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Joint Diseases and Related Surgery 2023The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments.
OBJECTIVES
The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments.
PATIENTS AND METHODS
Between May 2020 and April 2021, a total of 29 patients (13 males, 16 females; mean age: 52.3±13.0 years; range, 30 to 78 years) who were operated and followed in our clinic for AO A2 and A3 distal radius fractures were included in this prospective study. Surface ultrasound (US) imaging was made to the dorsal sides of both wrists of the operated patients at different timepoints postoperatively. The length of screws with radius dorsal cortex penetration and the presence of tendinitis were recorded.
RESULTS
In 15 of 23 patients, the presence of 29 protruding screws was accompanied by tendinitis and, in eight patients, no tendinitis was observed, despite the partial protrusion of screws. A statistically significant correlation was found between the screw protrusion and presence of tendinitis (p<0.05). The number of protruding screws and tendinitis were seen mostly in the second compartment. There was a statistically significant correlation between the protruding screw length of >1.6 mm and the presence tendinitis (p<0.05).
CONCLUSION
Dorsal cortex screw protrusions in the application of volar plate for distal radius fractures can cause tendinitis. Screw protrusions occur more frequently in the second compartment and the development of tendinitis in this compartment is associated with a screw length of >1.6 mm. Screw penetration can be easily identified with intraoperative US to prevent tendinitis and potential tendon ruptures.
Topics: Male; Female; Humans; Adult; Middle Aged; Aged; Radius Fractures; Prospective Studies; Fluoroscopy; Radius; Bone Screws; Wrist Fractures
PubMed: 36700271
DOI: 10.52312/jdrs.2023.856 -
Surgical Neurology International 2021There have been many reports on the clinical, radiographic, and surgical management of thoracolumbar burst fractures attributed to high-energy trauma. Interestingly, few...
BACKGROUND
There have been many reports on the clinical, radiographic, and surgical management of thoracolumbar burst fractures attributed to high-energy trauma. Interestingly, few reports have described how to extract bone fragments associated with these injuries protruding into the spinal canal contributing to significant neurological deficits.
METHODS
An 18-year-old male presented with a severe L3-level paraparesis (i.e., loss of motor/sensory function below L3 lower extremity hyporeflexia, and sphincter dysfunction: American Spinal Injury Association [ASIA] Impairment Scale B) following a high-speed crash. The computed tomography and magnetic resonance studies revealed a L3 burst fracture with bone fragments protruding into the spinal canal causing marked cauda equina compression. Following a L3-L4 laminectomy, and opening of the dorsal dura, the bone fragments were ventrally impacted into the fractured L3 vertebral body a pedicle/screw L1-L5 fusion was then completed.
RESULTS
One month later, the patient recovered to an ASIA Scale of C, (i.e., residual proximal 3/5 and distal 2/5 motor deficits, with partial sensory sparing).
CONCLUSION
Transdural ventral impaction of protruded bone fragments attributed to high speed lumbar burst fractures contributing to significant cauda equina compression can be safely/effectively accomplished.
PubMed: 34513171
DOI: 10.25259/SNI_611_2021 -
Annales de Chirurgie Plastique Et... Oct 2016The umbilicus is our first scar. It is the last remain of our life in utero. Besides the umbilical hernia, a common pathology during the first three years of life that...
The umbilicus is our first scar. It is the last remain of our life in utero. Besides the umbilical hernia, a common pathology during the first three years of life that rarely requires surgery, there are some rare congenital abnormalities such as gastroschisis and omphalocele, which occur in about 1-5/10,000 births. Gastroschisis is a birth defect of the anterior abdominal wall, through which the fetal intestines freely protrude and are not covered by any membranes. During the 13th week prenatal ultrasound, the umbilical cord can be seen to be properly attached while the intestines float freely in the amniotic fluid. This defect is most common in young women who smoke and/or use cocaine and is not typically associated with genetic disorders. Omphalocele is an average coelosomy, in which a visceral hernia protrudes into the base of the umbilical cord. Omphalocele is typically diagnosed during the prenatal phase, and occurs most commonly in older mothers. It is frequently associated with genetic and morphologic abnormalities, therefore a karyotype should automatically be performed. For these two pathologies, the surgical problem lies in managing, during the reintegration, the conflict container/content responsible to lower vena cava syndrome and disorders ventilatory. Deciding on the technique will depend on the clinical form, and on the tolerance to reinsertion. The success of the surgery is directly linked to the postoperative emergence care for the pre-, per- and postnatal phases. The umbilical cord is preserved in the case of a gastroschisis. A primary or secondary umbilicoplasty will be performed for an omphalocele closure. The umbilicoplasty aims to create an umbilicus in a good position by giving it a shape, ideally oval, but also and especially an umbilication. The primary or secondary umbilicoplasty remains a challenge in a growing abdomen (change in position, deformation, loss of intussusception with growth). Many techniques are described: cutaneous flaps randomly placed, excision and skin plasty, resection and controlled wound healing. The choice of technique is a matter of practice but must be done in a rational way, depending on the scar condition when secondary reconstruction, and with minimal scarring, for primary reconstruction. To avoid morphological changes associated with growth, secondary umbilicoplasty should be proposed after the age of five.
