Hypertrophic synovial plica in the lateral side of the knee - A case report: Case report and literature review.

INTRODUCTION: Plicae or synovial folds can be detected in different joints, especially around the knee. Synovial plicae pathologies are rare conditions with difficulty in diagnosis because of various symptoms overlapping with other diseases. PRESENTATION OF CASE: We reported a rare case of symptomatic hypertrophic synovial plica in the lateral side of the knee in a 12-year-old boy following a traumatic event almost two years before the surgery. The diagnosis and treatment were conducted by knee arthroscopy, and follow-up of the patients showed significant improvements with no pain or range of motion restrictions. DISCUSSION: The reported case had a significantly lower age of presentations compared to most previously reported cases, and he was diagnosed with lateral knee hypertrophic plicae, while medial knee hypertrophic plicae are more commonly reported, which is considered rare findings. Contrary to previous studies of lateral plica, our case had a history of significant direct trauma, and he was not a professional athlete. Furthermore, based on evidence, hypertrophic synovial plicae are mostly asymptomatic, but in our case, there was a pain in his knee that worsened in flexion. CONCLUSION: Physicians should consider the possibility of synovial hypertrophic plicae, especially in younger patients with histories of direct traumatic events.

Subtrochanteric fracture of the femur following knee replacement surgery: A case series and review of the literature.

INTRODUCTION AND IMPORTANCE: Knee arthroplasties as an effective intervention is primarily performed in patients with primary osteoarthritis and rheumatoid arthritis. Risk of hip fracture may be either decreased or increased in patients with Knee arthroplasties. There is conflicting evidence in this regard. Over the years, some studies have reported the occurrence of hip fractures following this operation as a rare but severe complication. The aim of the present case series was to report diagnosis and treatment of the mentioned five cases. CASE PRESENTATION: During a period of two years, five patients with a diagnosis of a subtrochanteric fracture and history of total knee arthroplasty who referred to hospital were selected to include in the present case series. CLINICAL DISCUSSION: the presence of RA and treatment with glucocorticoids, a reduction of BMD following knee replacement surgery, and ultimately, an increase in physical activity and movement after the arthroplasty due to the improvement of preoperational pain, may all contribute in a complex manner to the observed outcome of increased fracture risk in the hip following TKA. CONCLUSION: In summary, special care including using medications to improve BMD should be taken to minimize the risk of such an event.

Surgical treatment of a nonunion following clavicle osteotomy in a child with a history of Erb's palsy: A case report.

INTRODUCTION AND IMPORTANCE: Erb's palsy defined as muscle weakness and loss of motion caused by a nerve condition in the shoulder and arm. Children with Erb's palsy might underwent clavicle osteotomy as an appropriate surgical treatment method. However, few number of these patients who underwent clavicle osteotomy experienced nonunion and complained of shoulder deformity and pain. The aim of the present case report was to present new surgical treatment of a nonunion following clavicle osteotomy in a child affected by Erb's palsy. CASE PRESENTATION: A six years old boy with a history of Erb's palsy who underwent clavicle osteotomy at age of 6 months was referred to hospital. There was a nonunion following clavicle osteotomy. The patient had right shoulder deformity and complained of its-related pain. To correct a nonunion following clavicle osteotomy in this case, middle third fibula auto grafting and fixing it to the cite of clavicle nonunion by pins was used. After five months of follow-up, a clavicle nonunion and shoulder deformity was thoroughly corrected. CLINICAL DISCUSSION: As clavicle osteotomy, the most commonly surgical method for Erb's palsy, has been demonstrated to not work effectively and cause nonunion in some cases, a new surgical method for correcting clavicle nonunion other than repeated clavicle osteotomy is needed. In the present case report, fibula auto grafting and fixing it to the cite of clavicle nonunion by pins was applied and demonstrated remarkable improvement. CONCLUSION: Totally, use of fibula auto grafting and fixing it to the cite of clavicle nonunion by pins might be an effective surgical treatment for such cases.

A rare case of fully recovered necrotizing fasciitis.

Necrotizing fasciitis (NF) is a severe soft tissue infection caused by bacterial fascia invasion and quick spreading to the muscle and subcutaneous tissues. Treatments of NF should be conducted by extensive debridement and antibiotic therapies. This report presented a 53-year-old woman with diabetes mellitus (DM) and hypothyroid who was referred to our medical center with lower limb pain and significant swelling after mild trauma. The patient was diagnosed with NF due to E. coli. She underwent surgical interventions for debridement and long-term antibiotic therapy. The patient recovered successfully without complications or range of motion (ROM) restriction in the hip and knee. It is recommended that immediate actions be taken in NF cases to preserve the remaining tissues and provide better outcomes.