A Case of a Failed Hemiarthroplasty of the Hip Treated by an Extended Trochanteric Osteotomy.

Hip bipolar hemiarthroplasty, a widely employed surgical intervention for managing hip fractures and degenerative hip diseases, can pose significant challenges when revisions become necessary due to complications such as implant loosening, instability, or breakage. This case report presents the intricate management of a 58-year-old male who presented with worsening left hip pain a decade after undergoing hip replacement surgery. Despite a thorough preoperative assessment ruling out infection, intraoperative complexities included the necessity for extended trochanteric osteotomy (ETO) to address a broken stem and associated metallosis. Successful revision surgery was meticulously executed, incorporating techniques for implant removal, femoral shaft augmentation, and postoperative rehabilitation. The ensuing discussion explores the multifaceted aspects of failed hemiarthroplasty, emphasizing the critical roles of surgical precision, judicious patient selection, and ongoing research endeavors aimed at refining surgical strategies to optimize patient outcomes. This case underscores the imperative of a multidisciplinary approach and the continued imperative for advancements in surgical methodologies for effectively managing revision hip arthroplasty cases, thus enhancing the quality of patient care in this intricate clinical domain.

Flexor Digitorum Profundus Avulsion With Distal Interphalangeal Joint Dorsal Dislocation: A Case Report.

An irreducible closed dorsal dislocation of the distal interphalangeal (DIP) joint of the finger is a rare injury, often caused by factors such as the interposition of the volar plate, entrapment of the flexor digitorum profundus (FDP) tendon behind the head of the middle phalanx, or the buttonholing of the middle phalanx head through the volar plate or flexor tendon. This case report presents a rare instance of FDP avulsion combined with dorsal dislocation of the DIP joint in a 42-year-old male who sustained trauma to his right middle finger during a workplace accident. Clinical examination and imaging confirmed FDP avulsion along with dorsal dislocation of the DIP joint. Urgent surgical intervention was performed, successfully reducing and repairing the FDP tendon and stabilizing the DIP joint. Subsequent follow-up showed satisfactory functional outcomes. This case highlights the importance of prompt diagnosis and appropriate surgical management in treating complex finger injuries.

Inferior Pole of the Patella Fracture Fixed by Percutaneous Approach: A Case Report.

Fractures of the inferior pole of the patella are rare but challenging orthopedic injuries. This case study presents the management of such a fracture using a percutaneous approach. A 70-year-old female patient presented with significant knee pain and swelling following a fall. Radiographic examination revealed a displaced fracture of the inferior pole of the patella along with an ipsilateral tibial plateau fracture. Surgical intervention was deemed necessary due to the extent of displacement and the potential for compromised knee function. A percutaneous technique was employed for fracture reduction and fixation using cannulated screws under fluoroscopic guidance. Postoperative rehabilitation focused on early mobilization and strengthening exercises. At a six-week follow-up, the patient demonstrated satisfactory clinical outcomes with restoration of knee function and minimal residual symptoms. This case highlights the efficacy of percutaneous fixation in managing inferior pole patellar fractures, offering a minimally invasive approach with favorable functional outcomes.

Fixation of Paediatric Proximal Humerus Fractures Using Percutaneous Pinning: A Case Report.

A 12-year-old male came to our Emergency Department with chief complaints of pain and inability to move the right shoulder for one day following a fall while playing. The range of motion of the right shoulder was restricted and painful in all directions. Initial radiographs revealed a transverse, displaced proximal humerus fracture at the head-shaft junction. The patient was managed by closed reduction internal fixation with percutaneous K-wiring (Kirschner wires). The K-wires were removed after four weeks, and the shoulder was mobilized. The patient had a near-normal and pain-free range of motion at three months of follow-up. Percutaneous K-wiring remains a viable option for the treatment of paediatric proximal humerus fractures, and good post-operative rehabilitation can help restore near-normal function, as demonstrated in this report.

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.

A Rare Case of Synovial Chondromatosis in the Proximal Interphalangeal Joint of the Right Index Finger.

Synovial chondromatosis is a rare condition that is also known as Reichel syndrome. It is a disorder that affects the monoarticular joints. The proliferation and metaplasia of the synovial cartilage are its defining characteristics. Many tiny, intra-articular osseocartilaginous loose bodies are formed as a result of this proliferation. They are fed by the synovial fluid once they break off from the synovial surface and enter the joint cavity, where they develop into calcification and ossification. If left untreated, it usually causes the afflicted joint to malfunction severely. Large joints such as the knee, hip, elbow, and shoulder joints are frequently the sites of nodular proliferation. Smaller joints such as the hand's interphalangeal and metacarpal joints and thumb are among the more unusual locations. Although the disease usually resolves on its own, conservative management options include painkillers, activity modification, and cryotherapy. Surgical options include synovectomy, which is the gold standard procedure and involves removing the loose bodies. The following case study presents a 60-year-old female patient with a rare instance of synovial chondromatosis. She presented to the outpatient department (OPD) due to escalating pain and swelling in the proximal interphalangeal (PIP) joint of her right index finger, which significantly restricted her range of motion. On the hand X-ray, several small, uniformly sized calcified bodies were visible within the synovium. After negative results from autoimmune disease tests, the patient was recommended for surgical exploration as the patient reported a six-month increase in pain and difficulty flexing his index finger. Surgical exploration of the PIP joint and adjacent proximal and middle phalanx revealed several small, evenly sized, firm, smooth, creamy-white nodules. Post-op, the patient was given a splint cast for a span of seven days, followed by physical therapy, and the range of motion was achieved by the end of six months.