Patient: Male, 43Final Diagnosis: NeurofibromatosisSymptoms: Hip painMedication: —Clinical Procedure: —Specialty: Orthopedics and TraumatologyObjective:Rare diseaseBackground:Neurofibromatosis type 1 is a disease known for orthopedic manifestations such as spine deformities, congenital pseudarthrosis of the tibia and other bony dysplasias; joint dislocations are rare. Joint arthritis caused by neurofibromatosis, with a stable hip, has never been reported in the English literature before.Case Report:A 43-year-old man diagnosed with neurofibromatosis type 1 (NF-1) presented with hip pain of 5 years duration, with no history of trauma and no clinical or radiological signs of dislocation. He had classical clinical and radiological signs of hip arthritis, with acetabular erosions and femoral head arthritis. The patient was treated with total hip arthroplasty metal-on-metal (MoM).Conclusions:Hip arthritis alone without subluxation or dislocation due to NF-1 is an extremely rare presentation. This is the first reported presentation and provisional treatment with total hip arthroplasty.
Alkaptonuria is a rare metabolic disorder caused by the deficiency of homogentisic acid oxidase enzyme, which is responsible for eliminating homogentisic acid from the body through the renal system. Excessive accumulation of homogentisic acid leads to ochronosis and ochronotic arthritis. Owing to the rarity of the disease, long-term functional outcomes of joint replacements of the hips and knees in ochronosis arthropathy are unconfirmed, and only a limited number of case reports are available on this. We present a case of a 45-year-old man with ochronosis and advanced osteoarthritis of both the hips and knees. He underwent bilateral hip and knee replacements as staged procedures. At a follow-up of more than 12 years, the man had full mobility with no loosening of implants.
A 16-year-old girl who had Morquio syndrome presented with severe bilateral hip pain and limited mobility because of bilateral hip osteoarthritis and fixed flexion deformities. She was wheelchair bound for the previous 6 months. Cervical spine flexion-extension views showed mild subluxation (<3 mm), and there was thoracolumbar spine kyphosis. Magnetic resonance imaging of the cervical and thoracolumbar spine showed hypoplasia of the odontoid and vertebral bodies, but no spinal cord compression. Bilateral cemented total hip arthroplasty was performed through a posterior approach under general anesthesia with fiberoptic intubation. The femoral canals accepted a small-diameter stem, the right femoral head was used as a graft for superior right acetabular deficiency, and low-profile all-polyethylene acetabular cups were implanted. Follow-up at 15 years after surgery showed that the patient was fully ambulatory without pain or supports, and radiographs showed no loosening. In summary, total hip arthroplasty at a young age may be necessary in patients who have Morquio syndrome because of severe arthritis and soft tissue contractures. Extensive preoperative evaluation that includes imaging of the entire spine is mandatory because of the risk of developing spinal cord compression.
Objectives:The objective of this study was to assess the outcome of displaced lateral third clavicle fractures which were fixed using hook plates. Introduction:The lateral third clavicle fractures in adults are unstable fractures requiring operative treatment and are prone to non-union and delayed union. The clavicle hook plate is one of the many operating techniques that can achieve a high rate of union and relatively low rate of complications for this type of fracture, as evident from its extensive use in the last decade or so. Literature suggests good results with many studies reporting union rates of up to 100%. However, the technique is not without its fair share of controversies regarding complications like shoulder impingement, resulting in long term shoulder pain and subacromial osteolysis. We aim to assess the outcome of the patients treated with hook plate and determine whether this technique has good outcome.Methods: 22 patients, who were previously operated on at two health-care centres of Peshawar from April 2016 to March 2019 for displaced fractures of the lateral third of the clavicle by using hook plate technique, were assessed retrospectively from case records and radiographs and clinical examinations of patients, to determine their functional and radiological outcome. The follow-up duration ranged from six months to three years. Result:The average age was 31.6 years with range of 18 to 53 years. Among these 17 were males and 5 females. All the fractures united successfully making the union rate 100%. The implant was removed from 6 of the cases, with only 3 of them due to complications. One of them had a periprosthetic fracture while the other 2 experienced persistent pain and limitation of abduction. Only 37% of the patients had long-lasting pain and 16% complained of stiffness with all of them returning to their work/sports successfully. The functional outcome according to constant score was above 80 in 90% cases. Conclusion:Surgical fixation of lateral-third clavicle fractures with a hook plate is an effective technique resulting in excellent rate of union and relatively good functional outcome.
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.