Orthopedics
-
Although the Morel-Lavallé lesion was originally described over 150 years ago and is a well known entity about the pelvis and femora, its occurrence in the prepatellar region has only recently been reported. While Tejwani et al asserted that prepatellar MLL and prepatellar bursitis can be readily distinguished clinically, the absence of prepatellar MLL from the literature until recently suggests that it may be under-diagnosed. ⋯ Because both entities are initially treated in the same manner, MRI might be reserved for collections that fail to resolve following conservative therapy or in cases where the diagnosis is questioned. Serial percutaneous aspiration and sclerodesis should be considered in the management of recalcitrant collections or in the initial management of athletes depending on lesion size and range of motion.
-
The infraclavicular brachial plexus block is a routinely used anesthesia technique for orthopedic hand, wrist, and arm surgeries. Although the pulmonary anatomy surrounding the brachial plexus would suggest a theoretical potential for pneumothorax development during infraclavicular brachial plexus blockade, this complication is rarely reported in the literature. We report two occurrences of pneumothorax development following routine infraclavicular brachial plexus blockade performed by physicians at an academic training institution with technical experience. ⋯ Possible preventative strategies to avoid pneumothorax complications during infraclavicular brachial plexus blockade are discussed. This case report indicates there is a risk of iatrogenic injury during infraclavicular brachial plexus blockade. This information could be valuable in determining anesthesia modalities used for orthopedic upper extremity surgeries in patient populations with problematic follow-up or limited access to health care.
-
Reports of spinal subdural hematoma are rare. In the few reported cases, type of onset, symptoms, and course have varied, precluding diagnosis based on simple radiography. Obtaining a definitive diagnosis and deciding on a treatment approach can thus sometimes be difficult. ⋯ With subacute spinal subdural hematoma, progression to paraplegia occurs slowly, over a period of > or =1 week. Although several cases of spontaneous resolution have been described early surgical treatment is commonly required. This article presents a case of an 85-year-old woman with subacute spinal subdural hematoma who regained the ability to walk following surgical treatment.
-
Subtalar dislocations are rare in routine orthopedic practice. While many of these dislocations are a result of high-energy injuries such as fall from a height or traffic accidents, it is not uncommon for patients to present after slipping down a few stairs. Two types of dislocation have been described, medial and lateral. ⋯ The reverse is true of lateral dislocation. Medial dislocation has been referred to as "basketball foot" due to its preponderance in basketball players.4 The deciding factor is the inverted or everted position of the foot when the force is dissipated through the weak talonavicular and talocalcaneal ligaments. This article presents a case of an adult with lateral subtalar dislocation following a fall.
-
This study reviewed surgical treatment methods in patients with type II odontoid fracture who were admitted to a level 1 spinal cord injury center during a 20-year period. Of the 186 patients who met inclusion criteria, 75 were treated operatively. The rate of surgical intervention increased during the study period. ⋯ The Brooks technique and anterior odontoid screw fixation declined in frequency, whereas the Magerl technique has been used at a consistent rate since its introduction. The C1 lateral mass and C2 pedicle/isthmus screw technique has increased significantly since its description. Pneumonia, vocal cord, and swallowing problems occurred more often with anterior approaches.