Introduction: Knee dislocations are an uncommon complication following total knee arthroplasty (TKA). There are many causes of TKA dislocation; however, Wernicke-Korsakoff syndrome is one uncommon neurologic condition that increases the risk of TKA dislocation. Case Report: A 71-year-old male with presented to a local community hospital with knee pain due to advanced osteoarthritis of the knee and subsequently underwent an uncomplicated TKA with a cruciate retaining prosthesis. He eventually returned to the hospital due to infection, medical instability, chronic knee instability, and posterior tibiofemoral dislocation. A revision process was required. Throughout the course of management, the patient had altered mental status and was admitted to the intensive care unit. The first procedure involved removing the cruciate retaining prosthesis and replacing it with a static cement antibiotic spacer. This prosthesis was eventually dislocated through the tibia and a second procedure requiring the placement of an intercalary fusion was needed. The patient has not followed up after the hospital admission. Conclusion: Wernicke-Korsakoff Syndrome is an uncommon condition that affects lcoholics and complicates treatment with joint replacement surgery. Patients with Wernicke-Korsakoff syndrome provide a unique set of challenges that may require multiple surgeries and varying prostheses. Chronic posterior tibiofemoral dislocation is one specific complication that may affect the management of these patients. As orthopedic surgeons, it is important to consider alcohol use disorder and Wernicke-Korsakoff Syndrome when treating patients with total joint replacement.
The purpose of this article is to review the literature related to extensor pollicis longus tendon rupture following nondisplaced distal radius fractures in the pediatric population. This injury is more commonly seen in adults and is relatively rare in children and adolescents. In our literature search, only one case report of pediatric extensor pollicis longus rupture after nondisplaced displaced distal radius fracture is reported. Therefore, it is possible that anatomic and physiologic differences in pediatric patients may be protective against the physical irritation and ischemia thought to cause this injury in their adult counterparts. More research, including biomechanical studies and vascular studies, ought to be done to evaluate for the physiologic differences in pediatric patients that may account for the decreased risk of extensor pollicis longus rupture after nondisplaced distal radius fractures.
The purpose of this article is to review the outcomes of surgical fixation of pediatric both bone forearm fractures with intramedullary nailing versus plating in regards to forearm rotation and its effect on athletic performance. The majority of pediatric both bone forearm fractures can be treated nonoperatively with closed reduction and immobilization; however certain displacement parameters will benefit from operative fixation. Controversy exists on whether to fix both bone forearm fractures with intramedullary nailing or with plates and screws. Historically, it has been shown that the decrease in forearm rotation with intramedullary nailing does not affect function when performing activities of daily living, but this does not account for the rotation needed by pediatric athletes to perform specific actions such as shooting a basketball or pitching a baseball. While the more anatomic reduction with plating has led to greater ranges of forearm rotation, there has yet to be a consensus on the preferred treatment in the high demand pediatric athlete. We recommend further research examining the effects of decreased pronosupination on sport-related function in athletes that had undergone surgical intervention for both bone forearm fractures in childhood or adolescence.
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