DOCSLIB.ORG

Posters, Which Were Displayed on All Orthopaedic Wards and Emailed Individually to All Orthopaedic Trainees and Consultants

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Abstract no.: 36413 PATHOLOGICAL INFLUENCES OF CONNECTIVE TISSUES DYSPLASTIC DISORDERS ON SURGICAL TREATMENT RESULTS OF PECTUS EXCAVATUM IN CHILDREN Iskandar KHODJANOV, Sherali KHAKIMOV, Khatam KASYMOV Scientific Research Institute Traumatology and Orthopedics, Tashkent city (UZBEKISTAN) Recently, several complications associating with the instability of the installed bar, PC deformity occurrence and the PE relapse have been occurred in more than 20% after surgery. Purpose was the determination of the role of the connective tissues dysplastic disorders for remodeling processes of the anterior chest wall in children with PE in post- operative periods. Investigation performed on 40 children, who underwent operative treatment by the D. Nuss procedure in Clinic of SRITO RUz, with PE. Genetic assessment was carried out by the T. Milkovska-Dmitrova and A. Karakeshev classification (1985). Good results were obtained in 35 cases in the nearest postoperative periods, 5 cases were with the severe pain and in long-term periods was occurred the PC deformity in 2 cases, secondary atypical deformation in 1, the relapse of PE till I degree in 1 and in 1 case was saved the neuralgic pain. The connective tissues dysplasia is a congenital character genesis, characterized by metabolic disorders in the stroma tissues and several enzymopathy. The osseo-cartilaginous structural system growth processes were not behavioral in the necessary age norm of locomotors apparatus and with the delaying of ossification processes also in the adolescent's age and the sterno-costal complex became most pliable. These changes complicated the correction method of PE, extended the period of immobilization. It is hard to determine the outcome operative results of the patients with severe degrees of conjunctive tissues dysplasia. Abstract no.: 36416 EPIPHYSEAL OSTEOMYELITIS: A REPORT OF THREE CASES AND REVIEW OF LITERATURE. Nanjundappa S. HARSHAVARDHANA1, Vaibhav BAGARIA2, Amit NEMADE3 1ORIGYN, Gourock (UNITED KINGDOM), 2CARE hospital & ORIGYN Clinic, Nagpur (INDIA), 3LMC & ORIGYN CLINIC, NAGPUR (INDIA) Haematogenous osteomyelitis has classically been associated with the metaphysis or the diaphysis involvement. Involvement of the epiphysis is rare entity which poses a diagnostic and management dilemma. The differential diagnosis include chondroblastoma, chondromyxoid fibroma, enchondroma, osteoid osteoma, eosinophillic granuloma, foreign body granuloma. Treatment in the literature remains controversial. Here we present three cases:. Cases 1 presented as chronic pain in the knee with a radiologic picture of radiolucency in the distal femoral epiphysis. The diagnosis was confirmed in MRI and she underwent a curettage of the lesion. Case 2 1yr infant presented with a septic knee, at that point of time the x ray did not show any bony abnormality. He underwent an arthrotomy and after 6 weeks of parental therapy he developed an osteolytic lesion, but the knee was asymptomatic hence we continued conservative management. The patient was doing well till the last follow up. Case 3: 3 yr toddler presented with history of tying a holy thread around the wrist 6 months back. Few days later due to swelling the thread got buried in the subcutaneous tissues cutting through the skin which was partially removed. X ray pictures showed a lucent area adjacent to the distal radial physis. He was managed conservatively but the sinuses persisted hence a curettage was planned. The sinus tracts were curetted and the remaining thread was removed. Patient is doing well till the last follow up. The last case classically demonstrates the foreign body granulaoma presenting as epiphyseal osteomyelitis. Abstract no.: 36417 THE INCIDENCE OF SYNDESMOTIC INJURY Turner VOSSELLER, John KARL, Justin GREISBERG Columbia University Medical Center, New York, NY (UNITED STATES) Introduction: Injury to the tibio-fibular syndesmosis can occur with ankle sprain or fracture. The incidence of syndesmotic injury has not been specifically sought at a population level. Methods: Data on syndesmotic injury was obtained from the Healthcare Cost and Utilization Project (HCUP), a federal-state-private partnership. It is administered by the Agency for Health care Research and Quality (AHRQ), a division of the Unites States Department of Health and Human Services (HHS). Two HCUP databases were queried for eight states: the State Inpatient Database (SID) and the State Emergency Department Database (SEDD). The first six ICD-9 code diagnoses were searched for codes that are used for syndesmotic injury (i.e. 845.03). These data, along with data from the 2010 US Census, were used to yield incidence rates for syndesmosis injury, as well as for various