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1
Shetty, Kishore, and Vinay Vaidyanathan. "Intracranial and Orbital Complications of Sinusitis: A Case Series and Review of Literature." An International Journal Clinical Rhinology 4, no. 2 (2011): 87–92. http://dx.doi.org/10.5005/jp-journals-10013-1080.
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ABSTRACT Complications of paranasal sinus infection most often involve the orbit and periorbita. Because of widespread use of antibiotics, intracranial extension of paranasal sinusitis is rarely seen today. Nevertheless, the clinician must be aware of the potential of these complications, as late recognition of this condition and delay in treatment can increase morbidity and mortality rates. An interesting case series of sinusitis with orbital and intracranial complication is presented, which was radiologically evaluated, and was managed by endoscopic sinus surgery with drainage of subdural empyema by appropriate neurosurgical technique. The radiological tools played a very important role in both assessment and timing of surgical intervention. Unparallel role of radiological investigations cannot be overemphasized. The key to successful treatment is aggressive management and the timing for surgical intervention should not be deferred. The patients made full recovery at the time of discharge.
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Thiyagarajan, Deepu, and Prince Deva Ruban. "Early versus late laparoscopic cholecystectomy in the management of acute cholecystitis: a retrospective study." International Surgery Journal 6, no. 11 (2019): 3897. http://dx.doi.org/10.18203/2349-2902.isj20194634.
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Background: Early laparoscopic cholecystectomy (LC) is a life-saving procedure in the management of acute cholecystitis as it helps in prevention of late complications like development of adhesions, haemorrhage and sepsis. The study aims at comparing the outcomes of early versus late laparoscopic cholecystectomy in the management of acute cholecystitis.Methods: A retrospective study was done by analyzing the past 5 years medical records of 250 patients admitted to the emergency department with diagnosis of acute cholecystitis established according to the Tokyo criteria. The relevant clinio-social demographic data of the patients, clinical and radiological parameters, intra-operative and post-operative findings and follow-up data were compared between early and late LC group of patients.Results: The study included 125 middle aged patients who underwent early LC (within 24 hours) and 125 patients who underwent late LC (after 24 4hours). The complication rate, conversion to open cholecystectomy and duration of surgery showed no significant differences between early and late laparoscopic cholecystectomy except for an increased duration of stay among the late LC group.Conclusions: Early LC is an efficient procedure for acute cholecystitis but it has risks of complications which can be minimized by careful selection of patients after clear clinical and radiological evaluation.
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Eschler, Anica, Georg Gradl, Annekatrin Wussow, and Thomas Mittlmeier. "Late Corrective Arthrodesis in Nonplantigrade Diabetic Charcot Midfoot Disease Is Associated with High Complication and Reoperation Rates." Journal of Diabetes Research 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/246792.
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Introduction. Charcot arthropathy may lead to a loss of osteoligamentous foot architecture and consequently loss of the plantigrade alignment. In this series of patients a technique of internal corrective arthrodesis with maximum fixation strength was provided in order to lower complication rates.Materials/Methods. 21 feet with severe nonplantigrade diabetic Charcot deformity Eichenholtz stages II/III (Sanders/Frykberg II/III/IV) and reconstructive arthrodesis with medial and additional lateral column support were retrospectively enrolled. Follow-up averaged 4.0 years and included a clinical (AOFAS score/PSS), radiological, and complication analysis.Results. A mean of 2.4 complications/foot occurred, of which 1.5/foot had to be solved surgically. 76% of feet suffered from soft tissue complications; 43% suffered hardware-associated complications. Feet with only 2 out of 5 high risk criteria according to Pinzur showed significantly lower complication counts. Radiographs revealed a correct restoration of all foot axes postoperatively with superior fixation strength medially.Conclusion. Late corrective arthrodesis with medial and lateral column stabilization in the nonplantigrade stages of neuroosteoarthropathy can provide reasonable reconstruction of the foot alignment. Nonetheless, overall complication/reoperation rates were high. With separation into low/high risk criteria a helpful guide in treatment choice is provided. This trial is registered with German Clinical Trials Register (DRKS) under numberDRKS00007537.
