Cases reported "Osteoarthritis"

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1/48. Symptomatic osteoarthritis of the temporomandibular joint: report of a case.

    A case of osteoarthritis in the TMJ which manifested clinical symptoms, radiographic changes, and the classic microscopic alterations has been presented. Whether the condition was a primary or secondary form of the disease could not be unequivocally ascertained, as the symptoms preceded the injection of a sclerosing solution and a mandibular fracture, both of which could be significant contributing factors to a trauma-induced secondary osteoarthritic change. Nevertherless, a lack of symptoms in other joints would tend to exclude a generalized (primary) form of osteoarthropathy. In this regard, symptoms referable to the TMJ (to the exclusion of other joints) are more consistent with findings of secondary osteoarthritic change. Whether osteoarthritic changes were discernible by radiography in the TMJ before the traumatic episodes recorded in the history is unknown. Indeed, a developmental anatomic anomaly could not be ruled out. Regardless of whether the changes were the result of primary degenerative disease or chronic trauma, the symptoms were adequately resolved by surgical intervention.
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ranking = 1
keywords = fracture
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2/48. Early experience with total knee replacement.

    This paper presents a review of two years' experience with the geometric total knee replacement. The results of 23 arthroplasties in 22 patients are discussed. Relief of pain was consistent and dramatic, movement was increased postoperatively in only three patients, but imporvement in overall function occurred in 20 of the 22 patients. There was one failure requiring arthrodesis. In this patient, six months after surgery the medial tibial condyle collapsed and the polyethylene tibial component fractured. This complication has not been reported before. Early results are encouraging. Total knee joint replacement is a useful procedure in advanced arthritis when arthrodesis is the only alternative.
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ranking = 1
keywords = fracture
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3/48. Orthopaedic surgery in the elderly.

    Demographic estimations for the UK predict an increase in the number of major orthopaedic surgical procedures in elderly people. The two major indications for surgery are osteoporotic fractures and severe osteoarthritis of weight-bearing joints. Coexisting medical disease makes elderly patients a surgical high-risk group, and mortality and morbidity after emergency surgery remains high.
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ranking = 1
keywords = fracture
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4/48. Fat embolism syndrome after cementless total hip arthroplasty.

    There are few reports in the literature of fat embolism syndrome after cementless total hip arthroplasty (THA). Most reported cases have occurred after fracture or cemented THA. We report a case of a healthy 51-year-old woman who underwent THA for osteoarthritis under spinal anesthesia. A press-fit cup and extensively porous-coated diaphyseal locking stem were used and inserted without cement. In the recovery room, the patient became hypoxemic and hypotensive and developed cortical blindness. The next day, a petechial rash was evident. Gurd's criteria for fat embolism syndrome were fulfilled. Her symptoms resolved over a 2-week period. patients undergoing cementless THA are at risk for fat embolism syndrome, and this must be considered in the differential diagnosis for postoperative hypoxemia and neurologic deficits.
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ranking = 1
keywords = fracture
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5/48. Vertical-split fracture of mandibular condyle and its sequelae.

    A case of vertical-split fracture of the right mandibular condyle and its sequelae is presented. The patient was a 16-year-old female being assessed for orthodontic treatment. Orthopantomograph and plain joint view radiographs showed a remodelled condyle which had suffered trauma 10 years previously. This type of fracture is unusual in nature but has not led to any secondary lack of growth, restriction of movement or facial asymmetry.
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ranking = 6
keywords = fracture
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6/48. Tibial plafond fractures. How do these ankles function over time?

