1/180. Failure of the hinge mechanism of a trispherical total wrist arthroplasty: a case report and review of the literature.We report a patient with rheumatoid arthritis who developed late catastrophic failure of the hinge mechanism of her trispherical total wrist arthroplasty. This was associated with synovitis secondary to wear debris from titanium, cement, and polyethylene which produced exuberant flexor and extensor tendon synovitis and median nerve compression.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/180. Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty.Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty (TKA) has not been well reported before. A 63-year-old man with osteoarthritis of the right knee underwent TKA with a New Jersey LCS knee, with cementing on the tibia and patella but not on the femoral component. After 42 months, in addition to wearing of polyethylene of the tibia and patella, severe osteonecrosis of the medial femoral condyle was noted. osteonecrosis caused loss of osseous support of the medial flange of the femoral component, and the bone ingrowth of the central and lateral flange to the distal femur was so good that it overcame the yield stress of the metal of the femoral component and caused fracture of the femoral component. The osteolytic area was filled with autogenous iliac bone, and a new femoral component was inserted and cemented. The patient's condition became satisfactory with relief of pain. Although uncommon, fracture of the femoral component does occur associated with polyethylene wear and osteolysis.- - - - - - - - - - ranking = 215.54812878027keywords = fracture (Clic here for more details about this article) |
3/180. Shear syndrome: the worst case scenario of crush syndrome.Shear syndrome is described as a complication of crush syndrome. In addition to compression of and injury to the electrode, complete transection occurs. In this case, the free end migrated to the pulmonary artery with the potential for further complications.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
4/180. Reactions and complications after the implantation of Endobon including morphological examination of explants.In the study described here, the integration of hydroxyapatite (HA) ceramic implants (Endobon) was investigated. These implants have an interconnecting system of pores and are free from foreign protein. The material is not toxic, genotoxic, nor zytotoxic, and it is biocompatible. The progress of integration was investigated by means of clinical and radiological check-ups. From 10 patients, it was possible to obtain samples for histological analysis during a second operation (e.g., metal explantation). Microscopic examination showed bony integration with newly formed bone in direct contact with the HA ceramic; it also showed osteoblasts and osteoid seams. No second operation took place earlier than 4 months after the first operation, yet even after this relatively short period, bony integration was already evident. Clinical observation (based on x-rays, reports of pain, signs of inflammation) showed that in most cases healing was taking place without complications. More general operational complications such as thrombosis or nerve injury were observed in 4 patients. If the implant is not sufficiently protected from mechanical stress, bony integation will not take place, and the implant may fracture. HA ceramic, with a porosity between 30% and 80%, is not comparable to cortical bone but only to spongy bone. This factor must be taken into account when deciding whether a HA ceramic implant is indicated.- - - - - - - - - - ranking = 107.77406439014keywords = fracture (Clic here for more details about this article) |
5/180. Subclavian stents and stent-grafts: cause for concern?PURPOSE: To report cases of stent and stent-graft fracture in the subclavian vessels. methods AND RESULTS: Three patients with self-expanding stents of 3 different types in 1 subclavian artery and 2 subclavian veins presented with recurrent symptoms 6 months to 2 years after stenting. All devices showed signs of compression with stent fracture. The covered stent in the subclavian artery was excised. Of the 2 venous patients, 1 was treated with first rib resection and the other refused further treatment. CONCLUSIONS: The subclavian vessels are prone to flexion during movement, and the vessels may be compressed by external structures, including the clavicle and first rib. stents that have not been designed to withstand these forces may be damaged.- - - - - - - - - - ranking = 216.54812878027keywords = fracture, compression (Clic here for more details about this article) |
6/180. Deformation of self-expanding stent-grafts complicating endovascular peripheral aneurysm repair.PURPOSE: To demonstrate the deformation of self-expandable stents after endovascular repair of peripheral aneurysms. methods AND RESULTS: The Corvita Endoluminal Graft was used to treat a traumatic false aneurysm of the right subclavian artery and a common iliac artery aneurysm in 2 patients. In the subclavian case, the stent-graft showed a "cigar-shaped" deformation with hemodynamically significant stenoses at the proximal and distal ends at 3 months. In the second case, the same type of deformity was noted only 1 day after implantation. Two months later, the stent-graft occluded, necessitating surgical repair. CONCLUSIONS: Both cases demonstrate the possibility of stent deformation of self-expanding stent-grafts implanted at arterial sites not subject to external compression.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
7/180. sciatic neuropathy secondary to total hip arthroplasty wear debris.sciatic neuropathy after total hip arthroplasty can result from several causes. We present a case in which a large cystic mass developed around a failed total hip arthroplasty. The lesion extended through the greater sciatic notch and into the pelvis producing sciatic nerve compression. The diagnosis was delayed, and the patient underwent a laminectomy without relief of symptoms before an abdominopelvic computed tomography (CT) scan revealed the mass. After revision of the components and excision of the accessible portion of the lesion, the symptoms improved. Resolution of the intrapelvic portion of the mass was demonstrated on follow-up CT scan, suggesting that retroperitoneal resection of this type of lesion may not be required at the time of revision of the components.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
8/180. Lateral insufficiency fractures of the femur caused by osteopenia and varus angulation: a complication of total hip arthroplasty.Lateral femoral insufficiency fractures in total hip arthroplasty occur due to osteopenia and varus positioning of the femoral component, the femur itself, or both. The presentation of these fractures can be unclear but usually involves the insidious onset of unexplained thigh or groin pain. The patients are likely to have significant comorbidities as well. Characteristic radiographic findings may be present, depending on when the patient presents. The insufficiency fractures generally occur at the level of the femoral stem tip on the lateral cortex of the femur. If left untreated, pain and loss of function continue. Eventually an insufficiency fracture can progress to a displaced periprosthetic fracture. Nonsurgical treatment is not successful. Recommended treatment involves revision to a long-stem femoral component. The risk of postoperative complications is significant.- - - - - - - - - - ranking = 969.96657951124keywords = fracture (Clic here for more details about this article) |
9/180. Leaflet escape in a TEKNA and an original duromedics bileaflet valve.We report a case of leaflet escape in an Edwards-TEKNA bileaflet valve, in the mitral position. The examination findings of the explanted valve are compared with a similar case of leaflet escape in an original Edward-Duromedics prosthesis. Based on our findings alone, it is not certain whether the TEKNA valve continues to have a higher risk for fracture.- - - - - - - - - - ranking = 107.77406439014keywords = fracture (Clic here for more details about this article) |
10/180. Failure after customized curved femoral stems in total hip arthroplasty for Paget's disease.We describe 2 patients with Paget's disease who underwent total hip arthroplasty for osteoarthrosis. In view of the femoral deformity in each case, a custom-made, long, curved femoral stem was used. Both patients have subsequently sustained periprosthetic fractures at the level of the tip of the prosthesis.- - - - - - - - - - ranking = 107.77406439014keywords = fracture (Clic here for more details about this article) |
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