Threatening Fracture of Intraosseous Lipoma Treated by Internal Fixation

2019 ◽  
Vol 109 (1) ◽  
pp. 75-79
Author(s):  
Igor Frangež ◽  
Tea Nizič-Kos ◽  
Matej Cimerman
Keyword(s):  
Internal Fixation ◽  
Surgical Techniques ◽  
Bone Neoplasms ◽  
Pathologic Fracture ◽  
Calcaneal Fracture ◽  
Lateral Side ◽  
Intraosseous Lipoma ◽  
Internal Stabilization ◽  
Appropriate Treatment ◽  
Fracture Surgery

Intraosseous lipomas are rare benign bone neoplasms with an incidence of less than 0.1%; origin in the calcaneus has been reported in only a few patients. First-line treatment remains conservative, but several surgical techniques have also been described. We describe a 44-year-old woman with increasing pain in her left heel for a year and a half, who noticed swelling on the lateral side of the calcaneus. The patient underwent radiography, magnetic resonance imaging, and computed tomography of her left foot, which was suspicious for an intraosseous lipoma with a threatening calcaneal fracture. We performed a surgical procedure, curettage of the tumor, spongioplastics (by autologous bone transplant and β-tricalcium phosphate), and internal stabilization with a calcaneal plate considering the goal of immediate postoperative weightbearing. Histologic examination confirmed an intraosseous lipoma of the calcaneus. The patient's pain was relieved immediately after surgery. Internal stabilization of the calcaneus allowed the patient to immediately fully weightbear and to return to usual daily activities. Although a benign bone tumor, intraosseous lipoma can cause many complications, such as persistent pain, decreased function, or even pathologic fracture as a result of calcaneal bone weakening. Choosing an appropriate treatment is still controversial. Conservative treatment is the first option, but for patients with severe problems and threatening fracture, surgery is necessary. Internal fixation for stabilization enables immediate postoperative weightbearing and shortens recovery time.

scholarly journals Functional outcome of operatively treated displaced intra-articular calcaneal fractures using two parallel contoured reconstruction plates

1970 ◽  
Vol 8 (1) ◽  
pp. 12-17
Author(s):  
S Lakhey ◽  
RR Manandhar ◽  
RL Pradhan ◽  
BK Pandey ◽  
S Sharma ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Scoring System ◽  
Surgical Techniques ◽  
Calcaneal Fracture ◽  
Lateral Approach ◽  
Complication Rates ◽  
Calcaneal Fractures ◽  
Articular Fractures ◽  
Intraarticular Fractures

Introduction: The treatment of displaced intra-articular calcaneal fracture is controversial. Conventionally, they were treated non-operatively. However, some surgeons are now operatively treating these fractures because of continuing dissatisfaction with the outcome of conservative treatment of these fractures and improvements that have occurred in surgical techniques and complication rates. Objective: The aim of this study was to determine the functional outcome of operatively treated displaced intra-articular calcaneal fractures using two parallel contoured reconstruction plates. Materials and methods: 12 patients with 14 displaced intra-articular calcaneal fractures involving the subtalar joint were included in the study conducted between July 2005 and December 2008. The fracture site was exposed using extended lateral approach. Internal fixation was done by two nearly parallel 3.5mm reconstruction plates and screws contoured to form a gentle curve in all cases with the first plate fixed just below the articular surface. At the end of follow up, the patients' foot function was assessed by Calcaneal Fracture Scoring System of Kerr et al. Patients were also enquired about their satisfaction with their treatment outcome. Results: The patients were followed up for duration of 12 to 24 months (mean 15.64 months). The outcome score as measured by Calcaneal Fracture Scoring System ranged from 48 to 94 (mean 83.64). 11 of 12 patients (91.6 %) were satisfied with the treatment. Conclusion: Displaced intra-articular fractures treated by open reduction and internal fixation, using two nearly parallel, contoured reconstruction plates through an extensile lateral approach and following the principles of treatment of intraarticular fractures, have good functional results with high patient satisfaction rate. Key words: displaced intra-articular calcaneal fractures; operative treatment. DOI: 10.3126/kumj.v8i1.3215 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 12-17

The Repair and Healing of Two Traumatic Ilial Body Fractures Adjacent to Cemented Total Hip Acetabular Components

1992 ◽  
Vol 05 (02) ◽  
pp. 85-89
Author(s):  
P. K. Shires ◽  
T. L. Dew
Keyword(s):  
Internal Fixation ◽  
Cancellous Bone ◽  
Surgical Techniques ◽  
Autogenous Bone ◽  
Cancellous Bone Graft ◽  
Standard Methods ◽  
Intravenous Antibiotics ◽  
Prophylactic Use ◽  
Acetabular Components ◽  
Autogenous Bone Grafts

SummaryThis report has documented the repair and healing of two ilial fractures in dogs which were compounded by the presence of a cemented acetabular prosthesis. While specific recommendations can not be made from such a small number of cases, the information presented herein suggests that such fractures will heal without complication if aseptic surgical techniques and standard methods of internal fixation are employed. The authors strongly recommend the prophylactic use of intravenous antibiotics and the placement of cancellous bone graft when the repair of such fractures is attempted.Two traumatic ilial fractures involving the cement/bone interface of acetabular prostheses were repaired using lag screws, cerclage wires, and autogenous bone grafts. The fractures healed and ambulatory function was regained.

scholarly journals Measurement of femoral posterior condylar offset and posterior tibial slope in normal knees based on 3D reconstruction