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Williams, L. R., D. Kasir, S. Penny, J. J. Homer, and H.-U. Laasch. "Radiological balloon dilatation of post-treatment benign pharyngeal strictures." Journal of Laryngology & Otology 123, no. 11 (2009): 1229–32. http://dx.doi.org/10.1017/s0022215109990508.
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AbstractAims:To assess the technical success, clinical outcomes and complications of radiologically guided balloon dilatation of benign strictures developing after treatment for head and neck cancer.Materials and methods:Forty-six balloon dilatations were performed in 20 patients. All dilatations were performed over a guidewire.Results:Technical success was 100 per cent. Fifteen of the 20 patients demonstrated clinical improvement in dysphagia scores. Improvement in dysphagia was temporary in all patients (median 102 days), with multiple dilatations usually required (total dilatations ranged from one to seven). Immediate complications were encountered in six of the 46 (13 per cent) dilatations and were all minor. Late complications occurred after two procedures (4 per cent): localised perforation (later complicated by secondary infection) and recurrence of a previous, small, pharyngo-cutaneous fistula.Conclusion:Radiologically guided balloon dilatation is straightforward to perform and is well tolerated, but there is a small risk of perforation. Relief of symptoms is likely to be temporary, requiring multiple subsequent dilatations. A minority of patients will obtain no symptomatic relief.
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Džupa, Valér, Pavel Pazdírek, Vladimír Pacovský, Jan Bartoníček, and Jiří Skála-Rosenbaum. "Primary total hip arthroplasty for displaced intracapsular fracture of the femoral neck: Medium-term functional and radiographic outcomes." Open Medicine 3, no. 2 (2008): 207–13. http://dx.doi.org/10.2478/s11536-008-0005-2.
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AbstractThe number of complications after primary total hip arthroplasty for displaced intracapsular fractures of the femoral neck is higher than that after operations for osteoarthritis. The aim of this study is to evaluate the number of complications and mid-term functional and radiological findings of patients after primary THA for displaced intracapsular fractures of the femoral neck. Between 1995 and 1998, we operated on a total of 89 patients for acute displaced intracapsular fractures of the femoral neck, i.e. Garden Type 3 and 4. In all the patients we evaluated intraoperative and early postoperative complications. We reviewed clinical and radiological results in 65 patients. The only intraoperative complication was abruption of the greater trochanter. Early postoperative complications occurred in 13 patients (15%). The specific complications, THA dislocation, occurred in 3 patients. Non-specific complications were recorded in 10 patients. No delayed healing of the surgical wound, neural lesion or early, delayed or late infection was recorded. Of 65 patients followed-up for an average of 78 months (range, 62–109 months), 8 patients underwent revision surgery. Of 57 patients with primary THA, very good and good clinical results according to the Harris Hip Score were recorded in 48 patients (84%) and poor results in only 2 patients (4%). Nine of 57 followed-up patients showed radiological signs of loosening (16%). The radiolucent line could be seen in 3 patients in the region of the cup, in 1 patient in the region of the femoral component and in 5 patients in both components. Clinical complaints that would result in indication for reimplantation were recorded in none of the mentioned patients. Number of complications, functional results and resumption of full self-reliance by patients after THA for an intracapsular fracture of the femoral neck are so positive that we consider the indication of THA for a displaced femoral neck fracture fully justified.
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Johnston, R. N. "Pulmonary Sarcoidosis after Ten to Twenty Years." Scottish Medical Journal 31, no. 2 (1986): 72–78. http://dx.doi.org/10.1177/003693308603100203.
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One hundred and fifty-nine patients with Pulmonary Sarcoidosis have been studied ten to 20 years after diagnosis with a 90 per cent follow-up of survivors. Among the 76 patients with a mean follow-up of 22.5 years there is radiological evidence of pulmonary fibrosis in 13 and respiratory function tests revealed 12 with a transfer factor of less than 80 per cent of predicted. Of the further 83 patients followed to ten years there was radiological evidence of pulmonary fibrosis in five and a reduced transfer factor in four. Thirty-one patients received Prednisolone for various complications due to Sarcoidosis. There is no evidence of late respiratory disability. The complications and causes of death at ten and 20 years are examined and among the latter eight developed various forms of malignant disease. Since 1973 a further 139 patients have been studied, i.e. a total of 298 and two of these died from progressive Sarcoidosis despite corticostroid treatment. Six patients have developed late autoimmune diseases.
