Low-molecular-weight heparin (LMWH) has been considered superior to unfractionated heparin in several facets such as more effective anticoagulant, more predictable bioavailability, and less bleeding complications. We report two cases of LMWH, enoxaparin-induced spontaneous intramuscular hematoma with compartment syndrome of the lower extremity in patients with cardiac problems. The patients were treated with enoxaparin (LMWH) as bridging anticoagulation before use of warfarin due to cardiac problems. At the average 3 days of enoxaparin treatment, large and painful swelling was noticed in the lower extremities without intramuscular injection or trauma. The patients were diagnosed as having compartment syndrome with large intramuscular hematoma by CT. The patients underwent immediate fasciotomy and hematoma evacuation, and recovered without any complications.
Os peroneum is one of the normal sesamoids in the foot and it can be insertion of peroneus longus tendon. We report a case of as peroneum fracture with complete tear of peroneus longus tendon. This case was finally diagnosed in operation and treated by suture with peroneus brevis tendon and short leg cast.
Citations
Citations to this article as recorded by
Painful Os Peroneum Syndrome Presenting as Lateral Plantar Foot Pain Seon Jeong Oh, Young Hoon Kim, Sun Ki Kim, Min-Wook Kim Annals of Rehabilitation Medicine.2012; 36(1): 163. CrossRef
PURPOSE This study summarizes the satisfactory results obtained using a composite fixation method for the surgical treatment of long bone fractures in elderly patients with osteoporosis. MATERIALS AND METHODS We reviewed 10 cases of long bone fractures, that were treated by composite fixation, involving patients over 60 years of age that presented with radiological osteoporosis. Composite fixation was applied incorporating, traditional plate and screw fixation in conjunction with bone graft, plate or intramedullary bone cement at four cases of humeral shaft fractures, three cases of femur supracondylar fractures, two cases of femur shaft fractures, and one case of tibia shaft fracture. Results were evaluated in methods of ambulation, range of motion, bony union and complications. RESULTS Satisfactory ambulation and range of motion was observed in all cases, which showed bony union without early implant failure. No re-operation were necessary due to nonunion. No medical complication was noted. CONCLUSION The results shows that the composite fixation method provided a stable reduction and a rigid fixation, which facilitated bony union, and allowed elderly patients with osteoporosis an early range of motion and mobility after the surgical treatment of long bone fractures.
Radial head dislocation with ipsilateral radial shaft fracture is one of the reportable trauma case with very low incidence. Only 4 cases of this type injury have been reported worldwide. In 3 cases of them, good results were achieved after early closed reduction of the radial head, followed by internal fixation of the radial shaft. In the a u t h o r s'case, the patient received the same method of treatment mentioned at the previous successful 3 cases. But after that, he suffered from repeated dislocations and finally nonunion of the fracture. At last, the authors could obtain bony union and stable elbow joint after radial head resection and osteosynthesis using autologous cancellous bone graft, but resulted in limitation of motion. We report the case and the experience of treatment.
Citations
Citations to this article as recorded by
Delayed radial head dislocation after radial shaft fracture fixation: a case report and review of the literature Jiyong Yang, Jie Zhang, Zhengzhong Yang BMC Surgery.2022;[Epub] CrossRef
Postoperative periprosthetic fracture of the femur after hip arthroplasty is a serious complication that can be difficult to treat. Moreover, it has become more common in recent years, as the cases of hip arthroplasty and revisonal hip arthroplasty increase. We have experienced a postoperative periprosthetic fracture of th femur probably caused by a surgical instrument left in the medullary canal during hip arthroplasty. We report this case with reference to other related articles.
PURPOSE : The goal of treatment in elderly patients with hip fractures is restoration of function to preoperative ambulatory statuf as early as possible. The dementia patients who live in the asylum for the old need longer rehabilitation program for restoration of function, especially walking ability. The authors compare the modalities of the treatment for the hip fracture in the view point of walking ability. MATERIALS and METHODS : The twenty-eight dementia patients were operated due to hip fracture.
