RESUMO
The fabella (little bean) is a sesamoid bone found in the lateral head of the gastrocnemius muscle. Its incidence varies from 10% to 30%, and when present, usually occurs bilaterally. The fabella can lead to posterolateral knee pain either due to cartilage softening (chondromalacia fabellae) or other osteoarthritic changes on its articular surface. We present two patients with symptoms in the posterolateral aspect of the knee who underwent an arthroscopic excision of the fabella. We report on the technique used and the clinical outcome.
Assuntos
Artroscopia/métodos , Joelho/cirurgia , Músculo Esquelético , Dor/etiologia , Ossos Sesamoides/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Resultado do TratamentoRESUMO
This article aims to assess whether a detachable functional focused rigidity cast can be used as a one-off definitive treatment for proximal 5th metatarsal fractures. A prospective trial was carried out over a 2-year period. Forty-one patients with proximal 5th metatarsal fractures (tuberosity and Jones) were recruited and treated with a detachable focused rigidity cast after appropriate consent. Of the 39 patients with follow-up, six had a Jones fracture and 33 had tuberosity fractures. All 33 patients with tuberosity fractures achieved clinical union within 4-5 weeks (mean of 4.2 weeks). Four of the six patients with Jones fractures achieved clinical union in 8-12 weeks. One achieved union in 14 weeks and one underwent open reduction and internal fixation for delayed union. There were no complications related to the cast. The results support the use of a detachable focused rigidity cast as a one-off definitive treatment of tuberosity fractures of the 5th metatarsal. However, all the Jones fractures and the diaphyseal fractures should be referred to an orthopaedic team for further management.
Assuntos
Moldes Cirúrgicos/normas , Fraturas Ósseas/terapia , Ossos do Metatarso/lesões , Adesivos , Atitude Frente a Saúde , Ensaios Clínicos como Assunto , Desenho de Equipamento , Feminino , Fixação Interna de Fraturas , Consolidação da Fratura , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/psicologia , Fraturas não Consolidadas/etiologia , Fraturas não Consolidadas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem , Estudos Prospectivos , Radiografia , Inquéritos e Questionários , Resultado do TratamentoRESUMO
Traumatic hip dislocation in the paediatric population is a relatively rare occurrence and constitutes an orthopaedic emergency. A trivial force is all that is required and non-accidental injury should not be necessarily suspected. A case report involving a hip dislocation in a 21-month-old child, the youngest in the recent English literature is detailed.
