Cases reported "Osteitis"

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1/11. [Primary Ilizarov ankle fusion for nonreconstructable tibial plafond fractures]

    OBJECTIVE: ankle arthrodesis in a plantigrade position. In high-energy open injuries with segmental bone loss: proximal tibial metaphyseal corticotomy with distal Ilizarov bone transport for compensation of leg length discrepancy. INDICATIONS: Posttraumatic loss of the tibial plafond, usually resulting from open fracture type IIIC. CONTRAINDICATIONS: Ipsilateral foot injuries impairing ambulation after fusion. Severe injury to the posterior tibial nerve with absent plantar sensation. Soft-tissue injury not manageable surgically. Inadequate patient compliance. Advanced age. Severe osteoporosis. Acute infection. SURGICAL TECHNIQUE: Standard technique: anteromedial longitudinal incision. Removal of remaining articular cartilage. Passing of Ilizarov wires through the distal fibula, talar neck and body. Placement of 5-mm half-pins through stab incisions, perpendicular to the medial face of the tibial shaft. A lateral to medial 1.8-mm Ilizarov wire in the proximal tibial metaphysis is optional. Callus distraction/Ilizarov bone transport: exposure through an anteromedial incision or transverse traumatic wound. Removal of small residual segment of tibial plafond blocking transport. Retain small vascularized bone fragments not blocking transport. For Ilizarov external fixation, two rings in the proximal tibial region. Drill osteoclasis of the tibial metaphysis 1 cm distal to the tibial tuberosity and complete with Ilizarov osteotome. Secure the Ilizarov threaded rods or clickers. Weight bearing as tolerated. Begin distraction 14 days after corticotomy at a rate of 0.5-1 mm per day depending on patient's age. After docking: Ilizarov ankle arthrodesis. RESULTS: Between January 1993 and September 1996, four patients (two men, two women) with severe, nonreconstructable fractures of the tibial plafond were treated. Callus distraction and Ilizarov bone transport in three patients. Age range 19-68 years (average age 45.7 years). Mean follow-up 6.6 years (4 years 9 months to 7 years 4 months). Average duration of the entire treatment in external fixation 54.4 days/cm for the three bone distraction patients. Mean transport 6 cm (4.5-8.5 cm). One patient required repeat ankle arthrodesis.
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keywords = tibia
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2/11. Description of Mycobacterium conceptionense sp. nov., a mycobacterium fortuitum group organism isolated from a posttraumatic osteitis inflammation.

    A nonpigmented rapidly growing mycobacterium was isolated from wound liquid outflow, bone tissue biopsy, and excised skin tissue from a 31-year-old woman who suffered an accidental open right tibia fracture and prolonged stay in a river. The three isolates grew in 3 days at 24 to 37 degrees C. 16S rRNA sequence analyses over 1,483 bp showed that they were identical and shared 99.7% (4-bp difference) sequence similarity with that of Mycobacterium porcinum, the most closely related species. Partial rpoB (723 bp) sequence analyses showed that the isolates shared 97.0% sequence similarity with that of M. porcinum. Further polyphasic approaches, including biochemical tests, antimicrobial susceptibility analyses, and hsp65, sodA, and recA gene sequence analysis, as well as % G C determination and cell wall fatty acid composition analysis supported the evidence that these isolates were representative of a new species. Phylogenetic analyses showed the close relationship with M. porcinum in the mycobacterium fortuitum group. The isolates were susceptible to most antibiotics and exhibited evidence for penicillinase activity, in contrast to M. porcinum. We propose the name Mycobacterium conceptionense sp. nov. for this new species associated with posttraumatic osteitis. The type strain is D16(T) (equivalent to CIP 108544(T) and CCUG 50187(T)).
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ranking = 0.071428571428571
keywords = tibia
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3/11. mycoplasma hominis osteitis in an immunocompetent man.

    mycoplasma hominis has been associated with pelvic inflammatory illness, postpartum and neonatal infections and respiratory tract diseases. It is rarely isolated from patients with other infections. Reported here is a case of tibial osteitis that occurred in a 16-year-old immunocompetent man. Clinical and laboratory findings improved under treatment with clindamycin and fluoroquinolones.
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ranking = 0.071428571428571
keywords = tibia
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4/11. Complications of splintage in congenital dislocation of the hip.

    The use of abduction splintage in the treatment of congenital dislocation of the hip has an important morbidity. Six children who developed complications are presented in this paper. Sustained splintage of an unreduced hip, overcorrection of the femoral head displacement, avascular necrosis of the femoral head, full thickness pressure sores, and excessive tibial torsion may occur as a consequence of treatment. Expert supervision of abduction splintage, correct case selection, and regular review are necessary to reduce the incidence of such complications.
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ranking = 0.071428571428571
keywords = tibia
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5/11. Acute periostitis in early acquired syphilis simulating shin splints in a jogger.

    Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.
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ranking = 0.14285714285714
keywords = tibia
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6/11. Microvascular osteocutaneous groin flap in the treatment of an ununited tibial fracture with chronic osteitis. A case report.

    A 37-year-old man with an ununited tibial fracture combined with a significant skin defect underwent a microvascular transfer of an island osteocutaneous flap of groin skin and iliac crest bone. The bone component of the flap was shown to be a living transplant by the observation of brisk cancellous bone bleeding when the flap was isolated on its vascular stalk; by rapid fracture healing (weight-bearing 15 weeks postoperatively); and sequential bone scan investigations. Various aspects of the flap blood supply, particularly to bone, are discussed, and reference is made to the use of a more suitable vessel system.
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ranking = 0.35714285714286
keywords = tibia
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7/11. The treatment of osteitis complicating tibial fractures.

    A six-part scheme for the treatment of osteitis complicating tibial fractures is presented: (1) wound excision; (2) external fixation; (3) open irrigation drainage; (4) cancellous bone grafting; (5) split skin grafting; (6) full weight bearing in a plaster cast. Of 20 cases, 14 of which were ununited, remission of the infection was achieved in 17 with in 27 months (mean 10.8 months). All 14 ununited fractures went on to union within 20 months (mean 9.5 months).
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ranking = 0.35714285714286
keywords = tibia
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8/11. Apophyseal injuries in the young athlete.

    Apophyseal injuries, which are unique in the adolescent athlete, cause inflammation at the site of a major tendinous insertion onto a growing bony prominence. These injuries typically occur in active adolescents between the ages of eight and 15 years and usually present as periarticular pain associated with growth, skeletal immaturity, repetitive microtrauma and muscle-tendon imbalance. Common apophyseal injuries, and their sites, include Sever's disease (posterior calcaneus), Osgood-Schlatter disease (tibial tuberosity), Sindig-Larsen-Johansson syndrome (inferior patella), medial epicondylitis (humeral medial epicondyle) and apophysitis of the hip (iliac crest, ischial tuberosity). Conservative therapy, including rest, ice, compression, elevation, nonsteroidal anti-inflammatory agents, modification of the athlete's activity level and exercises for increased flexibility and strengthening, is usually effective.
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ranking = 0.071428571428571
keywords = tibia
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9/11. Osteosynthesis of 245 tibial shaft fractures: early and late complications.

    A consecutive series of 245 fresh fractures of the tibial shaft, including 60 open fractures underwent operation in a 5 year period (1980-1984). Two hundred and forty-two (98.8 per cent) of these fractures were followed-up for an average of 79 months (6.5 years). Early and late complications as well as complications after implant removal were taken into account for closed and open fractures. In the 185 closed fractures, infection was observed in 1.7 per cent and delayed union in 6.8 per cent. More than 94 per cent of the closed fractures had an excellent or good late result. In open fractures (60 cases) infection was seen in 6.8 per cent, and plate fatigue with delayed union was seen in 10.3 per cent. However an excellent or good functional result was obtained in 93 per cent of the open fractures. After implant removal refractures occurred in 1.3 per cent and other minor complications in 0.9 per cent.
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ranking = 0.35714285714286
keywords = tibia
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10/11. Osseous manifestations of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome.

    The SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome includes a complex group of disorders characterized by peculiar bone lesions, most commonly involving the anterior chest wall, and sometimes accompanied by dermatologic manifestations. The clinical and radiographic features of this syndrome are well described, but few studies have examined the histologic features of the bone lesions. We describe the clinical, radiographic, and histologic features of the osseous lesions encountered in eight patients with a clinical diagnosis of SAPHO syndrome. The patients included five female and three male patients ranging in age from 5 to 63 years (mean, 35.3 years). The most common clinical presentation was pain related to the sites of osseous involvement. Two patients also had some form of pustular dermatosis. The radiographic features of the osseous lesions varied but often suggested the possibility of a neoplasm. Nine pathologic specimens were available for review, five from the clavicle, two from the first rib, one from the calcaneus/cuboid, and one from the tibia. The histologic features varied but seemed related to the duration of the patients' musculoskeletal symptoms. Early lesions contained acute inflammation, edema, and prominent periosteal bone formation, histologically indistinguishable from ordinary bacterial osteomyelitis, whereas late lesions demonstrated markedly sclerotic bone trabeculae with prominent marrow fibrosis and only mild chronic inflammation; one of these biopsies appeared virtually identical to Paget's disease. One biopsy was performed after an intermediate duration of symptoms and contained prominent chronic inflammation only. The histologic findings in SAPHO are variable and nonspecific and may depend on the duration of disease, but it is important to recognize the spectrum of histologic changes possible in the syndrome and to realize that clinicopathologic correlation is necessary to avoid misdiagnosis and unnecessary long-term antibiotic therapy.
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ranking = 0.071428571428571
keywords = tibia
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