Femur neck fractures were 7 cases, and femur intertrochanteric fractures were 21 cases. The authors analyze these patient on the recovery of walking ability. One patient who died immediately after operation was excluded in thil study. The patients were divided into two groups. Of 27 patients, 13 patients were treated with osteosynthesis(Group I), and remaining 14 patients were treated with hemidrthroplasy(Group II). RESULTS Fixation loss was treated with hemiarthroplasty in two case of osteosynthesis. The dislocation was treated with open reduction in one cafe of hemiarthioplasty. In the group I, the walking abilities were significantly different between the preoperative(3.85) and the postoperative at 2 weeks(2.46), at 2 months(2.73) and at the final follow-up(2.55)(P<0.05). In the group II, the walking abilities were not significantly different between the preoperative (2.57) and the postoperative at 2 weeks(2.14), at 2 months(2.36) and at the final follow- up(2.29)(P>0.05). CONCLUSION : Although there is no difference between two groups in final walking ability, The group treated with endoprosthesis showed earlier recovery of safting ability.
Citations
Citations to this article as recorded by
CORR Insights®: What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study Eckart Mayr Clinical Orthopaedics & Related Research.2016; 474(12): 2630. CrossRef
Risk Factors Associated with Dislocation after Bipolar Hemiarthroplasty in Elderly Patients with Femoral Neck Fracture Yeesuk Kim, Joon-Kuk Kim, Il-Han Joo, Kyu-Tae Hwang, Young-Ho Kim Hip & Pelvis.2016; 28(2): 104. CrossRef
Acromioclavicular dislocation with a concomitant coracoid process fracture occurs infrequently, as only several cases have been reported in the literature. This injury usually occurs in the second or third decade of life. The mechanism of injury were sports, motor vehicle and direct trauma.
An axillary lateral radiograph of the shoulder often is needed to detect this fracture.
The authors present two cases of coracoid process fracture associated with acromioclavicular dislocation. Satisfactory function with minimal residual cosmetic deformity may be achieved by nonoperative measures. Also surgical treatment can produce good result in complete third acromioclavicular separation combined with the significantly displaced coracoid fracture.
As a complication of Smiths fracture, traumatic entrapment and closed rupture of the extensor pollicis longus tendon may occur rarely at the fracture site and cause loss of thumb extenion. Traumatic entrapment of the extensor pollicis longus tendon in Smiths fracture which was anatomic barrier of successful closed reduction was first described by Hunt in 1969. Since then, several authors reported another few cases.
The mechanism of tendon rupture in Smiths fracture is thought that the sharp dorsal edge of the proximal fragment may tear the stretched muscular tendon unit during extreme wrist flexion.
We experienced a case of traumatic rupture of the extensor pollicis longus tendon associated with a closed Smiths fracture and report this case with our treatment method.
The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is generally recommended. The success of operative treatment depends on the stable reduction and secure fixation.
But osteoporosis and comminution of the fracture geometry which are common in this aged group result in various complications and preclude satisfactory results. Because of these factors many surgeons are tempteed to develop new implant designs and new modifications of the reduction.
Stable reduction by either anatomic or nonanatomic means is preferred by most surgeons to lessen complications. Various sliding nail-plate devices and intramedullary nails are mainly used for fixation. Prosthetic replacement of the hip may be an altemative for osteoporotic risky patients.
Citations
Citations to this article as recorded by
Outcomes of Cephalomedullary Nailing in Basicervical Fracture Seok Hyun Kweon, Sung Hyun Lee, Seng Hwan Kook, Young Chae Choi Hip & Pelvis.2017; 29(4): 270. CrossRef
Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Unstable Intertrochanteric Femoral Fracture in Elderly Patients Dukhwan Kho, Kyoungmo Nam, Daemyung Kang, Hyeungjune Kim Hip & Pelvis.2013; 25(3): 203. CrossRef
Bipolar Hemiarthroplasty for Femoral Basicervical Fractures in the Elderly Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-Jun Kim, Dong-Heon Kim Journal of the Korean Fracture Society.2009; 22(4): 239. CrossRef
Bipolar Hemiarthroplasty Using Calcar Replacement Stem for Hip Fractures in the Elderly Duk-Hwan Kho, Ki-Hwan Kim, Hyeung-June Kim, Dong-Heon Kim Journal of the Korean Fracture Society.2008; 21(3): 232. CrossRef
Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients Duk-Hwan Kho, Ju-Yong Shin, Ki-Hwan Kim, Jun-Hyuck Lee, Dong-Heon Kim Journal of the Korean Fracture Society.2007; 20(2): 129. CrossRef