious work up came back *** further questioning,the patient was found to have close contact with farm animals and the recurrent fevers prompted the work-up for Q fever.Q fever serologies and cardiac positron emission tomography confirmed the diagnosis of chronic Q fever *** was then successfully treated with doxycycline and hydroxychloroquine for 18 *** Chronic Q fever myocarditis,if left untreated,carries a poor *** should be kept in differentials,especially in patients with recurrent fevers and contact with farm animals.

关键词： Chronic Q fever Myocarditis Coxiella burnetii Heart failure Farm animals Case report

Early and aggressive presentation of wild-type transthyretin amyloid cardiomyopathy:A case report

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World Journal of Cardiology 2022年第12期14卷 657-664页

作者： Ilham Boda Hassan Farhoud tarun Dalia Amandeep goyal Zubair Shah Andrija Vidic Department of Internal Medicine University of Kansas Medical CenterKansas CityKS 66160United States School of Medicine University of Kansas Medical CenterKansas CityKS 66160United States Department of Cardiovascular Medicine University of Kansas Medical CenterKansas CityKS 66160United States

BACKGROUND Wild-type transthyretin amyloidosis(ATTRwt)is the most common form of transthyretin amyloid cardiomyopathy,occurring mostly over age of 60 years(mean age of 80 years).Mean survival without treatment is 3.6 years,making early detection *** report an unusual case of a 58-year-old patient with ATTRwt cardiomyopathy requiring heart *** SUMMARY A 58-year-old male presented with progressive fatigue,shortness of breath,weight gain,leg swelling,orthopnoea,and paroxysmal nocturnal dyspnoea for several *** ten months before this clinical presentation,the patient had first received a diagnosis of heart failure with reduced ejection fraction(EF)of 15% to 20%.The patient was started on appropriate guidelinedirected medical therapy with only mild improvement in his *** further investigation,echocardiogram,technetium pyrophosphate scan(Tc PYP),and cardiac magnetic resonance imaging(cMRI)suggested a diagnosis of amyloidosis,and ATTRwt was subsequently confirmed with native heart tissue biopsy,congo red staining,liquid chromatography-tandem mass spectrometry,and genetic *** patient was successfully treated with heart transplantation and is doing well *** Wild-type ATTR amyloidosis should be kept on differentials in all patients(even less than 60 years old)with non-ischemic cardiomyopathy,especially in the setting of increased ventricular wall thickness and other classic echocardiogram,cMRI,and Tc PYP *** diagnosis and management can be consequential in improving patient outcomes.

关键词： Wild-type Transthyretin Amyloidosis Young Heart failure Heart transplant Case report