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Parkhutik, Vera, Aida Lago, Fernando Aparici, et al. "Late clinical and radiological complications of stereotactical radiosurgery of arteriovenous malformations of the brain." Neuroradiology 55, no. 4 (2012): 405–12. http://dx.doi.org/10.1007/s00234-012-1115-8.
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Abilash Kumar, Jacob Abraham, Jeffrey Jayaraj, Premchandran Menon, and Manohar Arumugam. "Late Asymptomatic Medial Patella Subluxation Post Total Knee Arthroplasty." Borneo Journal of Medical Sciences (BJMS) 15, no. 1 (2021): 61. http://dx.doi.org/10.51200/bjms.v15i1.2392.
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Post-operative complications are well known to impair the functional outcomes of total knee arthroplasty (TKA). Patella subluxations post-TKA is a grim complication rendering patients disable post-surgery. Howbeit, medial patella subluxation is a rarely recorded incident altogether. This case report describes a patient post successful TKA two years ago, who was incidentally diagnosed with a medial patellofemoral subluxation during a recent routine yearly follow up. This gentleman, however, had no complaints and the only evident clinical sign was anterior knee skin puckering. A radiograph of the knee confirmed our clinical suspicion of medial patella subluxation. The patient’s symptoms, his expectations, radiological findings, what went wrong during surgery and management of this rare entity were analysed. This rarely reported entity requires a high degree of suspicion especially if the patient complains of instability and peculiar anterior knee pain. Diagnosis is customarily clinical and revision surgery is almost invariably necessary.
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Ikramov, A. I., and G. B. Khalibaeva. "Radiology diagnostics of bladder and urethral injuries in pelvic trauma." Medical Visualization, no. 2 (July 16, 2019): 109–18. http://dx.doi.org/10.24835/1607-0763-2019-2-109-118.
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Purpose. To determine the capabilities of modern methods of radiology imaging in the diagnosis of bladder and urethral injuries in the pelvic trauma.Materials and methods. Diagnostics results of 21 pa - tients with bladder and uretra injuries, concomitant with pelvic fractures or isolated injuries of bladder were analyzed. The X-ray, ultrasound and computed tomography examinations were used.Results. Describing radiological signs of bladder and uretra injuries and radiological methods informativeness are based on the resulting data.Conclusion. The use of complex radiological study of bladder and uretra injuries in pelvic trauma contributes to the optimal choice of treatment and the prevention of early and late complications.
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Christensen, R. "C.1 Cerebral venous sinus thrombosis in preterm infants." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 49, s1 (2022): S6. http://dx.doi.org/10.1017/cjn.2022.102.
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Background: Previous studies of neonatal cerebral venous sinus thrombosis (CVST) have focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CVST in preterm infants. Methods: This was a retrospective cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CVST. All MRI/MRV and CT/CTV scans were re-reviewed. Clinical and radiological data were analysed using descriptive statistics, ANOVA and chi-square tests. Results: A total of 26 preterm infants with CVST were included. Of these, 65% were late preterm, 27% very preterm and 8% extreme preterm. Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinus were common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. None of the treated infants had hemorrhagic complications. Outcome at follow-up ranged from no impairment (50%), mild impairment (25%) and severe impairment (25%). Conclusions: Preterm infants with CVST are often symptomatic and have white matter brain lesions. Anticoagulation treatment of preterm CVST appeared to be safe and was not associated with hemorrhagic complications.
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Alabbas, Ali, Mohamed Sabouni, Lucy Angell, Poppy Bladon, Emma Bird, and Flora Whitticase. "EARLY AND LATE OUTCOME OF RETAINED FLEXIBLE INTRAMEDULLARY NAILS." Orthopaedic Proceedings 107-B, SUPP_3 (2025): 23. https://doi.org/10.1302/1358-992x.2025.3.023.
