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Background@#Total hip arthroplasty (THA) in patients with hypoplastic femurs presents a significant challenge to orthopedic surgeons due to the limited space available for implant placement. Therefore, the extra-small femoral stems have been proposed as a solution to this problem, but there are limited data on the outcomes. We aimed to evaluate clinical and radiological outcomes of THA in patients with extremely hypoplastic femurs using the Bencox CM stem (Corentec), an extra-small femoral stem. @*Methods@#We included 6 hips from 4 patients. The mean age of the patients was 41.2 years (range, 19.6–60.4 years). The mean height was 135.1 cm (range, 113.6–150.0 cm) with a mean body mass index of 25.7 kg/m 2 (range, 21.3–31.1 kg/m 2 ). The diagnoses for THA were sequelae of septic arthritis in childhood, pseudoachondroplasia, spondyloepiphyseal dysplasia, and juvenile rheumatoid arthritis. Preoperative computed tomography scans were conducted to assess the extent of proximal femoral hypoplasia. The clinical outcomes were assessed using the modified Harris Hip Score, while the radiological outcomes were evaluated using radiographs. The mean follow-up was 2.3 years (range, 1.0–5.9 years). @*Results@#The average modified Harris Hip Score improved to 88.8 at the final follow-up. Intraoperative femoral fractures occurred in 2 cases (33.3%). During the follow-up, 1 stem underwent varus tilting from postoperative 6 weeks to 6 months without subsidence. Otherwise, all stems showed good osteointegration at the latest follow-up. No hip dislocations, periprosthetic joint infection, or loosening of the prosthesis occurred. @*Conclusions@#The use of extra-small femoral stems in THA for extremely hypoplastic femurs can provide reasonable clinical and radiological outcomes with minimal complications. We suggest that this femoral stem could be a viable option for patients with extremely hypoplastic femurs.
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Background@#Hemiarthroplasty is frequently used to treat displaced femoral neck fractures in elderly patients, but it has a higher risk of postoperative dislocation. We introduced the posterior approach and inferior capsulotomy (PAICO) to enhance joint stability after bipolar hemiarthroplasty for femoral neck fracture. We evaluated whether the PAICO would have a lower dislocation rate than the conventional posterior approach with superior capsulotomy. @*Methods@#From January 2021 to December 2021, we prospectively recruited 25 patients (25 hips) aged 50 years or older who underwent bipolar hemiarthroplasty for femoral neck fractures due to low-energy trauma as the PAICO group. We compared the PAICO group with a historical control group who had undergone hemiarthroplasty in 7 institutes between 2010 and 2020. The primary endpoint was dislocation within 1 year after the surgery. We compared data from the PAICO group with the data from the historical control group from the Korean Hip Fracture Registry which was carried out in South Korea. @*Results@#A total of 25 patients (25 hips) were enrolled in the present study; 3,477 patients (3,571 hips) who underwent bipolar hemiarthroplasty were reviewed as the historical control group. In the PAICO group, we observed no dislocation, whereas the dislocation rate in the control group was 1.3%. @*Conclusions@#In patients with displaced femoral neck fractures, the PAICO approach demonstrated comparable results in operation time and complication rates when compared to bipolar hemiarthroplasty using superior capsulotomy. Notably, there were no observed cases of dislocation among patients who underwent the PAICO approach. We recommend this PAICO approach to surgeons using the posterior approach, hoping to prevent dislocation in bipolar hemiarthroplasty.
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Syphilis, a chronic systemic infection caused by Treponema pallidum, is usually sexually transmitted and characterized by episodes of active disease interrupted by a latent period. After an incubation period of averaging 2-6 weeks, a primary syphilis with a firm, non-tender chancre appears, often associated with regional lymphadenopathy. Secondary syphilis shows localized or diffuse mucocutaneous lesions and generalized non-tender lymphadenopathy. In about onethird of untreated cases, the tertiary stage appears, characterized by progressive destructive mucocutaneous, musculoskeletal or parenchymal lesions, aortitis or symptomatic central nervous system diseases. Without serological testing, the precise diagnosis is very difficult. In fact, it has often been called the great imitator because it was often confused with other disease. We report a very unusual case of luetic lymphadenitis presented as a solitary submandibular mass.
Sujet(s)
Aortite , Maladies du système nerveux central , Chancre syphilitique , Lymphadénite , Maladies lymphatiques , Cou , Tests sérologiques , Syphilis , Treponema pallidumRÉSUMÉ
Tonsillar lymphangiomatous polyp is an uncommon hamartomatous lesion that generally arises from the tonsillar surface. Due to the uncommon clinical and pathological features of these polyps, pathologist and clinician may experience difficulty in correctly classifying them. Although this is a rare clinical and pathologic entity for pathologists and clinicians, the diagnosis is not so difficult if one has a bit of experience about that. Recently, we experienced a 37-year-old women with a pale lymphangiomatous polyp of 3x1.5 cm size, which was treated by tonsillectomy. We report this case with a review of literature.
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Adulte , Femelle , Humains , Isothiocyanates , Tonsille palatine , Polypes , AmygdalectomieRÉSUMÉ
Castleman's disease, a benign lymphoproliferative disease of unknown etiology, rarely occures as a neck mass. Only 6% of the cases reported in the literature was detected primarily in the neck. This disease consists of unicentric or multicentric (or systemic) forms by clinical manifestation and hyaline vascular type or plasma cell type, histologically. The more common hyaline vascular type usually presents as an asymptomatic lymphoid mass. On the other hand, in plasma cell type, systemic manifestations are frequently observed. Definite diagnosis and treatment is possible with complete surgical resection following histologic evaluation. Recently, we experienced a 22 year old woman patient with 5 year history of right neck mass. She underwent surgical mass resection. Pathologic analysis confirmed hyaline vascular variant of Castleman's disease. Now, we report this case with a review of previously reported literature.
Sujet(s)
Femelle , Humains , Jeune adulte , Diagnostic , Hyperplasie lymphoïde angiofolliculaire , Main , Substance hyaline , Noeuds lymphatiques , Cou , PlasmocytesRÉSUMÉ
Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally and is one of the most significant life-threatening complications of otologic disease. Nowadays, mortality rates of up to 10 percent have been reported. Brain abscesses are developed up to 0.5 percent of cases of acute otitis media and 3 percent of cases of chronic suppurative otitis media. In this case, underlying middle ear pathology showed chronic otitis media with cholesteatoma. Successful management of otogenic brain abscess still includes medical and surgical treatment. Initial surgical treatment of abscess is very controversial today. Some authors prefer the surgical excision of brain abscess prior to the management of temporal bone, yet other authors prefer the surgery of temporal bone prior to the management of brain abscess. Although an enterococcus is a significant cause of human infections outside of the central nervous system but, enterococcal infections involving the central nervous system are uncommon clinical entities. Because of the relatively small number of individuals who develop brain abscess or meningitis due to an enterococcus, an appropriate therapy has not been well defined. We report a case of enterococcal otogenic brain abscess which was treated successfully using antibiotics, immediate radical mastoidectomy and later stereotactic abscess drainage with a review of literatures.