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liangxiao Bao ◽  
Shengwei Rong ◽  
Zhanjun Shi ◽  
Jian Wang ◽  
Yang Zhang
Keyword(s):  
Three Dimensional ◽  
Surgical Techniques ◽  
Inverse Correlation ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Lateral Side ◽  
Posterior Condylar Offset ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Posterior Condylar

Abstract Background Femoral posterior condylar offset (PCO) and posterior tibial slope (PTS) are important for postoperative range of motion after total knee arthroplasty (TKA). However, normative data of PCO and PTS and the correlation between them among healthy populations remain to be elucidated. The purpose of this study was to determine PCO and PTS in normal knees, and to identify the correlation between them. Methods Eighty healthy volunteers were recruited. CT scans were performed followed by three-dimensional reconstruction. PCO and PTS were measured and analyzed, as well as the correlation between them. Results PTS averaged 6.78° and 6.11°, on the medial and lateral side respectively (P = 0.002). Medial PCO was greater than lateral (29.2 vs. 23.8 mm, P <  0.001). Both medial and lateral PCO of male were larger than female. On the contrary, male medial PTS was smaller than female, while there was no significant difference of lateral PTS between genders. There was an inverse correlation between medial PCO and PTS, but not lateral. Conclusions Significant differences exhibited between medial and lateral compartments, genders, and among individuals. An inverse correlation exists between PCO and PTS in the medial compartment. These results improve our understanding of the morphology and biomechanics of normal knees, and subsequently for optimising prosthetic design and surgical techniques.

scholarly journals Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

2020 ◽  
Author(s):  
Chenggong Wang ◽  
Can Xu ◽  
Mingqing Li ◽  
Hui Li ◽  
Han Xiao ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Subtalar Joint ◽  
Calcaneal Fracture ◽  
Patient Specific ◽  
Calcaneal Fractures ◽  
Intraoperative Fluoroscopy ◽  
Joint Width ◽  
Preoperative Plan ◽  
Overlap Ratio ◽  
Minimally Invasive Internal Fixation

Abstract Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan.Methods: We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSI-assisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre- and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available.Results: Mean intraoperative fluoroscopy time was 3.95±1.78 h; IFAU in 16 patients (16 feet) was the same as the preoperative plan; mean surgery time was 28.16±10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre- and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2%±2.3%. AOFAS scores increased with time, with significant differences in the score at each time point.Conclusions: The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

scholarly journals Surgical treatment in children missed Monteggia lesions at Bhuj, Kutch, Gujarat: a retrospective study

2016 ◽  
Vol 3 (1) ◽  
pp. 30 ◽  
Author(s):  
Prakash Chauhan
Keyword(s):  
Internal Fixation ◽  
Radial Head ◽  
Medical Science ◽  
Surgical Techniques ◽  
Annular Ligament ◽  
Osteotomy Site ◽  
Cast Immobilization ◽  
Monteggia Lesion ◽  
Ulnar Osteotomy ◽  
Chronic Dislocation

<p class="abstract"><strong>Background:</strong> The treatment of an unrecognized Monteggia lesion continues to pose a therapeutic challenge, as evidenced by the variety of surgical techniques described. Moreover, there are high complication and redislocation rates following surgery. This report concerns a surgical technique to reduce a chronic dislocation of the radial head utilizing an ulnar osteotomy and internal fixation<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Present study was performed at department of orthopedics, Gujarat Adani institute of medical science, Bhuj, Kutch, Gujarat. Ethical clearance was taken from the institutional ethics board and informed consent was obtained from all the participants. Between July 2015 and September 2016 six children presented in a traumatic context with chronic dislocation of the radial head and malunion of the ulna.  Patient mean age was 6.5 (range 4–8) years, and the mean interval between injury and surgical procedure was 17 (range 1–49) months. Surgery consisted of an ulnar osteotomy with angulation and lengthening, bone grafting at the osteotomy site, and internal fixation. Open reduction of the radial head, repair or reconstruction of the annular ligament or temporary fixation of the radial head with a transarticular wire was not undertaken. Cast immobilization with the forearm in neutral rotation was maintained for 4-6 weeks.<strong></strong></p><p class="abstract"><strong>Results:</strong> There was one case of nonunion. At an average follow-up of 3 (range 1.5–4.4) years, all patients had regained painless function of the forearm, good range of elbow and forearm motion, and maintenance of the radial head reduction<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Both angulation and elongation of the ulna are required to allow for reduction of the radial head. We do not see any indication for procedures directed at the radio-capitellar joint<span lang="EN-IN">.</span></p>

The Lateral Side

2015 ◽  
Author(s):  
John Goodfellow ◽  
John O'Connor ◽  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray
Keyword(s):  
Rare Disease ◽  
Surgical Techniques ◽  
Lateral Compartment ◽  
Clinical Results ◽  
Medial Compartment ◽  
Lateral Side ◽  
Normal Anatomy ◽  
Valgus Stress ◽  
Pathological Lesions ◽  
As If

Lateral unicompartmental OA is a relatively rare disease said to account for about one eighth of all unicompartmental arthritis 1 . However, the incidence may be higher because it is a disease of flexion and is commonly missed on standing AP radiographs. To identify lateral OA reliably, either a valgus stress radiograph in 45° flexion or a Rosenberg view is necessary. The clinical results of UKA in the lateral compartment have sometimes been worse than in the medial compartment 2 and sometimes better 3 . Some early papers reported results of series containing both medial and lateral operations as if they were essentially the same, but the normal anatomy and the pathological lesions of the two compartments are very different so the surgical techniques are different.

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