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BackgroundFlexible intramedullary nailing (FIN) is a widely used technique in pediatric and adolescent orthopedic trauma due to its minimally invasive nature and excellent outcomes in appropriate indications. However, complications associated with retained flexible nails, particularly when left in situ beyond the intended duration, remain underreported in literature. This study aims to analyse complications arising from retained flexible nails, emphasizing their incidence, presentation, and management.ObjectiveTo study the clinical, radiological outcomes of the retained flexible intramedullary nail and their short and long term complications.MethodsA retrospective review was conducted on patients with flexible nails between 2010 and 2019 in Leeds General ifirmary, A total of 300 patients were found to have undergone flexible nails fixation. Patients underwent implant removal either elctively or due to reasons for pain, soft tissue irritation, infection and functional limitation. Unusual cases of nonunion and early nail failure were also identified.ResultAmong 300 patients, 38 patients had a radius nail only, 25 ulna, 153 both bones, 7 humerus, 18 tibia and 61 patients had femur FIN. 229 patients underwent metalwork removal.7 patients with femoral FINs had leg length discrepancy, 6 had coronal plane malaligment.1 patient had lost his radial bow.1 patient had FPL rupture.ConclusionWe stopped elective removal of flexible nails since COVID period, fortunately we didn't encouter any major complication, especially with upper limb FINs, which were well tolerated.We aim to monitor the patients till 2024 to look for longer term follow up and patients satisfaction.
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Ikenaga, Minoru, Jitsuhiko Shikata, Mitsuru Takemoto, and Chiaki Tanaka. "Clinical outcomes and complications after pedicle subtraction osteotomy for correction of thoracolumbar kyphosis." Journal of Neurosurgery: Spine 6, no. 4 (2007): 330–36. http://dx.doi.org/10.3171/spi.2007.6.4.8.
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Object Many patient complications have been reported after the use of the pedicle subtraction osteotomy (PSO) technique. To the authors' knowledge, no previous reseachers have reported on the causes of complications after using the single-stage PSO technique with a posterior approach. The purpose of this study was to investigate complications after the procedure, to clarify the factors influencing the complications, and to identify ways to minimize complications. Methods Records for 67 patients treated with the PSO technique were examined retrospectively. All complications were recorded and analyzed in relation to the radiological and clinical outcomes. No patient died or became paraplegic as a result of surgery. There were 48 surgery-related complications in 27 patients (40%): six intraoperative, four perioperative, and 38 late-onset postoperative complications. As the study progressed and more patients were treated, the rate of intraoperative complications decreased significantly. The incidence of late-onset complications associated with an adjacent-segment progression of kyphosis was lower in patients with a long fusion from a midthoracic vertebra to the sacrum or pelvis than in patients treated with a shorter fusion. The C-7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusions Intraoperative complications can be prevented or the risks minimized with adequate surgical training. Most of the late-onset complications in these patients were related to the progression of kyphosis. The frequency of complications was closely correlated with patient satisfaction at follow up. Correcting the C-7 plumb line value with minimal complications appeared to lead to better clinical results.
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Gatt, Thomas, Adriana Grech, and Homa Arshad. "The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review." Advances in Orthopedics 2023 (February 28, 2023): 1–12. http://dx.doi.org/10.1155/2023/6236045.
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While most literature on vitamin D supplementation in fracture patients focuses on fracture prevention, the effect of vitamin D on bone healing is a much less studied concept. The primary aim of this systematic review was to assess whether vitamin D supplementation in fracture patients improves clinical or radiological union complications. The secondary aims were to assess supplementation effect on patient functional outcome scores and bone mineral density (BMD). A systematic search of all relevant articles was performed using the following databases: MEDLINE, Embase, Google Scholar, and Web of Science. The population selection included human patients with a fresh fracture treated conservatively or operatively. The intervention included any form of vitamin D supplementation, compared to no supplementation or a placebo. The primary outcomes assessed were clinical or radiological union rates or complications arising from the nonunion. The secondary outcomes assessed were functional outcome scores, BMD scores after treatment, and pain scores. A total of fourteen studies, assessing a total of 2734 patients, were included. Eight studies assessed the effect of vitamin D on clinical or radiological union. Five studies reported no significant difference in complication rates when supplementing fracture patients. Alternatively, three studies reported a positive effect with supplementation between the groups. One of these studies found a difference only for early orthopaedic complications (<30 days), but no differences in late complications. The other two studies found significant differences in clinical union; however, no changes were observed in radiological union. Six studies investigated functional outcome scores after supplementation. Four of these studies found no significant differences between most functional outcome scores. Only three studies reported BMD outcomes, one of which found limited effect on total hip BMD. The overall findings are that vitamin D alone does little to influence fracture healing and subsequent union rates or functional outcome. The studies suggestive of a positive effect were generally of a lower quality. Further high quality RCTs are needed to justify routine supplementation at the time of fracture.
