RESUMO
We report the treatment of two patient with humeral fractures with one or more risk factors for nonunion. The first patient was elderly with a previously diagnosed central nervous sys-tem injury. The second elderly patient previously sustained a cerebral vascular accident affecting the fractured arm. The fracture was oblique in the proximal third of the humerus. We achieved bone healing non-operatively utilizing a spe-cialized plastic orthosis that included a deforming element made of dense foam. This device asymmetrically increases the soft tissue pressure around the fracture.
Assuntos
Consolidação da Fratura , Fraturas não Consolidadas , Fraturas do Úmero , Aparelhos Ortopédicos , Humanos , Desenho de Equipamento , Fraturas não Consolidadas/cirurgia , Fraturas não Consolidadas/fisiopatologia , Fraturas não Consolidadas/etiologia , Fraturas do Úmero/cirurgia , Fraturas do Úmero/fisiopatologia , Fraturas do Úmero/diagnóstico por imagem , Radiografia , Fatores de Risco , Resultado do TratamentoRESUMO
There have been a dozen case reports of congenital absence of pedal sesamoid absence. We present the first documented case of congenital bilateral absence of tibial sesamoids with use of magnetic resonance imaging to identify a naturally occurring compensatory aberration of the flexor hallucis brevis. The right foot had bifurcation of the flexor hallucis brevis with one slip blending into the abductor hallucis tendon and capsule and the other slip traversing laterally and attaching to lateral flexor hallucis brevis tendon and fibular sesamoid. On the left foot, the entire flexor hallucis brevis traversed laterally and attached onto the fibular sesamoid and lateral flexor hallucis brevis. The present findings of this patient's anatomical variation could help provide valuable information to prevent known deformities that are the sequalae of a tibial sesamoidectomy.
Assuntos
Músculo Esquelético , Tendões , Pé , Humanos , Tendões/diagnóstico por imagem , Tendões/cirurgia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Dedos do PéRESUMO
Appendicular metastasis from multiple myeloma (MM) frequently presents with a pathologic fracture. In this case report, a patient with a long history of MM and an associated pathologic fracture was treated using a specialized brace. This orthosis uses a deforming element to asymmetrically increase the soft tissue pressure around the pathologic fracture. The patient experienced rapid pain relief and bony healing without surgical intervention.
Assuntos
Neoplasias Ósseas/terapia , Fixação de Fratura/instrumentação , Fraturas Espontâneas/terapia , Mieloma Múltiplo/terapia , Aparelhos Ortopédicos , Fraturas do Rádio/terapia , Idoso , Neoplasias Ósseas/complicações , Neoplasias Ósseas/secundário , Desenho de Equipamento , Consolidação da Fratura , Fraturas Espontâneas/diagnóstico por imagem , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/fisiopatologia , Humanos , Masculino , Mieloma Múltiplo/complicações , Mieloma Múltiplo/secundário , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/etiologia , Fraturas do Rádio/fisiopatologia , Resultado do TratamentoRESUMO
Bone metastases can present in a wide variety of appearances across all imaging modalities. We present a unique appearance of a distal femoral metastasis in a patient who initially complained of knee pain. The radiographic and CT findings were initially suspicious for calcium pyrophosphate deposition (CPPD) arthropathy; however, an MRI demonstrated multiple lesions with a lamellated appearance confirmed on biopsy to be metastatic disease. This unusual lamellated appearance has not been previously described. We present this case to help distinguish this entity radiographically and better classify this finding as a manifestation of metastatic disease.
RESUMO
We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution's Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement.
Assuntos
Ureter/lesões , Cateterismo Urinário/efeitos adversos , Evolução Fatal , Feminino , Humanos , Erros Médicos , Pessoa de Meia-Idade , Oligúria/etiologia , Ruptura/etiologia , Tomografia Computadorizada por Raios X , Cateterismo Urinário/instrumentaçãoRESUMO
Metallosis following open reduction and internal fixation (ORIF) for fracture, usually presenting as a soft tissue mass, is barely discussed in the literature. In this case report, the imaging and pathological findings of metallosis after ORIF for a humeral fracture are presented and comprehensively discussed.