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21/751. Salvage of failed resection of the distal ulna. Case report.

    A 45-year-old woman completely lost the ability of active supination of the forearm after a Darrach resection for malunited fracture of the distal radius. A three-component reconstruction was performed to stabilise the distal stump of the ulna and prevent convergence between the two forearm bones. The procedure combined advancement lengthening osteotomy of the ulna, longitudinal intramedullary tenodesis of the extensor carpi ulnaris tendon, and dorsal transfer of the pronator quadratus through the interosseous space. Four months after the salvage procedure she again had full active supination of the forearm and she returned to work two months later.
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ranking = 1
keywords = fracture
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22/751. Unusual mode of spread and presentation of meningioma: a case report.

    Although rare, extracranial extension of a meningioma has been well documented. An interesting natural history of neglected meningioma with skull vault hyperostosis and predominantly extracranial extension is described. Following surgical resection of the highly vascular meningioma, the patient developed fatal coagulopathy.
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ranking = 0.042237613883386
keywords = skull
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23/751. Gorham syndrome: anaesthetic management.

    Gorham syndrome is a rare chronic disease of children and young adults, featuring massive osteolysis with pathological fractures and complicated by respiratory and neurological deficits. To date, 175 cases have been reported in the literature but information on anaesthetic management is sparse. We present a child with Gorham syndrome who underwent urgent surgical medullary decompression and who subsequently developed bilateral pleural effusions.
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ranking = 1
keywords = fracture
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24/751. Visual loss associated with fibrous dysplasia of the anterior skull base. Case report and review of the literature.

    The authors present a case of visual loss associated with fibrous dysplasia of the anterior skull base and the surgical management of this case. Preoperative computerized tomography scanning in this patient demonstrated a patent optic foramen and a rapidly growing cystic mass within the orbit, which was responsible for the patient's visual loss. A literature review revealed that this case is typical, in that cystic mass lesions of various types are frequently responsible for visual loss associated with fibrous dysplasia. The authors did not find significant evidence in the literature to support the notion that visual loss associated with fibrous dysplasia is the result of progressive optic canal stenosis, thus raising questions about the value of prophylactic optic canal decompression. Instead, as demonstrated by this case and those uncovered in the literature review, most instances of visual loss result from the rapid growth of mass lesions of cystic fibrous dysplasia, mucoceles, or hemorrhage. Findings of the literature review and the present case of fibrous dysplasia of the anterior skull base support a role for extensive surgical resection in these cases and indicate a need for additional prospective analysis of a larger number of patients with this disease.
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ranking = 0.25342568330032
keywords = skull
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25/751. Missed orbital wall blow-out fracture as a cause of post-enucleation socket syndrome.

    BACKGROUND: Post-enucleation socket syndrome (PESS: deep upper lid sulcus, ptosis or upper lid retraction, enophthalmos and lower lid laxity) is a well-recognised complication of a volume-deficient anophthalmic socket. A patient requiring enucleation following severe ocular trauma may have an underlying orbital wall blow-out fracture which if overlooked can cause severe volume deficit with poor cosmesis and limited prosthesis motility. PURPOSE: To establish the prevalence of an undiagnosed blow-out fracture in patients with PESS and a history of relevant trauma. methods: medical records and orbital computed tomography (CT) scans were reviewed for all patients presenting with PESS and a history of relevant trauma. RESULTS: Undiagnosed blow-out fractures were found in 15 (33%) of 45 patients presenting between August 1993 and December 1996. These were significant enough to warrant surgical repair in 13 (29%) patients. CONCLUSIONS: We suggest that any patient presenting with PESS and a history of relevant trauma should be considered to have an orbital wall blow-out fracture until proven otherwise by CT scanning of the orbit. Similarly any patient requiring enucleation following severe ocular trauma should undergo CT scanning to rule out a coexisting blow-out fracture which could be repaired at the time of enucleation.
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ranking = 9
keywords = fracture
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26/751. Management of low lumbar fractures by dorsal decompression, fusion, and lumbosacral laminar distraction fixation.

