RESUMO
INTRODUCTION: Osteochondroma is the most common benign bone tumor and usually occurs in the metaphyseal region of the long bones. Anterior cruciate ligament (ACL) tear is the most common ligament injury of the knee joint, and reconstruction of the ACL is the most commonly performed procedure in the knee joint nowadays. CASE PRESENTATION: A 26-year-old male with multiple osteochondromas around the knees, shoulders, and ankles presented with a chronic ACL injury. Reconstruction of ACL using quadrupled hamstring tendon grafts was done. Anterior drawer and Lachman tests were negative postoperatively. The Cincinnati score increased from 180 to 310 at 3-month follow-up. This is a novel case report to describe ACL injury in a case of osteochondromatosis managed by an arthroscopic ACL reconstruction. The problems faced are discussed. CONCLUSION: Our report highlights the fact that ACL tear may occur in a patient having osteochondromas around the knee. ACL reconstruction can be performed in routine fashion in such patients with particular attention to careful harvesting of grafts and tunnel placements.
RESUMO
INTRODUCTION: Midfoot injuries involving naviculocuneiform and calcanealcuboid joints are very rare. These injuries result from high-energy crushing trauma and most often causes dislocation of the midfoot in plantar direction. CASE REPORT: A 30-year-old female sustained an injury to the left foot after a fall from a very low height. A radiograph of the left foot demonstrated naviculocuneiform joint and calcaneocuboid joint fracture-dislocation. This unusual pattern of injury required open reduction and internal fixation with K-wires after a failed attempt of closed reduction. K-wires were removed after 8 weeks. At 24 months follow-up, she achieved a complete range of movements of left foot and ankle without any complications. CONCLUSION: Injuries involving naviculocuneiform and the calcaneocuboid joint can occur following low-energy impact. Such complex injuries should be diagnosed and treated as early as possible. Initial open reduction and stable anatomical fixation are the keys to achieve a good functional outcome in such kind of injuries.
RESUMO
INTRODUCTION: The study aims at providing an overview of morphometric measurements of the skull baselines in normal Indian population and compares these dimensions with those of other races and ethnicities. This study will help in defining "normal" baseline values for Indian population. It will also compare dimensions as measured on X-ray and computed tomography (CT) scan to assess the reliability of X-ray as a diagnostic modality for the assessment of the skull baselines in Indian population. MATERIALS AND METHODS: Retrospective study with a sample size of 116 patients and duration of 30 months. RESULTS: The mean value for distance between dens tip and Chamberlain line on CT was 0.498 mm and on X-ray was 0.528 mm and for the distance between dens tip and McGregor line on CT was 0.213 mm and on X-ray was 0.228 mm. The mean distance between the dens tip and McRae line was 4.67 1.69 mm on CT scan and 4.7 1.76 mm on X-ray. CONCLUSION: There was not a single patient in whom the dens tip crossed the McRae line. Any protrusion of the dens tip beyond the foramen magnum is abnormal. Hence, the McRae line is easiest to understand and remember. Furthermore, the Chamberlain and McGregor lines rely on identifying the hard palate, which may not be included in routine X-ray, CT, and magnetic resonance imaging studies depend on the field of view. Hence, we recommend the use of McRae line for screening purposes while evaluating pathologies of the craniovertebral junction. X-ray is a reliable diagnostic technique for assessing morphometry of the skull baselines in an emergency or rural setting if facility for CT scan is not available.