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Spontaneous and simultaneous complete bilateral rupture of the quadriceps tendon in a patient receiving hemodialysis: A case report and literature review

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World Journal of Orthopedics 2018年第9期9卷 180-184页

作者： Wassim Zribi Mohamed Zribi Ahmed Racem Guidara Mohamed Ben Jemaa Ameur Abid Nabil Krid Abdessalem Naceur Hassib Keskes Department of Orthopaedic Surgery and Traumatology Habib Bourguiba University Hospital Department of Orthopaedic Surgery and Traumatology Marechal Leclerc Argentan Hospital

The spontaneous and simultaneous rupture of both quadriceps tendons is uncommon and has rarely been reported in the literature. The current case involves a 43-year-old man with end-stage renal disease requiring hemodialysis for the past 20 years. The patient experienced bilateral knee pain and swelling and was unable to bear weight. Physical examination revealed bilateral quadriceps tendon defect above the patella and loss of active extension. Although plain radiographs of both knees showed no fracture or widening of the joint space, an inferiorly positioned patella was observed. Ultrasonography of the knees revealed a quadriceps tendon defect at the upper edge of each patella, while MR imaging revealed a tear in each quadriceps tendon from the superior poles of the patella. The patient then underwent surgical correction wherein the tendons were repaired using sutures passed through drill holes in the patella. The knees were immobilized with splints for 4 wk before starting physiotherapy. The patient subsequently regained full functional activity within 1 year.

关键词： Quadriceps tendon Tear Krackow sutures Renal failure Hyperparathyroidism

Prosthetic design of reverse shoulder arthroplasty contributes to scapular notching and instability

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World Journal of Orthopedics 2016年第11期7卷 738-745页

作者： Gazi Huri Filippo Familiari Nima Salari Steve A Petersen Mahmut Nedim Doral Edward G Mc Farland department of orthopaedic and traumatology surgery Hacettepe University Medical School Division of Shoulder surgery Department of Orthopaedic Surgerythe Johns Hopkins University

AIM To evaluate whether implant design, glenoid positioning, and other factors influenced instability and scapular notching in reverse total shoulder arthroplasty.METHODS We retrospectively reviewed records of patients who had undergone reverse total shoulder arthroplasty by the senior author from July 2004 through October 2011 and who had at least 24 mo of follow-up. The 58 patients who met the criteria had 65 arthroplasties: 18 with a Grammont-type prosthesis(Grammont group) and 47 with a lateral-based prosthesis(lateral-design group). We compared the groups by rates of scapular notching and instability and by radiographic markers of glenoid position and tilt. We also compared glenoid sphere sizes and the number of subscapularis tendon repairs between the groups. Rates were compared using the Fisher exact test. Notching severity distribution was compared using the χ2 test of association. Significance was set at P < 0.05.RESULTS The Grammont group had a higher incidence of scapular notching(13 of 18; 72%) than the lateral-design group(11 of 47; 23%)(P < 0.001) and a higher incidence of instability(3 of 18; 17%) than the lateral-design group(0 of 47; 0%)(P = 0.019). Glenoid position, glenoid sphere size, and subscapularis tendon repair were not predictive of scapular notching or instability, independent of implantdesign. With the lateral-based prosthesis, each degree of inferior tilt of the baseplate was associated with a 7.3% reduction in the odds of developing notching(odds ratio 0.937, 95%CI: 0.894-0.983). CONCLUSION The lateral-based prosthesis was associated with less instability and notching compared with the Grammonttype prosthesis. Prosthesis design appears to be more important than glenoid positioning.

关键词： Arthroplasty Reverse Instability Scapular notching Shoulder

Ipsilateral proximal and shaft femoral fractures

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Chinese Journal of traumatology 2017年第3期20卷 155-157页

作者： Eric Lawson Soumaila Madougou Pascal Chigblo Gildas Quenum Abdourahmane Ouangre Fiacre Tidjani Oswald Goukodadja Aristote Hans-Moevi Akue department of orthopaedic and traumatology surgery Cotonou Teaching Hospital Jericho Cotonou Benin

Purpose: To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods: A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied: epidemiology, fracture characteristics, therapeutic, anatomical and functional outcomes. The correlation between different parameters was analyzed with Fischer test. The significant threshold was defined for p value <0.05. Results: Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years (range: 29-62 years). It was about traffic road accidents in all cases. Motorcycle-motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h (range: 1.5-24 h). Left side was most reached in 8 cases. According to Garden classification, there was type III cervical fracture in 2 cases, type II in 1 case and type IV in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type VI in 2 cases and type VII in 1 case. According to AO classification, there was type A shaft fracture in 6 cases (A2 in 4 cases and A3 in 2 cases), type B in 2 cases (B1 in 1 case and B2 in 1 case) and type C in 2 cases (C1 in 1 case and C2 in 1 case). Average surgical delay was 28.7 days (range: 11-61 days). For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130 ° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95 ° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130 ° . Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months (range: 3-12 months) for proximal femoral fracture and 5 months (range: 3-8 months) for shaft femoral fractur

关键词：股骨骨折平均年龄延迟时间性别分类 Gamma 种植体摩托车不愈合

Should proximal ruptures of the anterior rectus femoris muscle be treated surgically?