Topics: Child; Gastroschisis; Hernia, Umbilical; Humans; Surgical Flaps; Umbilicus; Wound Healing
PubMed: 27289546
DOI: 10.1016/j.anplas.2016.05.002 -
Journal of Biochemistry Jan 2010To characterize the structure of jaw muscle fibres expressing masticatory (superfast) myosin, X-ray diffraction patterns of glycerinated fibres of dog masseter were...
To characterize the structure of jaw muscle fibres expressing masticatory (superfast) myosin, X-ray diffraction patterns of glycerinated fibres of dog masseter were compared with those of dog tibialis anterior in the relaxed state. Meridional reflections of masseter fibres were laterally broad, indicating that myosin filaments are staggered along the filament axis. Compared with tibialis anterior fibres, the peak of the first myosin layer line of masseter fibres was lower in intensity and shifted towards the meridian, while lattice spacings were larger at a similar sarcomere length. These suggest that the myosin heads of masticatory fibres are mobile, and tend to protrude from the filament shaft towards actin filaments. Lowering temperature or treating with N-phenylmaleimide shifted the peak of the first myosin layer line of tibialis anterior fibres towards the meridian and the resulting profile resembled that of masseter fibres. This suggests that the protruding mobile heads in the non-treated masticatory fibres are in the ATP-bound state. The increased population of weakly binding cross-bridges may contribute towards the high specific force of masticatory fibres during contraction. Electron micrographs confirmed the staggered alignment of thick filaments along the filament axis within sarcomeres of masticatory fibres, a feature that may confer efficient force development over a wide range of the sarcomere lengths.
Topics: Animals; Dogs; Electrophoresis, Polyacrylamide Gel; Jaw; Mastication; Skeletal Muscle Myosins; Temporal Muscle; X-Ray Diffraction
PubMed: 19762343
DOI: 10.1093/jb/mvp143 -
Molecular and Clinical Oncology Nov 2019The current study indicates the case of intracholecystic papillary neoplasm (ICPN) protruding into the common bile duct (CBD) without superficial spread. A 58-year-old...
The current study indicates the case of intracholecystic papillary neoplasm (ICPN) protruding into the common bile duct (CBD) without superficial spread. A 58-year-old woman presented to hospital with a fever that lasted for three days. Laboratory tests revealed elevated hepatobiliary enzyme levels. CT, MRI and endoscopic ultrasonography revealed a polypoid, papillary tumor inside the gallbladder cavity, which also extended to the CBD. On peroral cholangioscopy, a papillary tumor with mucin production was found at the middle bile duct. Biliary biopsy and bile cytology indicated adenocarcinoma. Based on a diagnosis of ICPN extending to the CBD, the patient underwent subtotal stomach-preserving pancreaticoduodenectomy and gallbladder bed resection. However, pathological examination revealed that the ICPN was confined to the gallbladder and cystic duct, whereas the CBD was tumor-free. The present case indicates that when ICPN increases in size, it may protrude into the CBD due to an increased intracholecystic pressure, which increases the risk of overestimation of tumor extension and may result in unnecessary additional bile duct resection.
PubMed: 31602301
DOI: 10.3892/mco.2019.1919 -
Spinal Cord Aug 2022Spinal gout is uncommon. The clinical manifestations of spinal gout are not characteristic. Huge tophi can invade the vertebral joints and protrude into the spinal...
BACKGROUND
Spinal gout is uncommon. The clinical manifestations of spinal gout are not characteristic. Huge tophi can invade the vertebral joints and protrude into the spinal canal, even causing spinal canal stenosis, which may result in irreparable spinal cord injury. Therefore, early diagnosis and treatment is very important. Summarizing the imaging features of spinal gout may help clinicians with an early diagnosis and promptly intervention.
STUDY DESIGN
Retrospective case series.
OBJECTIVES
To describe the findings from computed tomography (CT) images of spinal gout, including the tophi location, growth pattern, involvement of adjacent joints, and differentiation from other spinal lesions.
METHODS
We analyzed CT images from the atlantoaxial joint and lumbar spine in 17 cases with spinal gout.
RESULTS
17 cases had tophi as high-density masses. 14 (82.4%) cases involved lumbar facet joints, including 7(41.2%)cases involving single vertebral facet joints and 7(41.2%) cases involving multiple vertebral facets. CT imaging showed bone resorption and erosion of the facet joints, as well as narrowing of the joint space. The other three cases (17.6%) involved the atlantoaxial joint, showing a high-density mass around the odontoid process with bone resorption and invasion under the articular surface. One case was secondary to a pathological fracture. Four cases (23.6%) showed a huge mass protruding into the spinal canal where the nerve root was compressed, and even spinal cord injury, leading to serious lower back pain symptomatic of brachial plexus or sciatic nerve compression, and even affected the motor function of lower limbs.
