Cases reported "Rupture"

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1/31. Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft.

    A case report of saphenous neuralgia following arthroscopically assisted anterior cruciate ligament reconstruction with hamstring tendons is presented. The patient complained of paresthesia in the anteromedial region of the lower leg and tenderness at the medial side of the knee without motor or reflex abnormalities. Because saphenous neuralgia can mimic disorders of the knee, peripheral vascular disease, and lumbar nerve root compression, diagnosis can be confirmed by anesthetic blockade. The patient underwent saphenous neurolysis. Six months after surgery, the patient had normal cutaneous sensation at the medial aspect of the lower leg and ankle and she no longer complained of any painful dysesthesia. To minimize the risk of damaging the saphenous nerve when harvesting hamstring tendons, the knee should be flexed and the hip external rotated.
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ranking = 1
keywords = anteromedial
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2/31. brachial artery injury in closed posterior elbow dislocation case report.

    The authors describe a case with a closed posterior elbow dislocation associated with a distal radial fracture and complete transsection of the brachial artery. The patient had a pulseless distal upper extremity and immediate gross swelling of the elbow and forearm. As closed reduction was not possible, open reduction had to be performed through an anteromedial approach to the elbow. End-to-end suture of the brachial artery was successful. After fasciotomy and internal fixation of the distal radial fracture, the elbow was stabilized with an external fixator spanning the elbow joint. After two years, despite good function of the elbow, restoration of the hand function is not optimal owing to persistent motor deficit of the ulnar nerve.
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ranking = 1
keywords = anteromedial
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3/31. Impingement fracture of the anteromedial tibial margin: a radiographic sign of combined posterolateral complex and posterior cruciate ligament disruption.

    Marginal fractures of the tibial plateau are associated with a high incidence of soft tissue injuries to the stabilising structures of the knee joint. Injuries to the anterior cruciate ligament are associated with the Segond fracture and impingement fractures of the posteromedial tibial plateau. Recognition of these fractures aids diagnosis of these injuries. Marginal fractures of the tibial plateau associated with posterior cruciate ligament injuries are less common, though recently a "reverse" Segond fracture has been recognised. We describe a fracture of the anteromedial tibial plateau associated with complete disruption of the posterior cruciate ligament and posterolateral complex.
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ranking = 5
keywords = anteromedial
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4/31. Operative treatment in case of a closed rupture of the anterior tibial tendon.

    Closed rupture of the tibial anterior tendon is a rare clinical entity. case reports in the literature reveal a total of only 49 cases up to the year 2000. According to these reports, the age group affected is 50 to 70 years old, and there are more men than women affected. Although the functional limitation is quite considerable, late diagnosis is common. An appropriate clinical examination, including an exact history taking, should lead to the right diagnosis. Ultrasound examination and magnetic resonance imaging (MRI) may be helpful. 'Restitutio ad integrum' can only be achieved by operative treatment. If technically possible, reinsertion of the tendon directly into bone or direct tendon repair is preferred. After delayed diagnosis, a secondary reconstruction through tendon transfer or transplantation is often necessary. A 64-year-old woman presented with pain and swelling in the area of the ankle joint 5 months after falling. She showed insecurity in walking, and the heel-walk could not be demonstrated. The distal neurovascular function was intact. The area of the retinaculum showed a swelling, and the tendon was not palpable in comparison with the other forefoot. An intact tendon could not be seen by ultrasound, and MRI confirmed these findings. A complete rupture was noted during the operative revision. The proximal and the distal tendon stumps were found to be thickened and knotted, the proximal stump was also atrophic. An augmented tenoplasty was performed. Afterwards, the tendon was tense in the neutral position. The lower leg was put in a plaster cast for 6 weeks, followed by physiotherapy. Ten months after the operation, the tendon was palpable in the correct position, the dorsal extension was powerful, and the patient did not experience any difficulty. rupture of the anterior tibial tendon is a rare clinical entity and should be considered in the differential diagnosis of pain in the area of the ankle joint. An early operative treatment is advantageous.
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ranking = 2.3579026635139E-5
keywords = group
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5/31. Complete knee dislocation without posterior cruciate ligament disruption. A report of four cases and review of the literature.

    Complete knee dislocation usually causes disruption of both the anterior and posterior cruciate ligaments. Four cases of complete knee dislocation without posterior cruciate ligament (PCL) disruption are reported. All cases involved either anterior or anteromedial dislocation with anterior cruciate ligament disruption and collateral ligament injury, but without posterior cruciate disruption. This is an uncommon finding in complete dislocation of the knee. The PCL may occasionally be spared significant injury in anterior type dislocations, however, thus favorably affecting treatment options.
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ranking = 1
keywords = anteromedial
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6/31. Chopstick technique for nucleus removal in an impending dropped nucleus.

