Successful Surgical Intervention and Remarkable Recovery in a Child With Traumatic Spondyloptosis.

More than 100% of the traumatic subluxation of one vertebral body over another in the coronal or sagittal plane is known as traumatic spondyloptosis, which typically results in the contusion of the spinal cord. It is an uncommon yet severe spinal column injury. Here, we present traumatic lumbosacral spondyloptosis at the L5 and S1 levels with complete spinal cord compression with paraplegia and bowel and bladder involvement. The patient underwent posterior spinal fusion (delta fixation) and decompression. The patient improved his motor and sensory deficits at one-month follow-up. By the eighth-month follow-up, the patient had recovered entirely from his motor and sensory deficits and was stable for the entire year.

A Comprehensive Review of Proximal Humerus Fractures: From Epidemiology to Treatment Strategies.

This comprehensive review delves into the intricate landscape of proximal humerus fractures (PHFs), exploring their epidemiology, historical evolution, contemporary classification systems, treatment strategies, and outcome measures. PHFs present a complex orthopedic challenge, necessitating a nuanced understanding of their multifaceted dimensions. Despite their clinical significance, PHFs remain relatively understudied in population-based epidemiology. This review critically examines existing literature to uncover the incidence, prevalence, and demographic patterns associated with these fractures. A foundational understanding of the epidemiological landscape is crucial for effective preventive strategies and optimized fracture management. Tracing back to historical records, the review explores the evolution of diagnostic and therapeutic approaches for PHFs. From ancient treatment modalities documented on the Edwin Smith papyrus to contemporary X-ray-based classifications such as Neer and AO/OTA, a historical context is provided to understand the journey of managing these fractures. Navigating through a spectrum of treatment strategies, the review contrasts nonoperative approaches with various surgical interventions. The challenges and outcomes associated with conservative management are juxtaposed against methods like open reduction internal fixation and tension band osteosynthesis. Evidence synthesis guides clinicians in making informed decisions based on patient characteristics and fracture complexities. Central to assessing PHF management are patient-reported outcome measures. The review explores the significance of instruments such as the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Constant-Murley score in evaluating treatment success. The shift toward subjective measures is discussed, considering their correlation with patient experiences and the concept of minimal clinically important difference. The impact of demographic factors, including age and gender, on PHFs is scrutinized. The association between these fractures and osteoporosis is highlighted, emphasizing the crucial role of bone health in fracture prevention and management. Through this comprehensive exploration, the review provides a robust foundation for understanding, evaluating, and advancing the management strategies for PHFs. The synthesis of historical perspectives, contemporary classifications, and treatment modalities serves as a valuable resource for the orthopedic community, fostering improved clinical decision-making and patient outcomes.

Subvastus Arthrotomy and Multifaceted Fixation in Medial Femoral Comminuted Hoffa's Fracture: A Case Report.

In managing orthopedic trauma, Hoffa's fracture, a rare intra-articular fracture affecting the femoral condyle, presents a unique challenge. We report a case of a 45-year-old male patient who had a traumatic injury and complained of substantial knee discomfort and limited range of motion. The patient had a medial femoral comminuted Hoffa's fracture. Subvastus arthrotomy was employed to handle the fracture successfully, and then a locking reconstruction plate, Herbert screws, and 4 mm cannulated screws were used for precise reduction and fixation. At the one-year follow-up, the patient showed acceptable postoperative results, including recovered knee function and radiographic indications of fracture repair.

Zoledronic Acid Supplementation With Excision of a Giant Cell Tumor of the Distal End Radius to Prevent Recurrence: A Case Report.

Giant cell tumors are benign yet locally aggressive neoplasms commonly observed in the distal radius, exhibiting higher recurrence rates compared to other tumor types. This study presents a case involving a 50-year-old farmer who presented with swelling at the distal end of his wrist. The patient underwent treatment involving intralesional curettage and supplementation with zoledronic acid, resulting in a significant reduction in the tumor's potential for recurrence. This approach aims to achieve an optimal balance between functional outcomes and disease management in the majority of cases. While this strategy proves effective in most instances, there may be scenarios where resection becomes imperative due to the severity of the disease, ensuring adequate disease clearance. In such circumstances, judicious decision-making coupled with an appropriate treatment plan is crucial to guarantee a satisfactory outcome, even in the face of challenges.

Diagnosis and Management of Monostotic Fibrous Dysplasia of the Tibia in an Adolescent Patient: A Case Report.

A rare benign bone condition called monostotic fibrous dysplasia (MFD) is characterized by the growth of fibrous tissue in place of a normal bone. It may lead to deformity in the affected bone, pain, and a pathologic fracture due to bone weakness. Hereunder, a case report of MFD in a 17-year-old male adolescent presenting to the hospital with localized bone pain and swelling in his right tibia is presented. After clinical examination and radiographic imaging, a provisional diagnosis of benign osteolytic lesion was considered. A magnetic resonance imaging (MRI) scan of the leg suggested the possibility of fibrous dysplasia or adamantinoma. The patient was managed with an intralesional curettage of the dysplastic bone and packing the cavity with blocks of a synthetic bone. The excised material was sent for histopathology, which established the diagnosis of fibrous dysplasia.