demographic groups. National estimates of injury totals were also calculated. Results: In the eight states there were a total of 1,821 syndesmotic injuries. Given the population of these states, the incidence rate of syndesmotic injury was 2.09 syndesmotic injuries per 100,000 person years. This incidence correlates to an estimated 6,445 syndesmotic injuries per year in the US. Conclusions: This data provides some baseline numbers as to the incidence of syndesmotic injury in the US. Although the incidence was low relative to some other injuries, the fact that syndesmotic injuries tend to occur in younger patients may have greater impact in terms of productive years of life lost. Abstract no.: 36420 CLINICAL CHARACTERISTICS OF ATYPICAL FEMORAL FRACTURES IN PATIENTS WITH OSTEOPOROSIS TREATMENT Joon-Soon KANG1, Kee Haeng LEE2, Jong Oh KIM3, Kyeong Ho MOON1 1Inha university hospital, Incheon (SOUTH KOREA), 2Catholic University of Korea, College of Medicine, Buchoen St. Mary’s Hospital, Bucheon (SOUTH KOREA), 3Ewha university hospital, Seoul (SOUTH KOREA) Background: We investigated the relationship between taking bisphosphonate and clinical characteristics of atypical femoral fracture throughout Korean multicenter studies. Object and Method: We retrospectively analyzed the bone mineral density, prodromal symptoms before femoral fracture, medication history of osteoporosis and union period of femoral fracture in 76 cases of atypical femoral fracture. Result The mean age of cases is 71.4 years old. The mean follow up period was 24.5 months. The mean BMD of femur is -1.9 ± 1.4(range, -4.8 - 2.3). Prodromal symptoms including thigh pain before femoral fracture appeared in 28.9%. The period of taking bisphosphonate before fracture is 36.8 months. The delayed union is developed in 43 (56.5 %) of 76 patients. The group of taking osteoporosis medication more than three years showed relatively longer union period compared to those for a short period medication group (p=0.017). The delayed union was developed in 43(56.5%) of 76 patient and in group with long term therapy showed significantly high incidence. (p=0.021) The bilateral femoral fracture was developed in 23 (30.2%) of 76 patients and in groups with medicated more than three years showed high incidence. (p=0.039). Conclusion Medical and surgical strategy should be considered in the clinical setting for the acceleration of fracture healing, especially in patients on long term bisphosphonate therapy who present with atypical femoral fracture. Careful observation is required for contralateral femur due to high incidence of bilateral femoral fracture. Abstract no.: 36421 THE EFFECT OF ORTHOPAEDIC SURGERY ON THE INTRINSIC PROPERTIES OF SURGICAL GLOVES Ali ABDULKARIM, Andrew MORIARITY, Eoin SHEEHAN Midland Regional Hospital Tullamore, Tullamore , Co Offaly (IRELAND) Introduction: Surgical gloves function as a mechanical barrier that reduces transmission of body fluids and pathogens. The effectiveness of this barrier is dependent upon the integrity of the glove. Methods: A total of 20 unused sterile surgical gloves (neoprene and latex) were exposed to blood, bone shavings and cement over 15, 30 and 60 minute intervals. Following each time point, the palmar surface and finger tips of each glove was analyzed under the scanning electron microscope (SEM), and were tested for changes in contact angle and tensile properties. Results: Exposure to cement caused a significant increase in both the neoprene and latex glove porosities at 15 min but no significant further changes at any later time points. The latex gloves had a greater increase in pore diameter than the neoprene gloves. Exposure to cement for 15 min duration significantly decreased the tensile strength of both latex and neoprene gloves. Exposure to either blood or bone shavings did not cause any significant changes in the latex or neoprene glove properties. Conclusions: This study provides evidence that exposure to cement, a common orthopaedic material, can disrupt the intrinsic properties of the surgical gloves worn in the operating theatre. Abstract no.: 36423 CHILDHOOD OBESITY AS A RISK FACTOR FOR UPPER EXTREMITY FRACTURES Ali ABDULKARIM, Andrew MORIARITY, Javaria AHMED, Dorothy NIALL, Eoin SHEEHAN Midland Regional Hospital Tullamore, Tullamore , Co Offaly (IRELAND) Introduction:to investigate the relationship between BMI and upper extremity fractures in children and adolescents of different ages and genders. Methods: We prospectively collected data on 280 children and adolescents between 2 to 19 years of age who presented to hospital with upper extremity trauma. We determined BMI and BMI-for-age percentiles for each patient. Fracture types were classified and the management was recorded.The associations among the BMI class and specific upper extremity fractures were estimated using
Recommended publications
  • Glossary for Narrative Writing