    We describe a bimanual chopstick technique for nucleus removal after a posterior capsule tear and an impending dropped nucleus during phacoemulsification. The technique stabilizes the nucleus and nuclear fragments by providing posterior support with a Sinskey hook introduced from the pars plana. Once supported, the nucleus is gripped between 2 instruments, brought out of the capsular bag into the anterior chamber, and then taken out of the enlarged wound. This bimanual removal technique causes minimal disturbance to the vitreous, iris, and cornea.
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ranking = 0.015247087444849
keywords = nucleus
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7/31. Mesh wrap in severe pediatric liver trauma.

    PURPOSE: This study reviews the authors' experience in treating severe pediatric liver injuries with absorbable mesh wrapping. The authors found this relatively new therapeutic method very useful in selected cases, although its use is not very common in children. The authors analyze the indication describe some technical aspects, and discuss the advantages and the pitfalls of the method. methods: In a 10-year period between 1990 and 2000, 181 children were admitted to Hillel-Yaffe Medical Center with blunt hepatic trauma. A total of 132 children were treated conservatively, and 49 (27%) were operated on. The operated group included 35 cases of isolated liver injuries and 14 cases of additional intraabdominal injuries. Thirty-four children were operated on between 1990 and 1995 (36% of 96 children), whereas between 1995 and 2000, 15 children were operated on (17% of 85 children), including 4 children aged 18 months to 15 years with massive liver bleeding who were treated with mesh wrap technique. The retrospective analysis of these 4 cases indicates a progressive policy in the recognition of cases suitable for mesh wrapping and gallbladder conservation. RESULTS: The perihepatic mesh wrap technique controlled the bleeding in all children. In 3 of them the right lobe was wrapped, and, in 1 case, total liver wrapping was performed. Hepatic enzymes and bilirubin levels were elevated in the first 3 to 7 days and declined gradually to normal levels. The perihepatic mesh was not an obstacle to a transcutaneous drainage of an intrahepatic biloma. All 4 children returned to normal physical activities. CONCLUSIONS: liver mesh wrap is a simple, effective, and rapid way to obtain hemostasis and to conserve parenchyma in severe traumatized liver. The decision to wrap the liver should be done early to prevent acidosis and hypothermia. cholecystectomy is not an integral part of the procedure in children. The morbidity is low, and most of the complications can be treated nonsurgically.
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ranking = 2.3579026635139E-5
keywords = group
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8/31. Delayed repair of the quadriceps using the Mitek anchor system: a case report and review of the literature.

    Extensor mechanism disruptions are relatively uncommon knee injuries. Within this group, delayed treatment is an infrequent but difficult clinical situation. Fibrous degeneration, muscle contraction and subsequent hiatus present a challenge to the orthopaedic surgeon. We present an unusual case of a successful delayed repair using the Mitek anchors system (Mitek Products Inc., a division of Ethicon Inc., Westwood, massachusetts).
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ranking = 2.3579026635139E-5
keywords = group
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9/31. Lysozyme amyloidosis: report of 4 cases and a review of the literature.

    Autosomal dominant hereditary amyloidosis represents not 1 disease but a group of diseases, each the result of mutations in a specific protein. The most common form is transthyretin amyloidosis, which has been recognized clinically for over 50 years as a familial polyneuropathy. Nonneuropathic amyloidoses (Ostertag type amyloidosis) include those due to abnormalities in lysozyme, fibrinogen Aalpha-chain, and apolipoprotein a-i and A-II. The role of lysozyme in amyloid-related human disorders was first described in 1993; to date, there have been only 9 publications describing this disorder, which is a nonneuropathic form of hereditary amyloidosis. Reported cases have involved 7 unrelated families. We describe here our own experience with 4 families suffering from lysozyme amyloidosis: the first had prominent renal manifestations with sicca syndrome, the second and third had prominent gastrointestinal symptoms, and the fourth had a dramatic bleeding event due to rupture of abdominal lymph nodes. To our knowledge, this last symptom has not been reported previously, but is reminiscent of the hepatic hemorrhage seen in a previously reported case of a patient with lysozyme amyloidosis. To characterize the manifestations of this disorder, we performed an exhaustive literature review.Although hereditary amyloidosis is thought to be a rare disease, it is probably not as rare as we think and may well be underdiagnosed. Moreover, some cases of lysozyme amyloidosis are probably confused with acquired monoclonal immunoglobulin light-chain (AL) amyloidosis, formerly known as primary amyloidosis, which is the most frequent type of amyloidosis. Because treatment for each type of amyloidosis is different, and because therapy directed at 1 type may worsen symptoms of the other types, it is important to determine precisely the nature of the amyloid protein. Thus, hereditary lysozyme amyloidosis should be considered in all patients with systemic amyloidosis, particularly in patients who present with renal, gastrointestinal, or bleeding complications without evidence of AL or AA (secondary) amyloidoses.
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ranking = 2.3579026635139E-5
keywords = group
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10/31. Spontaneous complete hamstring avulsion causing posterior thigh compartment syndrome.

    Complete avulsion of the hamstring muscle group from its ischial origin is an uncommon condition, and has been mostly reported in young athletes. A case is presented in which a middle aged man sustained this injury and developed a compartment syndrome of the thigh, which has not been previously reported. The surgical management of this patient is described.
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ranking = 2.3579026635139E-5
keywords = group
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