    OBJECT: The authors conducted a study to assess the anatomical appropriateness of using the S-2 dorsal neuroforamina as a hook fixation point, and they present the results of their clinical experience of using a nonscrew alternative for the surgical management of low lumbar (L-4 or L-5) burst fractures. methods: The technique used involves lumbar laminar fixation, rod contouring (to preserve lordosis), S- sublaminar wire fixation, S-2 dorsal neuroforaminal hook fixation, cross-fixation, and distraction. Because the S-2 dorsal neuroforamina was used as a unique fixation point, anatomical data obtained in 10 cadavers supporting the technique's utility are provided. Surgery was performed in six patients by using this technique, and solid fusion was achieved in all. CONCLUSIONS: The reestablished lordotic posture was preserved in all but one patient. From an anatomical perspective, the findings corroborate the use of the S-2 dorsal foramina as a hook fixation point.This technique provides a viable adjunct or alternative to sacral screw and ilial fixation techniques.
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ranking = 5
keywords = fracture
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27/751. Atlantal stenosis: a rare cause of quadriparesis in a child. Case report.

    The authors report the case of a 3-year-old boy who suffered from quadriparesis and respiratory distress after failing to execute a somersault properly. neuroimaging revealed spinal cord contusion with marked spinal canal stenosis at the level of the atlas. No subtle instability, occult fracture, or other congenital abnormalities were confirmed. spinal cord contusion with marked canal stenosis is rare, and only several adult cases have been reported. Severe stenosis at the level of the atlas may predispose individuals to severe spinal cord contusion, as occurred in our patient after sustaining trivial trauma.
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ranking = 1
keywords = fracture
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28/751. A case of malignant otitis externa following mastoidectomy.

    We present a case of a 63-year-old diabetic male who developed malignant otitis externa following mastoidectomy. Extensive skull base osteomyelitis caused thrombosis of the jugular bulb and subsequent paralysis of cranial nerves VII, IX, X and XII. He was treated aggressively with intravenous antibiotics and debridement of granulation tissue in the mastoid bowl with full recovery of the cranial nerve palsies associated with recanalization of the jugular bulb. We believe this is the first reported case of malignant otitis externa to occur following mastoidectomy with complete recovery of the cranial nerve paresis.
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ranking = 0.042237613883386
keywords = skull
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29/751. Early experience with poly L-lactic acid bioabsorbable fixation system for paediatric craniosynostosis surgery. Report of 3 cases.

    OBJECTIVE: The authors describe early experience in the use of bioabsorbable fixation devices for cranial reconstruction of paediatric craniosynostosis patients. methods: Three patients, individually respectively presenting sagittal synostosis, metopic synostosis, and clover leaf skull deformity, underwent cranial reconstruction using poly L-lactic acid (PLLA) plates and screws. The patients ranged in age from 2 to 10 months at the time of surgery. The postoperative clinical follow-up ranged from 16 to 18 months. All patients showed satisfactory wound healing without signs of infection or local inflammation. The plates provided satisfactory fixation and were not palpable through the skin after 16 to 18 postoperative months. CONCLUSION: Our experience demonstrated the efficacy of PLLA bioabsorbable plates and screws for cranial reconstruction in cases of infant craniosynostosis. prospective studies and longer follow-up of a larger number of patients is desirable for confirmation of these findings.
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ranking = 0.042237613883386
keywords = skull
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30/751. Extensor tendon rupture after internal fixation of a distal radius fracture using a dorsally placed AO/ASIF titanium pi plate. Arbeitsgemeinschaft fur Osteosynthesefragen/association for the Study of Internal Fixation.

    Extensor tenosynovitis has been reported as a complication of the Arbeitsgemeinschaft fur Osteosynthesefragen/association for the Study of Internal Fixation (AO/ASIF) pi plate. The authors present a case of extensor tendon rupture after internal fixation with a pi plate after one of the screws in the distal limb loosened. This mechanism of extensor tendon rupture has not been reported previously. With appropriate prevention, monitoring, and intervention this complication could have been avoided. Schnur DP, Chang B. Extensor tendon rupture after internal fixation of a distal radius fracture using a dorsally placed AO/ASIF titanium pi plate.
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ranking = 5
keywords = fracture
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