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Introduction and importance: A distal radioulnar joint (DRUJ) dislocation is an uncommon occurrence. If not managed properly could result in severe functional impairment. Case Presentation: We report a case of a 45-year-old lady who was injured 6 months ago. She suffered a volar dislocation of the DRUJ and an ulnar head fracture. The DRUJ was stable after open reduction and reconstruction using suture-button technique. Discussion: Application of the first suture-button still result in positive ballottement with subluxation of ulnar head. Additional of second suture-button improved the stability and restored DRUJ motion. Conclusion: The double suture-button technique restored the DRUJ's stability and produced a good functional outcome.
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Introduction: Congenital muscular torticollis (CMT) is identified as a thickening and/or stiffening of one side of the sternocleidomastoid muscle (SCM) due to muscle fibrosis. This condition results in shortening of SCM and constricted neck motion. Case presentation: A four-year-old girl came with neck muscle stiffness, tilted head to the left, and chin facing to the right presenting since birth. She was diagnosed with CMT at birth. The patient was born via spontaneous vacuum-assisted vaginal delivery. At three years old, the patient did brief conservative treatment. This patient was planned for unilateral sternocleidomastoid muscle release via bipolar tenotomy. Twelve months after the surgery, there were no complications or recurrence observed. Discussion: The etiology of CMT remains unknown to date, but recent studies suggest that early treatment of CMT produce better prognosis. The initial treatment for CMT is regular muscle stretching (physiotherapy), as well as education to the child's caregivers about the environmental changes and the child's posture. If the initial attempt fails, surgical intervention is needed. Conclusion: Early detection and early physiotherapy treatment will lead to minimize the risk of surgery. However, for cases that fail conservative therapy or neglected cases, it is recommended to carry out operative therapy to improve quality of life later.
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OBJECTIVE: There is evidence of a vascular contribution to the pathogenesis of osteoarthritis (OA). The aim of this study was to examine the association between popliteal artery wall thickness, which was previously shown to be associated with the risk of OA, and structural changes in the knee in an asymptomatic cohort. METHODS: A total of 297 adults with no significant knee pain, injury, or history of clinical knee disease were recruited. Participants underwent magnetic resonance imaging of the knee at baseline and 2 years later. Popliteal artery wall thickness, knee cartilage volume, and bone marrow lesions (BMLs) were assessed. RESULTS: Of 278 participants with valid popliteal artery wall thickness measurements, 254 (91.4%) completed the 2-year followup assessment. After adjusting for age, sex, body mass index, and tibial bone area, increased popliteal artery wall thickness was found to be associated with a reduced medial tibial cartilage volume (B = -6.7 [95% confidence interval (95% CI) -12.9, -0.6], P = 0.03) and an increased rate of medial tibial cartilage volume loss (B = 0.06 [95% CI 0.01, 0.12], P = 0.03). There was a trend toward worsening of medial tibiofemoral BMLs in relation to increased popliteal artery wall thickness (odds ratio 1.07 [95% CI 0.99, 1.15]; P = 0.07). No significant associations with the lateral tibiofemoral compartment were observed. CONCLUSION: Increased popliteal artery wall thickness was associated with adverse changes in knee structure, as evidenced by reduced medial tibial cartilage volume, increased rate of cartilage volume loss, and a trend toward worsening of BMLs over 2 years. These findings suggest an association between vascular pathology and early structural changes in the knee, which supports the hypothesis that vascular health may play a role in the development of knee OA.