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Chinese Journal of traumatology 2022年第4期25卷 232-236页

作者： Camille Choufani Frederic Khiami Olivier Barbier orthopaedic surgery and traumatology department Saint-Anne Military Teaching HospitalToulon83000France Toulon Mediterranean Orthopedic and Sport Trauma Toulon83000France orthopaedic surgery department Pitie-Salp^etriere HospitalParisFrance

Purpose:No therapeutic consensus has been established about proximal ruptures of the rectus femoris muscle.The objective of this literature review is to determine a therapeutic course of action.Methods:We conducted a literature review on the PubMed database using the following keywords(in French and English,respectively):"quadriceps/quadriceps","droit antérieur/rectus femoris","proximal/proximal","chirurgie/surgical","avulsion/avulsion".We collected 266 articles,36 of them were selected,which were related to our topic:proximal rupture of the anterior rectus femoris.Patients with a proximal rupture of the rectus femoris,minor or major patient of traumatic origin were included in this study.Patients injured at another lesion level,or non-traumatic lesions of the proximal rectus femoris(tendinitis without ruptures,tumor or others)were excluded.For each patient,the indications,the type of treatment and the functional result were analyzed,with the time to recovery and the level of recovery from sports and professional activities(same sport/profession or not,same level or not)as the main criterion of judgment.Fisher exact test was used for statistical comparison.Results:The aims of conservative treatment are to be pain free for the patient,to fight hematoma and to rehabilitate the injury as quickly as possible.The surgical techniques are varied,with most consisting of either a reinsertion of the musculo-tendon stump or a resection of the scar tissue with myo-tendinoaponeurotic suture in place.The functional results are good for the majority of the treatments proposed,but the conservative treatment has a shorter recovery time(3 months vs.4 months for the best surgical results).Highly displaced bone avulsion is the only indication for first-line surgical treatment.Conslusion:The main disadvantage of conservative treatment is the risk of residual pain beyond 3 months(10%),justifying an MRI to guide secondary surgical treatment.We propose a treatment plan for proximal rupture of the proximal rectus femoris rupture.

关键词： Avulsion fractures Quadriceps muscle surgery

Damage control orthopaedics: State of the art

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World Journal of Orthopedics 2019年第1期10卷 1-13页

作者： Enrique Guerado Maria Luisa Bertrand Juan Ramon Cano Ana María Cerván Adolfo Galán Department of Orthopaedic Surgery and Traumatology Hospital Costa del Sol University of Malaga

Damage control orthopaedics(DCO) originally consisted of the provisional immobilisation of long bone-mainly femur-fractures in order to achieve the advantages of early treatment and to minimise the risk of complications, such as major pain, fat embolism, clotting, pathological inflammatory response, severe haemorrhage triggering the lethal triad, and the traumatic effects of major surgery on a patient who is already traumatised(the "second hit" effect). In recent years, new locations have been added to the DCO concept, such as injuries to the pelvis, spine and upper limbs. Nonetheless, this concept has not yet been validated in well-designed prospective studies, and much controversy remains.Indeed, some researchers believe the indiscriminate application of DCO might be harmful and produce substantial and unnecessary expense. In this respect, too,normalised parameters associated with the acid-base system have been proposed,under a concept termed early appropriate care, in the view that this would enable patients to receive major surgical procedures in an approach offering the advantages of early total care together with the apparent safety of DCO. This paper discusses the diagnosis and treatment of severely traumatised patients managed in accordance with DCO and highlights the possible drawbacks of this treatment principle.

关键词： Damage control orthopaedics Early total care Early appropriate care Polytrauma Resuscitation External fixation Packing Embolisation Compartment syndrome

Epidemiology and injury patterns of aerial sports in Switzerland

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World Journal of Orthopedics 2020年第2期11卷 107-115页

作者： Henrik Constantin Bäcker J Turner Vosseller Aristomenis K Exadaktylos Carsten Perka Lorin Michael Benneker Fabian Götz Krause Moritz Caspar Deml Department of Orthopaedic Surgery and Traumatology InselspitalUniversity Hospital BernUniversity BernBern 3010Switzerland department of orthopaedic surgery New York Presbyterian/Columbia University Medical CenterNew YorkNY 10032United States Department of Orthopaedic Surgery and Traumatology University Hospital BerlinCharitéBerlinBerlin10117Germany department of Emergency Medicine InselspitalUniversity Hospital BernUniversity BernBern3010Switzerland

