Gluteus medius calcific tendonitis as a cause of severe anterior hip pain.

Calcific tendinopathy in the gluteus medius is uncommon and sporadically reported. It may be asymptomatic or present with acute or chronic pain. Pain is usually isolated to the lateral hip overlying the gluteal muscles or greater trochanter. We present a rare case of gluteus medius calcific tendonitis as a cause of severe anterior hip pain. Given the atypical local and clinical presentation these can be often misdiagnosed as septic arthritis or fracture which may lead to overtreatment and even unnecessary surgery. This article will detail the clinical presentation, imaging findings, and clinical course following treatment. This will facilitate the clinician in making a timely diagnosis and establishing an effective treatment course.

Chronic Quadricep Tendon Rupture Reconstruction with Poly-Tape and Achilles' Tendon Allograft: A Case Report and Review of the Literature.

Introduction: Chronic rupture of the quadriceps tendon is an uncommon but debilitating injury, seen only in 1.37/100,000 patients per annum. The problems associated with this injury are the inability to walk due to disruption of the extensor mechanism and pain. There is limited literature on the reconstruction methods for this injury. This study aims to provide a case report and review of similar cases, using artificial tape and allograft. Case Report: A 60-year-old male patient was operated on for chronic quadriceps tendon rupture after falling on his knee with forced flexion. The surgical management in our case consisted of mobilization of the proximal quadriceps tendon and muscle belly with a V-Y tendon plasty, advancement of the tendon, and repair using the Krakow technique through intraosseous patellar tunnels, augmented with Poly-Tape (Neoligaments©) and an Achilles' tendon allograft. This was used due to poor patient tissue quality and the extent of the defect. We also searched the literature for chronic quadriceps tendon ruptures reconstruction using poly tape or Achilles' tendon allograft. Conclusion: Chronic quadriceps tendon rupture repairs have relatively poor outcomes, and no surgical procedure has been proven to be the gold standard treatment. We believe the novel combination of Poly-Tape supplemented with Achilles' tendon allograft produces a structurally competent reconstruction in patients with poor tissue quality and large defects and produced good results in our case report.

Use of Traction Table for Reducing Complex Distal Femur Fractures: A Technical Trick.

Complex intra-articular distal femur fractures (AO 3.3.C) present many challenges, especially with regard to patient preparation and approach. Traditionally, patients lie supine with a bolster or triangular wedge placed below the knee to allow knee flexion. This corrects the hyperextension deformity of the distal femoral fragment caused by the gastrocsoleus complex. Although well established, the minimally invasive plate osteosynthesis (MIPO) technique presents with limitations, especially with regard to patient preparation and approach. In this case report, we describe a lateral approach to the MIPO technique using the Eschmann traction table with the tibia nailing attachment and femoral condyle pads to achieve and maintain satisfactory fracture reduction throughout the procedure. Importantly, this also allows less dependency on surgical assistance. To our knowledge, this is the first case report describing a lateral approach to the MIPO technique using the Eschmann traction table for the reduction of complex distal femur fractures.

MANAGEMENT OF A DISTAL FEMORAL NON-UNION WITH COEXISTING FAILURE OF THE KNEE EXTENSOR MECHANISM USING OSTEOBRIDGE KNEE-ARTHRODESIS SYSTEM--A CASE REPORT.

INTRODUCTION: Reconstruction of bone defects is a long, challenging process both for the patient and for the treating surgeon. Bone defects frequently occur as a result of aggressive surgical debridement and bone resection in case of acute trauma, open fractures, chronic bone infections, tumors and non-unions. Early amputation is often superior to prolonged attempts at salvage because they can create serious problems in the patients' lives. There are numerous alternative methods of limb-salvage nowadays. CASE REPORT: We report a case of a fifty-year-old man with a distal femoral non-union and a co-existing failure of the knee extensor mechanism, who was treated using an intramedullary segmental defect bridging knee arthrodesis system (Osteobridge). At the final check-up twenty four months later, he had excellent clinical, functional and radiological results. CONCLUSION: Osteobridge is an excellent knee arthrodesis system, which is preferable to other methods in case of resection of the distal femur along with the failure of the knee extensor mechanism.