Anterior cruciate ligament (ACL) tibial avulsion occurs predominantly in children and young adults. It is seen in association with injuries due to hyperextension usually involving movements that are similar to riding a bicycle. Bony ACL avulsion is associated with severe restriction of knee range of motion, swelling, inability to bear weight, and continuous pain. Acute swelling does not allow a conclusive clinical examination. Bony ACL avulsion from the tibial side has been treated by various methods ranging from conservative management to a wide range of operative procedures. The various operative procedures that have been described require challenging operative skills, time, and resources, making these techniques demanding and technically challenging. We describe a technique for the treatment of Meyers-McKeever type II, III, and IV bony tibial ACL avulsions that uses regular anterolateral and anteromedial portals with an additional transpatellar portal. The avulsed fragments along with the ACL are held and buttressed with the help of FiberWires and fixed with the intra-articular portion of the proximal tibia. The technique is performed in an all-inside manner and is easy to master, even for beginners.A nterior cruciate ligament (ACL) avulsion injuries from the tibial side are seen most commonly among children and young adults. 1 They are commonly associated with sports injuries like those usually seen during hyperextension combined with a rotational injury of the knee. 2 ACL avulsion from the tibial side can be extremely debilitating because it limits daily activities, restricts range of motion, and is commonly found in association with continuous pain with or without weight bearing, knee swelling, and instability. Per the Meyers and McKeever classification, 3 types II, III, and IV are displaced avulsion fracture injuries for which one should consider intervening. It is important to realize that however small a tibial avulsion fragment may be, it can be very limiting to the patient. If not addressed adequately, this avulsion is associated with joint laxity, constant pain, fracture nonunion, and loss
<p class="abstract">Proximal radio ulnar synostosis is a rare entity presenting with restriction of supination and pronation. Among the various types, type 4 variety is even more-rare and its presentation, can pose a diagnostic challenge specially, if with history of trauma. Radiologically, it is usually overlooked as a malunited radial neck and therefore needs thorough evaluation. We presented a case of a 15-year-old male who complains of new onset extension block following trauma, with chronically restricted supination and pronation. History suggested the restriction in supination and pronation since birth, and the extension block occurring de novo. Radiographs and CT scan of the elbow revealed proximal radio-ulnar synostosis and anteriorly dislocated, mushroom-shaped radial head, misleading and mimicking like an old, neglected and malunited radial neck fracture with a deformed radial head. The family insisted to not address the restriction of supination pronation but, asked for solution to more disabling extension block. Thus, patient was managed with open procedure, involving radial head-neck excision and removal of malformed radial head. At 1-year follow-up, the child has a well-reduced and stable elbow joint with a functional range of flexion and extension movements with restricted supination and pronation. Type 4 congenital radio ulnar synostosis not only leads to conventionally known restriction of supination pronation but also give rise to extension block de novo as presented in this case. Excision of the deformed head and neck can treat the restriction in extension, however the synostosis will require various other augmented procedures.</p>
<p>Fracture of the acromion process is an uncommon injury. The most common mechanism of injury is direct trauma to the acromion. Isolated acromion fractures are rare as usually they are associated with concomitant skeletal and soft tissue injuries of the shoulder. We present a case of a 45-year-old male with a type 3 fracture of acromion process with reduction of subacromial space. Patient was managed surgically and fracture was fixed using tension band wiring. Patient was followed up using UCLA, DASH and VAS scores and showed good radiological and functional outcomes. Minimally displaced fractures should be regularly followed up for displacement and sub-acromial space compromise. Although acromion fractures are usually treated conservatively, albeit a higher non-union rate, they should be treated surgically in the event of displacement or sub-acromial space reduction, in order to achieve good functional recovery.</p><p><strong> </strong></p>
A pseudoaneurysm is a collection of blood leaking from a damaged arterial wall. Development of the false aneurysm is due to either initial injury of the vessel or is a complication of internal fixation of the femoral fracture. Femoral artery pseudoaneurysms (FAPs) may close spontaneously if the tear is small enough to allow for clotting and sealing. On the other hand, rupture of the aneurysm can trigger thrombosis, distal embolization and compression of adjacent structures. We present a case of left superficial femoral arterial pseudoaneurysm in a 36-year-old male with fracture of left femoral shaft. A 36-year-old male with history of road traffic accident presented to our institute with pain and swelling in left thigh. Patient was investigated and diagnosed with fracture left femoral shaft with a pseudoaneurysm of the left superficial femoral artery (SFA). Stenting was done for SFA followed by open reduction and internal fixation of the femoral shaft fracture. Such cases require multidisciplinary approach and a proper planning with involvement of different medical specialities to achieve optimal results and to minimise any intraoperative and post operative complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.