Unusual Presentation of Cerebral Fat Embolism Syndrome Post-femur Fracture: A Case Study and Diagnostic Insights.

Cerebral fat embolism syndrome (CFES) is a rare but certainly devastating impediment following long bone fractures. The diagnosis of CFES primarily depends on identifying clinical manifestations like respiratory distress, petechial rash, and neurological symptoms. However, in rare instances, CFES can manifest with atypical or absent clinical features, posing diagnostic challenges. Here, we present a rare case report of a woman in her 20s who developed CFES after suffering a femur shaft fracture devoid of conventional clinical features. The diagnosis of CFES was built upon clinical suspicion and a typical MRI brain finding of a starfield pattern. Our case highlights the importance of including CFES in the differential diagnosis of neurological deterioration, especially after long bone fractures. We suggest early plate osteosynthesis to stop more emboli from forming in people with FES, as well as continuous neuromonitoring and a reminder that CFES can show up without any other signs or symptoms in the body.

Acute Bony Bankart Injury With Glenoid Rim Fracture Treated by Arthroscopic Bankart Repair.

A bony Bankart lesion is a torn labrocapsular complex with a glenoid rim fracture. In this case report, a patient with an acute bony Bankart injury presented with severe shoulder pain and limited range of motion following a road traffic accident. The injury was diagnosed through imaging studies and required arthroscopic bony Bankart repair. The post-surgery rehabilitation program restored the patient's shoulder mobility, strength, and stability, significantly improving pain relief and functional ability. Overall, the case report highlights the importance of prompt diagnosis and appropriate surgical intervention in acute bony Bankart injuries, followed by a well-structured rehabilitation program to achieve optimal outcomes in pain relief, range of motion, and functional ability.

An Unusual Pattern of Scapular Avulsion Fracture in the Spine: A Case Study.

Acromion fractures, particularly isolated cases, are uncommon but significant in shoulder injuries. There is no universally accepted treatment protocol, but the classification of the fracture helps to guide clinical decisions. We present a case report aiming to contribute to the understanding of treatment options for acromion fractures. A 22-year-old male sustained a left shoulder injury during a wrestling match, resulting in a type 2 acromion fracture. Conservative treatment was initiated with regular follow-ups. Serial imaging showed no further displacement. Gradual rehabilitation exercises were introduced based on healing progress. The rarity of isolated acromion fractures complicates their management. Conservative management, coupled with rehabilitation exercises, yielded positive outcomes in our case, suggesting its efficacy as a primary treatment option for isolated displaced acromion fractures. Further research is needed to establish standardized protocols for managing such fractures, but until then, conservative care remains a viable approach, potentially preferred over surgical intervention.

Treatment of Failed Proximal Femoral Nail Anti-rotation Asia (PFNA2) in a Severely Osteoporotic Patient With a Revision Stem.

An intertrochanteric fracture is a prevalent and perilous kind of fracture that often affects older persons. A customized implant, proximal femoral nail anti-rotation Asia (PFNA2) is being used expressly in unstable intertrochanteric fractures in people with osteoporosis. In this case report, we examined a female osteoporosis patient, age 74, who underwent a failed PFNA2 procedure. Subsequently, the patient had bipolar hemiarthroplasty as a treatment. To prevent mechanical failure, it is crucial to strive for a high level of reduction quality and precise alignment of the central blade throughout hip X-ray procedures. Improved surgical proficiency and skill are crucial for managing patients with severe osteoporosis and prolonged weight-bearing requirements, hence reducing the occurrence of postoperative problems. Depending on the cause of the failure and the individual circumstances of the patient when internal fixation fails, it is recommended to either replace the joint with a prosthetic or reapply fixation. These interventions may facilitate the production of beneficial healing outcomes.

A Glomus Tumor Presenting on the Ventromedial Aspect of the Little Finger Causing Bony Erosion: A Rare Case From India.

