Introduction: Patellar injuries are usually caused while a person slips or falls on a flexed knee and when the forces from the extensors surpass the inherent strength of patella. As the bony failure advances, it concurs or follows injury to medial and lateral extensions of quadriceps mechanism. This happens by pulling mechanism of the muscles. The patient is unable to extend the affected knee actively. This is indicative of disruption of the extensor mechanism and a torn retinaculum. This requires repair or reconstruction through operative means. Case Presentation: To find out complications of comminuted fracture of patella and open reduction after 15 years of surgery. Case Report: A 32-year-old man had a history of fall on ground due to slipping of the wheelchair over wet floor while taking a patient on wheelchair which led to comminuted fracture of left patella with shift knee and had undergone Open reduction and Tension band Osteosynthesis. After this surgical intervention, the patient presented with knee stiffness and pain (rated 6 on numerical pain rating scale) and was referred to physiotherapy. Conclusion: This case study concluded that there is evident stiffness and muscle wasting observed after 15 years of post-fracture surgery of patella, which was managed with the physiotherapeutic rehabilitations.
Introduction: In Moyamoya disease there is long standing, continuous developing occlusion of the arteries of Circle of Willis which leads to development of typical collateral vessels seen on cerebral angiogram. Moyamoya Disease was diagnosed on performing the MR Angiography. Child with Moyamoya disease presents with recurrent episodes of sudden hemiplegia that might occur at alternative sides. The disease is progressive and dynamic in children. Acute management of this disease is symptomatic. MR Angiography clinches the diagnosis and neurosurgical intervention with physiotherapy which may be required as a part of definitive management. Objectives: Our case brings forth the significance of considering Moyamoya Disease to be classic etiology for acute ischemic strokes in children. Case Report: We report a rare case of 10 year old female child who was admitted at our medical center for the complaints of transient ischemic attack & left side hemiparesis with left facial palsy. In respect to our case, surgical intervention was not considered due to having satisfactory response on the commencing medical management. Conclusion: Our case brings forth the importance of considering MMD to be classic etiology for acute ischemic strokes in children .MMD is main diagnosis when we evaluate the children with cerebrovascular events. To asses this non operative MR angiography is investigation of choice. For favourable outcome in children with Moyamoya disease the key is early diagnosis and management.
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