    BACKGROUND: The intermediate outcome of fractures of the tibial plafond treated with current techniques has not been reported, to our knowledge. The purpose of this study, performed at a minimum of five years after injury, was to determine the effect of these fractures on ankle function, pain, and general health status and to determine which factors predict favorable and unfavorable outcomes. methods: Fifty-six ankles (fifty-two patients) with a tibial plafond fracture were treated with a uniform technique consisting of application of a monolateral hinged transarticular external fixator coupled with screw fixation of the articular surface. Thirty-one patients with thirty-five involved ankles returned between five and twelve years after the injury for a physical examination, assessment of ankle pain and function with the iowa ankle Score and ankle osteoarthritis Scale, assessment of general health status with the Short Form-36 (SF-36), and radiographic examination of the ankle. RESULTS: arthrodesis had been performed on five of the forty ankles for which the outcome was known at a minimum of five years after the injury. Other than removal of prominent screws (two patients), no other surgical procedure had been performed on any patient. The average iowa ankle Score was 78 points (range, 28 to 96 points). The scores on the SF-36 and ankle osteoarthritis Scale demonstrated a long-term negative effect of the injury on general health and on ankle pain and function when compared with those parameters in age-matched controls. The degree of osteoarthrosis was grade 0 in three ankles, grade 1 in six, grade 2 in twenty, and grade 3 in six. The majority of patients had some limitation with regard to recreational activities, with an inability to run being the most common complaint (twenty-seven of the thirty-one patients). Fourteen patients changed jobs because of the ankle injury. Fifteen ankles were rated by the patient as excellent; ten, as good; seven, as fair; and one, as poor. Nine patients with previously recorded ankle scores had better scores after the longer follow-up interval. The patients perceived that their condition had improved for an average of 2.4 years after the injury. CONCLUSIONS: Although tibial plafond fractures have an intermediate-term negative effect on ankle function and pain and on general health, few patients require secondary reconstructive procedures and symptoms tend to decrease for a long time after healing.
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ranking = 8
keywords = fracture
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7/48. Intracapsular fractures of mandibular condyle: diagnosis, treatment, and anatomical and pathological evaluations.

    The aim of this study was to attempt to establish a correlation between condylar localized fracture, onset of anatomicopathological lesions of the articular structures, and determination of ankylosis so as to define appropriate diagnostic and therapeutic procedures. Clinical, arthroscopic, and histological studies were carried out in two patients with a severe temporomandibular joint disorder after a condylar localized fracture. Treatment included removal of the displaced fragments, condylar surface remodeling, suture of retrodiskal perforations, and diskal repositioning. The histological study of the condylar specimens revealed signs of osteoarthrosis of the articular surface and chondroid metaplasia of the bilaminar zone with early onset of ankylosis. Results of this study confirmed the presence of causal relations between condylar localized fracture and ankylosis with alterations in retrodiskal tissue. These relations are found in 1) tissue damage caused by bony fragments remaining in the articular cavity (underestimated and poorly treated fractures), 2) the lesion that occurs in association with mechanical trauma; and, particularly, c) the disk and retrodiskal impairments caused by catabolic and degenerative osteoarthrotic changes secondary to condylar marrow damage. Thus, timeliness and accuracy of the diagnosis of condylar localized fracture are most important, as are correct diagnosis and treatment before the onset of degenerative anatomicopathological lesions.
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ranking = 9
keywords = fracture
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8/48. Avascular necrosis of the humeral head after dislocation with fracture of the greater tuberosity.

    A case of posttraumatic avascular necrosis of the humeral head in a young patient was detected 3 years after an anterior dislocation with a nondisplaced greater tuberosity fracture. The evolution to degenerative joint disease is described.
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ranking = 5
keywords = fracture
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9/48. Spinous process fractures associated with Baastrup disease.

    patients with Baastrup disease may experience pain owing to irritation of the periosteum or adventitial bursae between abutting spinous processes. We are not aware of any reports in the literature that describe stress fractures of the spinous fractures in patients with Baastrup disease. In this case report, we present two cases of spinous process fractures in lumbar vertebrae associated with Baastrup disease and describe their appearance with conventional radiography, bone scintigraphy, computed tomography (CT) and magnetic resonance (MR) imaging.
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ranking = 7.5554721176909
keywords = fracture, stress fracture
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10/48. Subperiosteal ganglion associated with Paget's disease of bone.

    Tumoral lesions related to Paget's disease may be classified as malignant, benign or pseudotumoral. While sarcomatous degeneration is the most feared complication, awareness of benign and pseudotumoral lesions is essential for assisting in accurate histological interpretation of the biopsy sample, which may avoid unnecessary repeat biopsies. We present the first case of a juxta-articular subperiosteal ganglion associated with Paget's disease, with classic imaging characteristics, especially on CT examination. The well-defined soft tissue mass at the medial aspect of the obturator rim, adjacent to a small fracture in pagetic quadrilateral plate, showed an ossified rim and internal gas lucencies, these being the hallmarks of a juxta-articular subperiosteal ganglion. On MRI, the lesion was of intermediate signal intensity on T1-weighted sequences, increased signal intensity on T2-weighted sequences, with rim enhancement after gadolinium contrast injection and preservation of fatty marrow signal of the underlying pagetic bone. Identification of the entity avoided an unnecessary biopsy or surgical intervention.
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ranking = 1
keywords = fracture
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