Treatment of a Neglected and Infected Knee Dislocation with a Traction Pin: A Case Report.

Neglected knee dislocations are rare and challenging orthopedic injuries. We report using a traction pin to treat a neglected knee dislocation and a concurrent infection. Following the primary reduction with extensive soft-tissue release, a proximal tibial traction pin was used to obtain complete reduction via traction weight change. No ligamentous repair was done for the patient. The patient's one-year follow-up showed an acceptable radiographic reduction supported by satisfactory clinical outcomes. In conclusion, the proximal tibial traction pin could be a good alternative for treating neglected knee dislocations. It makes future knee replacements more practical, a significant concern in such patients. Meanwhile, it is much more affordable than the other available techniques.

Acute Irreducible Rotational Patellar Dislocation with Patellar Tendon Rupture: A Case Report.

CASE: In this report, we present a case of acute patellar dislocation with both vertical and longitudinal rotation of the patella. As a result of rotation in the longitudinal axis, the articular surface of the patella faced outward, and the dorsal surface faced the femoral condyle. The patient underwent open reduction. One year after open reduction and soft-tissue repair, the patient had acceptable knee function and no knee pain. CONCLUSION: This case shows how similar cases may be treated with an open reduction to properly address the patellar dislocation.

Surgical Excision as the First Therapeutic Choice in Single-muscle Hemangiomas: a Case Series.

BACKGROUND: Conservative management is generally the primary treatment for intramuscular hemangimas. However, many patients will require surgery later in their life, after suffering a long period of pain. We aimed to evaluate the oncologic and functional outcomes of surgery as the initial treatment of single-muscle hemangiomas. METHODS: Medical profiles of 17 patients with hemangiomas of vastus medialis for whom surgery was selected as the initial treatment were reviewed. The indication for surgery was a bothersome pain. Postoperative muscle strength was assessed with manual muscle testing (range 0-5). The postoperative pain was measured by a visual analog scale (VAS) for pain (range 0-10). Lyshölm-Tegner knee scoring scale was used for the evaluation of knee function. RESULTS: The mean age of the patients was 25.9±8.6 years. Surgery was performed as wide resection in 13 cases and as marginal resection in 4 cases. At a mean follow-up of 55.76±30 months, two local recurrences (11.8%) were observed. At the last evaluation session, muscle strength grade was 5/5 in 13 patients and 4/5 in four patients. Postoperative pain was noticed in four patients (VAS=1). Knee function was excellent in 13 patients and good in four patients. Both of the local recurrences occurred in marginally resected lesions. Three out of four cases with reduced muscle strength, postoperative pain, and reduced function were also treated with marginal resection. CONCLUSION: If a wide surgical margin is achievable without compromising the limb function, surgical resection could be considered as the primary choice of treatment for single-muscle hemangiomas.