RESUMO
Slipped capital femoral epiphysis (SCFE) and Down syndrome are both uncommon in the population at large, and rarely are both conditions present in a single individual. Institutional records were searched for both Down syndrome and SCFE. At least 2 years of follow-up was required. Eight patients were identified. At presentation four patients could not walk due to pain and four could walk. Six of eight hips presented with grade III SCFE. Four hips were treated with internal fixation in situ and four were manipulatively reduced in the operating room at the time of fixation with percutaneous screws or pins. Three hips healed uneventfully. Five hips developed aseptic necrosis (three partial, two whole head). This small retrospective study suggests an extremely high rate of complications in adolescents with Down syndrome and SCFE.
Assuntos
Síndrome de Down/complicações , Epifise Deslocada/complicações , Quadril/anormalidades , Adolescente , Parafusos Ósseos , Criança , Epifise Deslocada/patologia , Epifise Deslocada/cirurgia , Feminino , Fêmur/patologia , Fêmur/cirurgia , Quadril/diagnóstico por imagem , Quadril/cirurgia , Humanos , Masculino , Prognóstico , Radiografia , Resultado do TratamentoRESUMO
The posterior thoracic vertebral body appears to be a novel origin for an exostosis causing myelopathy. A patient with hereditary multiple exostoses and myelopathy caused by an exostosis originating from the posterior aspect of the T5 vertebral body was treated with a staged anterior decompression/corpectomy and posterior spinal fusion. The patient had near-complete resolution of his myelopathy immediately after undergoing removal of the exostosis through a right-sided lateral thoracotomy approach. This was a unique origin for an exostosis causing spinal cord compression in a patient with hereditary multiple exostoses. The delivery of the exostosis was performed en bloc during the anterior decompression and corpectomy portion of the surgery. This resulted in the expected favorable outcome.
Assuntos
Exostose Múltipla Hereditária/complicações , Compressão da Medula Espinal/etiologia , Vértebras Torácicas/anormalidades , Adolescente , Exostose Múltipla Hereditária/genética , Humanos , Imageamento por Ressonância Magnética , Masculino , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/cirurgia , Fusão Vertebral , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Toracotomia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Broken guide pin removal from within the hip joint can be accomplished using a combined method of drilling and suction. This technique also may be of value when a small loose body or foreign object needs to be retrieved from the hip joint.