    Glossary for Narrative Writing

    Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper
  • Cohen2018.Pdf

    Cohen2018.Pdf

    Influence of treatment modality on morbidity and mortality in periprosthetic femoral fracture. A comparative study of 71 fractures treated by internal fixation or femoral implant revision S. Cohen, X. Flecher, S. Parratte, M. Ollivier, Jean-Noël Argenson To cite this version: S. Cohen, X. Flecher, S. Parratte, M. Ollivier, Jean-Noël Argenson. Influence of treatment modality on morbidity and mortality in periprosthetic femoral fracture. A comparative study of 71 fractures treated by internal fixation or femoral implant revision. Orthopaedics and Traumatology -Surgery and Research, Elsevier, 2018, 104 (3), pp.363-367. 10.1016/j.otsr.2017.12.018. hal-01960509 HAL Id: hal-01960509 https://hal.archives-ouvertes.fr/hal-01960509 Submitted on 22 Apr 2019 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Original article Influence of treatment modality on morbidity and mortality in periprosthetic femoral fracture. A comparative study of 71 fractures treated by internal fixation or femoral implant revision. S. Cohena, X. Flechera,*, S. Parrattea, M. Olliviera,
  • Life Science Journal 2015;12(1)

    Life Science Journal 2015;12(1)

    Life Science Journal 2015;12(1) http://www.lifesciencesite.com Can One Treat Pilon Fracture In Conjunction With Accurate Osseous Reduction And Rigid Fixation By Ilizarov And Assisted Arthroscopic Reduction? Ahmad Altonesy Abdelsamie and Amr I. Zanfaly Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt. [email protected] Abstract: Introduction: Anatomic restoration of the joint is the goal of management in fractures about the ankle. Open surgical treatment of comminuted tibialPilon fractures is associated with substantial complications in many patients. Indirect reduction and stabilization of fractures by means of distraction using a circular external fixator and anatomic repositioning of the joint surface assisted by arthroscopy can be a useful method of achieving satisfactory joint restoration. The potential benefits are less extensive exposure, preservation of blood supply, and improved visualization of the pathology. Patient and methods: This was a prospective study conducted between October 2010 and, September 2013 on twelve patients were presented to the emergency department of Zagazig university hospitals with high energy distal tibial fractures of closed and Gustilo Types I&II open fractures. All cases were treated using Ilizarov fixators with or without limited internal fixation and assessment of intra-articular reduction of tibial plafond by arthroscopy. All had been allowed to bear partial weight on the limb in the early postoperative period. A follow up review ranged from12 to 18 months(mean 15 months). Results: All cases had united with a mean time of 13.75 weeks (range from 8 to 19), good range of motion was achieved in most at the end of the follow up period.
  • Bone and Soft Tissue Tumors Have Been Treated Separately

    Bone and Soft Tissue Tumors Have Been Treated Separately

    EPIDEMIOLOGY z Sarcomas are rare tumors compared to other BONE AND SOFT malignancies: 8,700 new sarcomas in 2001, with TISSUE TUMORS 4,400 deaths. z The incidence of sarcomas is around 3-4/100,000. z Slight male predominance (with some subtypes more common in women). z Majority of soft tissue tumors affect older adults, but important sub-groups occur predominantly or exclusively in children. z Incidence of benign soft tissue tumors not known, but Fabrizio Remotti MD probably outnumber malignant tumors 100:1. BONE AND SOFT TISSUE SOFT TISSUE TUMORS TUMORS z Traditionally bone and soft tissue tumors have been treated separately. z This separation will be maintained in the following presentation. z Soft tissue sarcomas will be treated first and the sarcomas of bone will follow. Nowhere in the picture….. DEFINITION Histological z Soft tissue pathology deals with tumors of the classification connective tissues. of soft tissue z The concept of soft tissue is understood broadly to tumors include non-osseous tumors of extremities, trunk wall, retroperitoneum and mediastinum, and head & neck. z Excluded (with a few exceptions) are organ specific tumors. 1 Histological ETIOLOGY classification of soft tissue tumors tumors z Oncogenic viruses introduce new genomic material in the cell, which encode for oncogenic proteins that disrupt the regulation of cellular proliferation. z Two DNA viruses have been linked to soft tissue sarcomas: – Human herpes virus 8 (HHV8) linked to Kaposi’s sarcoma – Epstein-Barr virus (EBV) linked to subtypes of leiomyosarcoma z In both instances the connection between viral infection and sarcoma is more common in immunosuppressed hosts.
  • June 18, 2013 8:30 Am – 11:30 Am