CONCLUSIONS
In cases with gouty arthritis involving the axial spine, the lower lumbar spine is mainly involved, high-density tophi grow forward and backward around the facet joints, CT image shows bone resorption, erosion of facet joints, and narrowing of the joint space. With atlantoaxial joint involvement, there was evidence of bone resorption combined with joint.
Topics: Bone Resorption; Gout; Humans; Lumbar Vertebrae; Retrospective Studies; Spinal Cord Injuries; Tomography, X-Ray Computed
PubMed: 35177799
DOI: 10.1038/s41393-022-00773-2 -
Journal of Neurosurgery Sep 1986Saccular aneurysms arising at locations other than at arterial divisions are extremely rare. The authors describe eight such aneurysms that protruded from the dorsal...
Saccular aneurysms arising at locations other than at arterial divisions are extremely rare. The authors describe eight such aneurysms that protruded from the dorsal wall of the internal carotid artery (ICA) and were unrelated to any arterial junction. Radical surgery was performed in all eight cases. The aneurysms were saccular with a fragile wide or semifusiform neck. Intraoperative rupture occurred in three cases. From this experience, it is emphasized that these unusual protruding aneurysms of the dorsal ICA should be clipped with the clip blade parallel to the parent artery. In addition to clipping, complete wrapping with fascia or Bemsheet (cellulose fabric) is often advisable to prevent slippage of clips or postoperative rupture of residual aneurysm.
Topics: Adult; Carotid Artery Diseases; Carotid Artery, Internal; Female; Humans; Intracranial Aneurysm; Male; Middle Aged; Radiography
PubMed: 3734880
DOI: 10.3171/jns.1986.65.3.0303 -
American Journal of Ophthalmology Apr 1977Cut ends of 10-0 monofilament nylon sutures protruded and caused various combinations of severe pain, conjunctival inflammation, tarsal conjunctival ulcerations, eyelid...
Cut ends of 10-0 monofilament nylon sutures protruded and caused various combinations of severe pain, conjunctival inflammation, tarsal conjunctival ulcerations, eyelid edema, and corneal epithelial erosions in six patients postoperatively. These changes occurred one to three weeks after keratoplasty and one to three months after cataract surgery. In all six patients the signs and symptoms cleared after we trimmed or removed the offending sutures.
Topics: Adult; Aged; Blepharitis; Blepharoptosis; Cataract Extraction; Conjunctivitis; Corneal Transplantation; Edema; Eye Diseases; Female; Humans; Inflammation; Keratitis; Male; Middle Aged; Nylons; Postoperative Complications; Suture Techniques; Sutures; Transplantation, Homologous; Ulcer
PubMed: 326051
DOI: 10.1016/0002-9394(77)90564-5 -
Annals of Thoracic and Cardiovascular... 2016We report a rare case of protrusion of an invasive thymoma with intraluminal growth through the thymic vein into the superior vena cava (SVC) without direct invasion of...
We report a rare case of protrusion of an invasive thymoma with intraluminal growth through the thymic vein into the superior vena cava (SVC) without direct invasion of the vessel walls. The tumor and left brachiocephalic vein were resected, and the tumor in the SVC was removed with temporal bypass of the right brachiocephalic vein and right auricle. Histopathological finding showed that the thymoma had protruded via a thymic vein. During resection of a thymoma, a detailed examination of thymic vein is necessary to ensure that no tumor tissue remains in the vessels.
Topics: Biopsy; Brachiocephalic Veins; Chemotherapy, Adjuvant; Female; Humans; Middle Aged; Neoplasm Invasiveness; Thymectomy; Thymoma; Thymus Neoplasms; Tomography, X-Ray Computed; Treatment Outcome; Vena Cava, Superior
PubMed: 26299398
DOI: 10.5761/atcs.cr.15-00149 -
Acta Crystallographica. Section E,... Feb 2010In the title compound, C(26)H(32)N(4), the essentially planar (r.m.s. deviations of 0.0053 and 0.0242 Å) benzimidazole fragments are trans with respect to a central...
In the title compound, C(26)H(32)N(4), the essentially planar (r.m.s. deviations of 0.0053 and 0.0242 Å) benzimidazole fragments are trans with respect to a central ethene fragment, and are canted in opposite directions by 2.78 (6) and 5.87 (6)° with respect to the ethene plane, giving the mol-ecule a propeller conformation. The terminal ethyl fragments of the pendant n-propyl groups protrude to either side of the benzimidazole planes. Overall, the mol-ecule exhibits a pseudo-center of symmetry at the mid-point of the ethene fragment. Both π-π stacking and typical C-H⋯π inter-actions are notably absent, as are inter-molecular hydrogen bonds. When viewed along the a axis, the structure appears as criss-crossed layers of mol-ecules with the planar fragments separated along the c-cell direction by the protruding ethyl groups.
PubMed: 21580350
DOI: 10.1107/S1600536810003405