Glomus tumors are rare neoplasms originating from the glomus body that predominantly manifest in the subungual region of the digits and are distinguished by severe pain and a heightened sensitivity to cold. Bony erosion associated with glomus tumors is a rare phenomenon. Here, we present a unique case of a glomus tumor situated on the ventromedial aspect of the little finger, leading to notable bony erosion. A 42-year-old female from India presented with a chief complaint of severe and localized pain in the ventromedial region of her right little finger, exacerbated by exposure to cold temperatures. Radiological investigations demonstrated focal bone erosion at the site of the tumor. Surgical excision of the lesion was performed. A fish-mouth incision was made on the ventromedial aspect of the little finger, which was extended to the tip of the finger. The nail bed was kept intact. The tumor was excised using small forceps. The patient experienced complete resolution of symptoms postoperatively and reported no recurrence during the follow-up period. This case report highlights the exceptional presentation of a glomus tumor causing bony erosion on the ventromedial aspect of the little finger, a manifestation rarely encountered in clinical practice. Furthermore, this case contributes to the limited body of literature on this combination of uncommon clinical entities, shedding light on its diagnosis and management.

Elevated temperature-driven coordinative reconstruction of an unsaturated single-Ni-atom structure with low valency on a polymer-derived matrix for the electrolytic oxygen evolution reaction.

A high-temperature pyrolysis-controlled coordination reconstruction resulted in a single-Ni-atom structure with a Ni-Nx-C structural unit (x = N atom coordinated to Ni). Pyrolysis of Ni-phen@ZIF-8-RF at 700 °C resulted in NiNP-NC-700 with predominantly Ni nanoparticles. Upon elevating the pyrolysis temperature from 700 to 900 °C, a coordination reconstruction offers Ni-Nx atomic sites in NiSA-NC-900. A combined investigation with X-ray absorption spectroscopy, X-ray photoelectron spectroscopy, and soft X-ray L3-edge spectroscopy suggests the stabilization of low-valent Niδ+ (0 < δ < 2) in the Ni-N-C structural units. The oxygen evolution reaction (OER) is a key process during water splitting in fuel cells. However, OER is a thermodynamically uphill reaction with multi-step proton-coupled electron transfer and sluggish kinetics, due to which there is a need for a catalyst that can lower the OER overpotentials. The adsorption energy of a multi-step reaction on a single metal atom with coordination unsaturation tunes the adsorption of each oxygenated intermediate. The promising OER activity of the NiSA-NC-900/NF anode on nickel foam was followed by the overall water splitting (OWS) using using NiSA-NC-900/NF as anode and Pt coil as the cathodic counterpart, wherein a cell potential of 1.75 V at 10 mA cm-2 was achieved. The cell potential recorded with Pt(-)/(+)NiSA-NC-900/NF was much lower than that obtained for other cells, i.e., Pt(-)/NF and NF(-)/(+)NF, which enhances the potentials of low-valent NiSAs for insightful understanding of the OER. At a constant applied potential of 1.61 V (vs. RHE) for 12 h, an small increase in current for initial 0.6 h followed by a constant current depicts the fair stability of catalyst for 12 h. Our results offer an insightful angle into the OER with a coordinatively reconstructed single-Ni-atom structure at lower valency (<+2).

A Rare Case of Giant Cell Tumour of Tendon Sheath and Its Arthroscopic In Toto Excision.

The aim of this study is to bring attention to a unique occurrence in an uncommon location and to describe our approach to treatment in this context. We describe a case of a 36-year-old male who presented with complaints of pain in his left knee for three months, with a restricted range of motion, without a prior history of trauma. A thorough knee examination was performed, which was unremarkable except for a restricted range of motion and tenderness along the medial joint line. A plain radiograph of the knee revealed no bony injury. MRI was done to assess the extension and it confirmed a soft tissue mass beneath the patella. The patient was taken up for surgery after a pre-anesthetic checkup and the mass was removed arthroscopically in toto using a higher accessory antero-medial portal. The mass was removed with the help of a spatula without damaging it and sent for histopathological analysis. Histopathology confirmed that it was a giant cell tumour of the tendon sheath. The procedure was uneventful, and the patient achieved a full range of motion post-operatively.