    June 18, 2013 8:30 Am – 11:30 Am

    Tuesday – June 18, 2013 8:30 am – 11:30 am Poster Abstracts – Tuesday, June 18, 2013 #1 ORAL LESIONS AS THE PRESENTING MANIFESTATION OF CROHN'S DISEASE V Woo, E Herschaft, J Wang U of Nevada, Las Vegas Crohn’s disease (CD) is an immune-mediated disorder of the gastrointestinal tract which together with ulcerative colitis, comprise the two major types of inflammatory bowel disease (IBD). The underlying etiology has been attributed to defects in mucosal immunity and the intestinal epithelial barrier in a genetically susceptible host, resulting in an inappropriate inflammatory response to intestinal microbes. The lesions of CD can affect any region of the alimentary tract as well as extraintestinal sites such as the skin, joints and eyes. The most common presenting symptoms are periumbilical pain and diarrhea associated with fevers, malaise and anemia. Oral involvement has been termed oral CD and may manifest as lip swelling, cobblestoned mucosa, mucogingivitis and linear ulcerations and fissures. Oral lesions may precede gastrointestinal involvement and can serve as early markers of CD. We describe a 6-year-old male who presented for evaluation of multifocal gingival erythema and swellings. His medical history was unremarkable for gastrointestinal disorders or distress. Histopathologic examination showed multiple well-formed granulomas that were negative for special stains and foreign body material. A diagnosis of granulomatous gingivitis was rendered. The patient was advised to seek consultation with a pediatric gastroenterologist and following colonoscopy, was diagnosed with early stage CD. Timely recognition of the oral manifestations of CD is critical because only a minority of patients will continue to exhibit CD-specific oral lesions at follow-up.
  • Femoral Reconstruction Using External Fixation

    Femoral Reconstruction Using External Fixation

    SAGE-Hindawi Access to Research Advances in Orthopedics Volume 2011, Article ID 967186, 10 pages doi:10.4061/2011/967186 Research Article Femoral Reconstruction Using External Fixation Yevgeniy Palatnik and S. Robert Rozbruch Limb Lengthening and Deformity Service, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10065, USA Correspondence should be addressed to S. Robert Rozbruch, [email protected] Received 15 July 2010; Revised 28 October 2010; Accepted 3 January 2011 Academic Editor: Boris Zelle Copyright © 2011 Y. Palatnik and S. R. Rozbruch. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD), limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD) and lateral distal femoral angle (LDFA) for the entire group as well as the subgroups.
  • Advances in the Pathogenesis and Possible Treatments for Multiple Hereditary Exostoses from the 2016 International MHE Conference

    Advances in the Pathogenesis and Possible Treatments for Multiple Hereditary Exostoses from the 2016 International MHE Conference

    Connective Tissue Research ISSN: 0300-8207 (Print) 1607-8438 (Online) Journal homepage: https://www.tandfonline.com/loi/icts20 Advances in the pathogenesis and possible treatments for multiple hereditary exostoses from the 2016 international MHE conference Anne Q. Phan, Maurizio Pacifici & Jeffrey D. Esko To cite this article: Anne Q. Phan, Maurizio Pacifici & Jeffrey D. Esko (2018) Advances in the pathogenesis and possible treatments for multiple hereditary exostoses from the 2016 international MHE conference, Connective Tissue Research, 59:1, 85-98, DOI: 10.1080/03008207.2017.1394295 To link to this article: https://doi.org/10.1080/03008207.2017.1394295 Published online: 03 Nov 2017. Submit your article to this journal Article views: 323 View related articles View Crossmark data Citing articles: 1 View citing articles Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=icts20 CONNECTIVE TISSUE RESEARCH 2018, VOL. 59, NO. 1, 85–98 https://doi.org/10.1080/03008207.2017.1394295 PROCEEDINGS Advances in the pathogenesis and possible treatments for multiple hereditary exostoses from the 2016 international MHE conference Anne Q. Phana, Maurizio Pacificib, and Jeffrey D. Eskoa aDepartment of Cellular and Molecular Medicine, Glycobiology Research and Training Center, University of California, San Diego, La Jolla, CA, USA; bTranslational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA ABSTRACT KEYWORDS Multiple hereditary exostoses (MHE) is an autosomal dominant disorder that affects about 1 in 50,000 Multiple hereditary children worldwide. MHE, also known as hereditary multiple exostoses (HME) or multiple osteochon- exostoses; multiple dromas (MO), is characterized by cartilage-capped outgrowths called osteochondromas that develop osteochondromas; EXT1; adjacent to the growth plates of skeletal elements in young patients.
  • Canadian Society of Plastic Surgeons Société Canadienne Des Chirurgiens Plasticiens