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Hernefalk, L., P. Granström, and K. Messner. "Early Roentgenological Grading of Femoral Shortening is Correlated to the Late Outcome after Femoral Neck Fractures." Acta Radiologica 36, no. 3 (1995): 233–36. http://dx.doi.org/10.1177/028418519503600304.
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Using orthoradiography, the distance between the centre of the femoral head and the intercondylar notch was assessed at regular intervals in 144 patients who were followed for a 2-year period after osteosynthesis of a femoral neck fracture. Late complications, such as segmental collapse and non-union, occurred in 27% of the patients. The degree of femoral shortening was significantly correlated to the incidence of late complications. At 1 month, femoral shortening of more than 5 mm was observed in 85% of patients who developed late complications, and in only 5% of patients without such complications. Thus, the observation of a shortening of more than 5 mm predicted a greater than 6-fold increase of the incidence of late complications. The prognostic accuracy of this observation 1 month after treatment was 92%.
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Clay, Michelle Nyawira, Loice Sitienei, and Cornelius Kipchirchir. "Causes and Sites of Intra-Abdominal Abscesses at Moi Teaching and Referral Hospital." International Journal of Research and Innovation in Social Science IX, no. II (2025): 2344–55. https://doi.org/10.47772/ijriss.2025.9020184.
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Background: Intra-abdominal abscesses are a major contributor to morbidity and mortality around the world. More so in developing countries like Kenya where diagnosis and management are usually carried out late due to factors that include gender, level of education and long waiting time for specialized treatment. In the past and even currently, most of the Intra-abdominal abscesses (IAA) are treated via open surgery. However, with the age of Interventional Radiology, IAA are managed faster, and with better clinical and radiological outcomes. It is for these reasons that the role of Interventional Radiology needs to be assessed to see how better we can assist these patients. Objective: To determine the causative mechanisms of intra-abdominal abscesses at Moi Teaching and Referral Hospital. Methods: This was a census, a prospective study conducted among 39 patients scheduled for percutaneous catheter drainage from January 2020 to December 2020. The study population was all patients who had confirmed intra-abdominal abscess in the outpatient department and in the medical and surgical wards, referred to the Interventional Radiology section of the Radiology & Imaging Department. A data collection form was used to record the demographics, causative mechanisms, radiological findings, microbiological features, clinical features and complication findings. The IAA were drained by the consultant radiologist under ultrasound guidance using a 3.5-5MHZ curvilinear transducer of Mindray M7. Data was extracted from the patients’ records and there after presented in form of tables, diagrams and prose. Results: The median age of patients was 40 (IQR 25, 48) years. The proportion of males was slightly higher (56.4%) compared to females (43.6%). Most (38.5%) of the IAA were complications following surgery; followed by trauma (25.6%) and cancer (23.1%). Majority (30.8%) of these IAA were in the right lower quadrant, sub-phrenic constituted 17.9% and psoas represented 12.8% of the sites. Out of the 39 patients included in the study, 28(71.8%) reported to have procedural complications. Of these 28, 26(92.9%) had minor complications that requires no therapy(Level A), 1(3.6%) had complications that resulted in hospitalization (Level C and D) while another 1(3.6%) had major complications that resulted in permanent change of the percutaneous catheter(Level E). Majority (88.5%) of those who had minor complication complained of pain, 1(3.8%) had a leak requiring no intervention while another 1 (3.8%) had fever post procedural. Conclusions: The most common causative mechanism of IAA was as complications following surgery. Clinically most of the patients complained of abdominal pains. Radiologically, majority of the IAA contained purely fluid material. Only 1 of the patients had a major complication.
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Gulyamov, Yorqin. "Brief Overview of Modern Methods of Radiological Diagnostics of Osteomyelitis." Traumatology and Orthopаedics of Kazakhstan 3, no. 74 (2024): 55–59. https://doi.org/10.52889/1684-9280-2023-3-74-55-59.