BACKGROUND Airborne sports have become more popular in recent years.The number of accidents has increased linearly as athletes take increasingly greater risks to experience the adventurous spirit of this kind of sports.AIM To investigate the variety of injuries in airborne sport accidents,as well as which acute treatment these patients receive,both before and after admission to a levelone-trauma center.METHODS We performed a retrospective chart analysis at a major level-one-trauma center in Switzerland for 235-patients who were admitted following airborne sports injuries between 2010 and 2017.Patients’demographic data,injury patterns,emergency primary care procedures and intra-hospital care were recorded.RESULTS Overall,718-injuries in 235-patients were identified;the spine was the most commonly affected region with 46.5%of injuries(n=334/718)in 143-patients.In 69-patients(15.5%),the(non-spine)thorax was affected,followed by the lower and upper extremity,pelvis,head/face and abdominal injuries.Eleven-patients had to be intubated at the trauma site.Three patients were resuscitated after onset of pulseless-electrical-activity.Two-patients died in the resuscitation room.In 116-cases,surgery was indicated including 55-emergency surgeries.Another 19 patients(8.1%)were transferred to the intensive care unit.CONCLUSION Paragliders are most commonly affected,although the highest injury severities were identified for Building,Antenna,Span and Earth-jumping athletes.First responders,treating physicians and pilots should be aware of the risk for potentially serious and life-threatening injury with an in-hospital mortality of 0.9%.

关键词： Airborne sport Sport injuries Trauma Spine Pelvis Emergency medicine Paragliding Parachuting Delta-flying

A late dissociation of the ceramic component of a sandwich liner cup in a total hip arthroplasty<br>—Case report and review of the literature

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Case Reports in Clinical Medicine 2013年第2期2卷 138-140页

作者： Pieter-Jan De Roo Franky Steenbrugge Martijn Raaijmaakers department of orthopaedic surgery & traumatology Aalst Belgium

We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. She experienced in total 2 dislocations in 6 months. These events occurred without fracture of the ceramic liner. Sandwich ceramic liners were introduced with the idea of combining the benefits of ceramic and polyethylene bearings in total hip arthroplasty in order to reduce wear and to allow a ceramic on ceramic bearing to be used in a cup designed for polyethylene inserts only. Although some reports showed promising early results, case reports and later on retrospective analysis showed high fracture rates of the ceramic liner component. We believe that loosening of the ceramic component may precede fracture of the liner and that a ceramic on ceramic configuration is preferable.

关键词： Total Hip Arthroplasty Sandwich Cup Complication Hip Instability Cup Revision

Traumatic subcutaneous emphysema of the hand/forearm: A case report

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Chinese Journal of traumatology 2022年第6期25卷 395-399页

作者： Stephen Saela Alexander Decilveo Roman Isaac Deepak V.Patel department of orthopaedic surgery St Josephs University Medical CenterPatersonNJ 07503USA department of orthopaedic surgery Seton Hall UniversitySouth OrangeNJ 07079US

Subcutaneous emphysema is commonly associated with infection caused by gas-producing organisms.In this case report,we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the hand.Our objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues,thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway.A 16-year-old,otherwise healthy white female,presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right hand.She appeared nontoxic and had a clinically benign presentation.A comprehensive work-up was performed.She was splinted by the orthopedic surgery resident on call,and was admitted to the Pediatric Intensive Care Unit for overnight monitoring.She received tetanus vaccination and broad-spectrum antibiotics.The patient was discharged 2 days after admittance,with a splint applied to her right hand and forearm.She undertook home-based physical and occupational therapy.She had a pain-free range-of-motion in the right wrist,elbow and shoulder.The swelling in the right hand subsided completely.Although initially alarming,traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds(as featured in this case)does not necessarily mean one ought to proceed down an aggressive treatment algorithm.Careful evaluation of the patient's history,clinical examination findings,and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions.

关键词： Upper extremity Traumatic subcutaneous emphysema Sucking-wounds Penetrating Necrotizing fasciitis Case reports Laboratory Risk Indicator for Necrotizing Fasciitis(LRINEC)

Meniscus tears treatment:The good,the bad and the ugly-patterns classification and practical guide

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World Journal of Orthopedics 2023年第4期14卷 171-185页

作者： Roberto Simonetta Arcangelo Russo Michelangelo Palco Giuseppe Gianluca Costa Pier Paolo Mariani department of orthopaedic and traumatology Villa del Sole ClinicCatanzaro 88100Italy orthopaedic and traumatology Unit Umberto I HospitalEnna 94100Italy department of orthopaedic and traumatology Villa Stuart Sport Clinic-FIFA Medical Centre of ExcellenceRoma 00135Italy

Over the years,several studies demonstrated the crucial role of knee menisci in joint biomechanics.As a result,save the meniscus has become the new imperative nowadays,and more and more studies addressed this topic.The huge amount of data on this topic may create confusion in those who want to approach this surgery.The aim of this review is to provide a practical guide for treatment of meniscus tears,including an overview of technical aspects,outcomes in the literature and personal tips.Taking inspiration from a famous movie directed by Sergio Leone in 1966,the authors classified meniscus tears in three categories:The good,the bad and the ugly lesions.The inclusion in each group was determined by the lesion pattern,its biomechanical effects on knee joint,the technical challenge,and prognosis.This classification is not intended to substitute the currently proposed classifications on meniscus tears but aims at offering a readerfriendly narrative review of an otherwise difficult topic.Furthermore,the authors provide a concise premise to deal with some aspects of menisci phylogeny,anatomy and biomechanics.

关键词： Meniscus Meniscus anatomy Meniscus tear Meniscus repair Root lesion Ramp lesion