    Canadian Society of Plastic Surgeons Société Canadienne Des Chirurgiens Plasticiens

    ABSTRACTS/RÉSUMÉS Canadian Society of Plastic Surgeons Société Canadienne des Chirurgiens Plasticiens Abstracts presented at the 69th Annual Meeting / 69e Réunion annuelle June 2 – 6, 2015, Victoria, British Columbia Dr Edward Tredget: President/Président Dr Howard Clarke: Vice President / Vice-président, Scientific Program Chair / Comité de programme scientifique Dr Chris Taylor: Local Organizing Committee Chair / Président, Comité d’accueil 02 EYE-OPENER SESSION FUNCTIONAL OUTCOMES OF ENOPHTHALMOS 00 CORRECTION PELVIC, PERINEAL AND VAGINAL RECONSTRUCTION M McRae, A Budning, C Lynham, O Antonyshyn C Butler Toronto, ON University of Texas MD Anderson Cancer Center, Houston, Texas, PURPOSE: Determine functional outcomes of late post-traumatic enoph- USA thalmos repair, specifically, ocular motility, diplopia, and strabismus. Learning Objectives: METHODS: The study series comprises 81 consecutive patients with late 1. Participants will recognize advantages and disadvantages of flap reconstruc- post-traumatic enophthalmos with functional impairment, that underwent tion of pelvic and perineal defects following abdominal perineal resection or enophthalmos repair by a single surgeon (OA) between May 2002 and pelvic exenteration. April 2014. Of those, 39 patients fulfilled study inclusion and exclusion 2. Participants will identify strategies to reconstruct the pelvic, perineal and vaginal criteria. Outcomes (diplopia, limitations of ocular motility, and strabismus) structures using flaps from various donor sites. were assessed independently by a single ophthalmologist who specializes in 3. Participants will understand the advantages and disadvantages of thigh-based strabismus surgery (AB), and were performed preop and postop for each and abdominal-based flaps for pelvic/perineal reconstruction. patient. Results: Average age was 43.1 (range 15-79) with 26 males, and 13 females.
  • The Role of Hyaluronic Acid in Intervertebral Disc Regeneration

    The Role of Hyaluronic Acid in Intervertebral Disc Regeneration

    applied sciences Review The Role of Hyaluronic Acid in Intervertebral Disc Regeneration 1, 1,2 1, Zepur Kazezian y, Kieran Joyce and Abhay Pandit * 1 CÚRAM, SFI Research Centre for Medical Devices, National University of Ireland Galway, H91 W2TY Galway, Ireland; [email protected] (Z.K.); [email protected] (K.J.) 2 School of Medicine, National University of Ireland Galway, H91 TK33 Galway, Ireland * Correspondence: [email protected] Zepur Kazezian is currently at Imperial College London, London SW7 2AZ, UK. y Received: 17 August 2020; Accepted: 7 September 2020; Published: 9 September 2020 Abstract: Intervertebral disc (IVD) degeneration is a leading cause of low back pain worldwide, incurring a significant burden on the healthcare system and society. IVD degeneration is characterized by an abnormal cell-mediated response leading to the stimulation of different catabolic biomarkers and activation of signalling pathways. In the last few decades, hyaluronic acid (HA), which has been broadly used in tissue-engineering, has popularised due to its anti-inflammatory, analgesic and extracellular matrix enhancing properties. Hence, there is expressed interest in treating the IVD using different HA compositions. An ideal HA-based biomaterial needs to be compatible and supportive of the disc microenvironment in general and inhibit inflammation and downstream cascades leading to the innervation, vascularisation and pain sensation in particular. High molecular weight hyaluronic acid (HMW HA) and HA-based biomaterials used as therapeutic delivery platforms have been trialled in preclinical models and clinical trials. In this paper, we reviewed a series of studies focused on assessing the effect of different compositions of HA as a therapeutic, targeting IVD degeneration.
  • Exostoses, Enchondromatosis and Metachondromatosis; Diagnosis and Management