Unveiling the Dance of Crystals: A Surgical Odyssey in the Open Excision of Synovial Chondromatosis in the Right Knee.

Within the synovial membrane, cartilaginous nodules form as a result of a relatively rare joint condition called synovial chondromatosis. This case study describes the open surgical treatment of a male patient, age 25, who had severe discomfort in his right knee. The patient had synovial chondromatosis. The choice for open surgery was made because of the large and difficult nature of the lesions, even though arthroscopic procedures are commonly used in the management of this problem. The patient's history included a restricted range of motion, edema, and chronic right knee discomfort. Multiple intra-articular loose bodies were discovered during the clinical examination and imaging examinations, which led to the decision to do surgery. Owing to the size and position of the chondromatous lesions, an open surgical technique was considered suitable. Given the favorable result in this young adult patient, open surgical management of synovial chondromatosis may be an effective treatment option, especially in cases with complicated or widespread involvement.

Innovative Approach to Lateral Tibial Plateau Fracture: A Case Study on Anterolateral Submeniscal Arthrotomy With Cement Augmentation and Screw Fixation.

Lateral tibial plateau fractures are generally present as depressed fractures. The lateral tibial plateau is more common than the medial tibial plateau, often due to a bumper injury. If depressed fragments are more than 8-10 mm, then surgical management is usually needed. Anterolateral fixation is frequently used for unicondylar lateral tibial plateau fractures. Here, we present an articular depressed lateral tibia plateau fracture in a Schatzker type 3 case. The fracture was managed through an anterolateral approach with sub-meniscal arthrotomy, allowing for direct visualization and subsequent fixation using bone cement and a cannulated cancellous screw. Postoperative imaging confirmed proper reduction, and the patient had a satisfactory outcome..

New Technique of Reverse Bone Grafting With Core Decompression and Enriching With Regenerative Medicine Techniques for Grade 2 and Grade 3 Avascular Necrosis of Both Hips.

Early avascular necrosis (AVN) of the hip poses a significant clinical challenge, requiring prompt recognition and intervention to mitigate long-term complications. A case report describing a 30-year-old man with bilateral hip AVN is presented here. In addition, to reverse bone grafting and core decompression of both hips, the patient had platelet-rich plasma (PRP) infiltration in the right hip and bone marrow aspirate concentrate (BMAC) infiltration in the left hip. This method attempted to stop the disease's development and promote hip regeneration in both. Significant pain reduction and postoperative functional gains in both hips are seen in this instance. These results highlight the potential of combined orthopedic and regenerative therapies in young individuals with hip AVN and highlight the necessity of early intervention for maintaining long-term hip function.

A Comprehensive Review of Treatment Strategies for Early Avascular Necrosis.

Avascular necrosis (AVN), characterised by compromised blood supply leading to bone necrosis, poses a significant challenge in orthopaedic and rheumatologic practice. This review comprehensively examines early AVN treatment strategies, including aetiology and risk factors, clinical presentation, conservative and surgical approaches, emerging therapies, and rehabilitation. Key findings underscore the importance of early detection, personalised treatment plans, and a multidisciplinary approach involving orthopaedic specialists, rheumatologists, and physical therapists. The implications for clinical practice emphasise individualised care, staying abreast of emerging therapies, and patient education. Recommendations for future management strategies highlight the need for imaging technology advancements, regenerative therapies integration, and ongoing research into genetic and molecular pathways. As the field continues to evolve, translating research findings into clinical practice holds promise for improving outcomes and enhancing the overall quality of life for individuals affected by AVN.

Pigmented Villonodular Synovitis Presenting at an Atypical Site: A Case Report.

Pigmented villonodular synovitis (PVNS) is an idiopathic villous overgrowth and pigmentation of the synovial membrane of a single joint. It is an uncommon condition characterized by yellow or yellowish-brown colour due to deposits of cholesterol and hemosiderin, excessive secretion of yellowish-brown synovial fluid, and the formation of brownish chocolate synovial tissue. This condition commonly occurs at the knee joint at the age of 20-50 years. Here we present a case of a 75-year-old male with PVNS involving the lower third of the right thigh who came to the surgery department and was eventually referred to the orthopedic department on the basis of investigations performed. It is a case of PVNS at a unique location on the lower third of the right thigh. The swelling was painless initially, but the pain increased over a duration of 10 months. Clinically, the mass was suspected to be bursitis or lipoma with features of mild inflammation in the overlying skin. Magnetic resonance imaging (MRI) suggested a swelling of 100*70*40 mm in dimension with the possibility of PVNS. Ultrasonography (USG) of the mass and fine needle aspiration cytology (FNAC) supported the diagnosis of PVNS. An excisional biopsy of the swelling was submitted. Per-operatively, there were typical features of PVNS. The swelling was situated superficial to the iliotibial band. There was no defect or gap in the iliotibial tract, and the swelling didn't have any continuity to the knee joint. The occurrence of synovial tissue without any attachment to the joint or tendon is rare and hence reported.