Carpometacarpal Arthroplasty and Ulnar Collateral Ligament Reconstruction in a Patient with Suspected Ehlers-Danlos Syndrome: A Case Report and Review of the Literature.

Ehlers-Danlos syndrome (EDS) is a disorder that presents with a heterogeneous constellation of symptoms, ranging from clinically silent to rapidly deteriorating. It is a multisystemic connective tissue disorder that may result in any number of manifestations, with joint hypermobility being a classic manifestation. We present a case of a 58-year-old woman, with suspected EDS, who presented with several years' history of bilateral thumb pain, with imaging and physical examination findings consistent with bilateral thumb carpometacarpal (CMC) arthritis with metacarpophalangeal joint (MPJ) hypermobility. The Beighton hypermobility score was consistent with suspected EDS. Our patient underwent thumb CMC arthroplasty with ulnar collateral ligament (UCL) reconstruction.

Case cohort study of risk factors for post-thyroidectomy hemorrhage.

BACKGROUND: Post-thyroidectomy hemorrhage is a potentially life-threatening complication of thyroid surgery. The goal of our study was to determine potential risk factors for development of post-thyroidectomy hemorrhage. METHODS: A retrospective case cohort study of patients with post-thyroidectomy hemorrhage between December 2008 and August 2014 was performed. This group of patients was compared with a stratified randomized control group, and several parameters were assessed for association with post-thyroidectomy hemorrhage. RESULTS: Sixteen patients were identified in this time period as developing post-thyroidectomy hemorrhage requiring reoperation. Postoperative hypertension, vomiting and/or straining, longer operative times, and extent of surgical dissection were found to be statistically significant risk factors. Postoperative hypertension was found to be the most significant risk factor, resulting in a 20.3 times increased likelihood of developing post-thyroidectomy hemorrhage. CONCLUSIONS: A number of risk factors for post-thyroidectomy hemorrhage were identified. The most significant was postoperative hypertension. Early control of modifiable risk factors could improve patient outcomes and satisfaction.

A Case Report and Review of the Literature of Adult Gastric Duplication Cyst.

Gastrointestinal (GI) duplication cysts are a rare congenital disease. They may involve any level of the alimentary tract, but they most commonly involve the ileum, esophagus, and jejunum. Gastric duplication cysts represent approximately 4-8% of GI duplication cysts, the majority of which present in early childhood. We present a rare case of adult gastric duplication cyst in a 25-year-old female found to have abdominal mass on computed tomography imaging. There are several potential methods to diagnose gastric duplication cyst and treatment of choice is complete surgical resection.

An orthopedic-, surgical-, and epidemiological-based investigation of leprosy, in the Tamil Nadu state of India.

No other research paper has ever been written about leprosy in this manner. The orthopedic and surgical implications, as well as the functional debility caused by the disease, have not been previously explained by past research as they have in such a comprehensive manner in this paper. The results of this study have regional and global implications as they pertain to disease pathology, risk factor recognition/disease prevention, and treatment. This paper is a unique, in that it also serves as a combination of a review of the current medical literature, as well as an epidemiological survey of the disease in a region of the world which has never been researched in the past. Clinical data points to the possibility of a new strain of the disease. This information is of significance because it effects prevention and improved treatment of the disease, which leads to devastating sequela. This was a cross-sectional study involving subjects diagnosed with leprosy in the Chengalpet region of the Kancheepuram District, of the Tamil Nadu state of India. The study was performed at the Tamil Nadu Medical College Teaching Hospital and Research Center. This study included various physical examinations, observation and survey of lesions, questionnaires in regard the debilitating orthopedic and medical effects of the disease, as well as treatment options.