    Exostoses, Enchondromatosis and Metachondromatosis; Diagnosis and Management

    Acta Orthop. Belg., 2016, 82, 102-105 ORIGINAL STUDY Exostoses, enchondromatosis and metachondromatosis; diagnosis and management John MCFARLANE, Tim KNIGHT, Anubha SINHA, Trevor COLE, Nigel KIELY, Rob FREEMAN From the Department of Orthopaedics, Robert Jones Agnes Hunt Hospital, Oswestry, UK We describe a 5 years old girl who presented to the region of long bones and are composed of a carti- multidisciplinary skeletal dysplasia clinic following lage lump outside the bone which may be peduncu- excision of two bony lumps from her fingers. Based on lated or sessile, the knee is the most common clinical examination, radiolographs and histological site (1,10). An isolated exostosis is a common inci- results an initial diagnosis of hereditary multiple dental finding rarely requiring treatment. Disorders exostosis (HME) was made. Four years later she developed further lumps which had the radiological associated with exostoses include HME, Langer- appearance of enchondromas. The appearance of Giedion syndrome, Gardner syndrome and meta- both exostoses and enchondromas suggested a possi- chondromatosis. ble diagnosis of metachondromatosis. Genetic testing Enchondroma are the second most common be- revealed a splice site mutation at the end of exon 11 on nign bone tumour characterised by the formation of the PTPN11 gene, confirming the diagnosis of meta- hyaline cartilage in the medulla of a bone. It occurs chondromatosis. While both single or multiple exosto- most frequently in the hand (60%) and then the feet. ses and enchondromas occur relatively commonly on The typical radiological features are of a well- their own, the appearance of multiple exostoses and defined lucent defect with endosteal scalloping and enchondromas together is rare and should raise the differential diagnosis of metachondromatosis.
  • Periprosthetic Fractures Around Loose Femoral Components

    Periprosthetic Fractures Around Loose Femoral Components

    Review Article Periprosthetic Fractures Around Loose Femoral Components Abstract Roshan P. Shah, MD, JD The development of periprosthetic fractures around loose femoral Neil P. Sheth, MD components can be a devastating event for patients who have undergone total hip arthroplasty (THA). As indications for THA expand Chancellor Gray, MD in an aging population and to use in younger patients, these fractures Hassan Alosh, MD are increasing in incidence. This review covers the epidemiology, risk Jonathan P. Garino, MD factors, prevention, and clinical management of periprosthetic femoral fractures. Treatment principles and reconstructive options are discussed, along with outcomes and complications. Femoral revision with a long-stem prosthesis or a modular tapered stem is the mainstay of treatment and has demonstrated good outcomes in the literature. Other reconstruction options are available, depending on bone From Columbia University, New York, quality. Surgeons must have a sound understanding of the diagnosis NY (Dr. Shah), the University of and treatment of periprosthetic femoral fractures. Pennsylvania, Philadelphia, PA (Dr. Sheth, Dr. Gray, and Dr. Alosh), and the Pennsylvania Orthopedic Center, Alvern, PA (Dr. Garino). otal hip arthroplasty (THA) The incidence of periprosthetic hip Dr. Shah or an immediate family Treliably treats hip pain caused by fractures is increasing. Bhattacharyya member has stock or stock options articular cartilage degeneration; et al5 found a 216% increase between held in Pfizer, Merck, GlaxoSmithKline, Alnylam, and Intuitive Surgical. however, the development of peri- 2002 and 2006. Several reasons for Dr. Sheth or an immediate family prosthetic femoral fractures after the increase have been proposed.1,2 member serves as a paid consultant to THA is a devastating complication.
  • Treatment of Common Hip Fractures: Evidence Report/Technology

    Treatment of Common Hip Fractures: Evidence Report/Technology

    This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290 2007 10064 1). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment. This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. Evidence Report/Technology Assessment Number 184 Treatment of Common Hip Fractures Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. HHSA 290 2007 10064 1 Prepared by: Minnesota Evidence-based Practice Center, Minneapolis, Minnesota Investigators Mary Butler, Ph.D., M.B.A. Mary Forte, D.C. Robert L. Kane, M.D. Siddharth Joglekar, M.D. Susan J. Duval, Ph.D. Marc Swiontkowski, M.D.