RESUMEN
We report the treatment of two patient with humeral fractures with one or more risk factors for nonunion. The first patient was elderly with a previously diagnosed central nervous sys-tem injury. The second elderly patient previously sustained a cerebral vascular accident affecting the fractured arm. The fracture was oblique in the proximal third of the humerus. We achieved bone healing non-operatively utilizing a spe-cialized plastic orthosis that included a deforming element made of dense foam. This device asymmetrically increases the soft tissue pressure around the fracture.
Asunto(s)
Curación de Fractura , Fracturas no Consolidadas , Fracturas del Húmero , Aparatos Ortopédicos , Humanos , Fracturas del Húmero/cirugía , Fracturas del Húmero/fisiopatología , Fracturas del Húmero/diagnóstico por imagen , Fracturas no Consolidadas/cirugía , Fracturas no Consolidadas/fisiopatología , Fracturas no Consolidadas/etiología , Factores de Riesgo , Masculino , Resultado del Tratamiento , Anciano , Femenino , Diseño de Equipo , Anciano de 80 o más Años , RadiografíaRESUMEN
There have been a dozen case reports of congenital absence of pedal sesamoid absence. We present the first documented case of congenital bilateral absence of tibial sesamoids with use of magnetic resonance imaging to identify a naturally occurring compensatory aberration of the flexor hallucis brevis. The right foot had bifurcation of the flexor hallucis brevis with one slip blending into the abductor hallucis tendon and capsule and the other slip traversing laterally and attaching to lateral flexor hallucis brevis tendon and fibular sesamoid. On the left foot, the entire flexor hallucis brevis traversed laterally and attached onto the fibular sesamoid and lateral flexor hallucis brevis. The present findings of this patient's anatomical variation could help provide valuable information to prevent known deformities that are the sequalae of a tibial sesamoidectomy.
Asunto(s)
Músculo Esquelético , Tendones , Pie , Humanos , Tendones/diagnóstico por imagen , Tendones/cirugía , Tibia/diagnóstico por imagen , Tibia/cirugía , Dedos del PieRESUMEN
Appendicular metastasis from multiple myeloma (MM) frequently presents with a pathologic fracture. In this case report, a patient with a long history of MM and an associated pathologic fracture was treated using a specialized brace. This orthosis uses a deforming element to asymmetrically increase the soft tissue pressure around the pathologic fracture. The patient experienced rapid pain relief and bony healing without surgical intervention.
Asunto(s)
Neoplasias Óseas/terapia , Fijación de Fractura/instrumentación , Fracturas Espontáneas/terapia , Mieloma Múltiple/terapia , Aparatos Ortopédicos , Fracturas del Radio/terapia , Anciano , Neoplasias Óseas/complicaciones , Neoplasias Óseas/secundario , Diseño de Equipo , Curación de Fractura , Fracturas Espontáneas/diagnóstico por imagen , Fracturas Espontáneas/etiología , Fracturas Espontáneas/fisiopatología , Humanos , Masculino , Mieloma Múltiple/complicaciones , Mieloma Múltiple/secundario , Fracturas del Radio/diagnóstico por imagen , Fracturas del Radio/etiología , Fracturas del Radio/fisiopatología , Resultado del TratamientoRESUMEN
Bone metastases can present in a wide variety of appearances across all imaging modalities. We present a unique appearance of a distal femoral metastasis in a patient who initially complained of knee pain. The radiographic and CT findings were initially suspicious for calcium pyrophosphate deposition (CPPD) arthropathy; however, an MRI demonstrated multiple lesions with a lamellated appearance confirmed on biopsy to be metastatic disease. This unusual lamellated appearance has not been previously described. We present this case to help distinguish this entity radiographically and better classify this finding as a manifestation of metastatic disease.
RESUMEN
We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution's Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement.
Asunto(s)
Uréter/lesiones , Cateterismo Urinario/efectos adversos , Resultado Fatal , Femenino , Humanos , Errores Médicos , Persona de Mediana Edad , Oliguria/etiología , Rotura/etiología , Tomografía Computarizada por Rayos X , Cateterismo Urinario/instrumentaciónRESUMEN
Metallosis following open reduction and internal fixation (ORIF) for fracture, usually presenting as a soft tissue mass, is barely discussed in the literature. In this case report, the imaging and pathological findings of metallosis after ORIF for a humeral fracture are presented and comprehensively discussed.