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Osteomyelitis is inflammation of the bone that is usually due to infection. An inadequate or late diagnosis increases the degree of complications and morbidity; for these reasons, imaging techniques are essential to confirm the presumed clinical diagnosis and to provide information regarding the exact site and extent of the infection process.This review discusses various imaging tools employed to diagnose osteomyelitis: X-ray, computed tomography, magnetic resonance imaging, ultrasound, bone scintigraphy, and positron emission tomography. When used appropriately, diagnostic imaging can provide high sensitivity and specificity for detecting osteomyelitis, making radiological evaluation a crucial step in the diagnostic process of this debilitating condition.
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Savic, Milan, Zeljko Garabinovic, Nikola Colic, et al. "Colopleurocutaneous fistula associated with empyema as a late complication of colorectal cancer." Journal of Infection in Developing Countries 19, no. 05 (2025): 800–803. https://doi.org/10.3855/jidc.19318.
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Introduction: Pleurocutaneous fistula is a pathological communication of subcutaneous tissue with the pleural cavity, and can occur as a result of infectious, malignant processes and iatrogenic procedures. Colopleural fistula is rare and is mainly caused by processes in the abdomen. The appearance of empyema is usually described as a complication of colopleural fistulas that are the result of pathological processes in the abdomen. Case Presentation: We report an extremely rare case of colopleurocutaneous fistula with pleural empyema present, 8 years after left hemicolectomy due to colon adenocarcinoma. Radiological diagnostic procedures performed confirmed the existence of colopleurocutaneous fistula. The patient was given antibiogram therapy and regular thoracocentesis for empyema, as well as a fistulous canal toilet. Conclusions: After achieving sterility of the fistulous canal and regression of empyema, the fistulous canal was closed with fibrin glue, and during the next 6 months follow-up, there was no reopening of the fistula, nor did the patient have any other complications.
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Petrosyan, Mikael, Joaquin J. Estrada, Stefano Giuliani, Monica Williams, Heather Rosen, and Rodney J. Mason. "Gastric Perforation and Pancreatitis Manifesting after an Inadvertent Nissen Fundoplication in a Patient with Superior Mesenteric Artery Syndrome." Case Reports in Medicine 2009 (2009): 1–4. http://dx.doi.org/10.1155/2009/426162.
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Superior mesenteric artery (SMA) syndrome is an uncommon but well-recognized clinical entity. It can lead to proximal small bowel obstruction and severe morbidity and mortality in lieu of late diagnosis and concomitant existing comorbidities. We report a 54-year-old female, with SMA syndrome which manifested itself after Nissen fundoplication along with two major complications. The diagnosis of SMA was established by clinical symptoms and radiological findings.
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Moradi, M., S. Babaniamansour, M. Majidi, S. Karkon-Shayan, MD Firouzabadi, and A. Atarodi. "Langerhans Cell Histiocytosis of the Right Scapula." Journal of Biomedical Research & Environmental Sciences 2, no. 4 (2021): 268–71. http://dx.doi.org/10.37871/jbres1223.
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Langerhans Cell Histiocytosis (LCH) is a rare granulomatous disease with an unknown origin. LCH occurs at any age and affects any organ. It is presented as self-limited to aggressive forms. Late diagnosis of LCH, after the evidence is revealed at the radiological imaging or microscopic investigations, aggravates the possible complications. This study reported a rare case of LCH with a bone lytic lesion at the right scapula with a good prognosis.
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Ahmadreza, Atarodi. "Langerhans Cell Histiocytosis of the Right Scapula." Journal of Biomedical Research & Environmental Sciences 2, no. 4 (2021): 268–71. https://doi.org/10.37871/jbres1223.
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Langerhans Cell Histiocytosis (LCH) is a rare granulomatous disease with an unknown origin. LCH occurs at any age and affects any organ. It is presented as self-limited to aggressive forms. Late diagnosis of LCH, after the evidence is revealed at the radiological imaging or microscopic investigations, aggravates the possible complications. This study reported a rare case of LCH with a bone lytic lesion at the right scapula with a good prognosis.
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Prejbeanu, R., D. Crişan, A. Bălănescu, H. Haraguş, and B. Deleanu. "Late Results after Cement Bone Filling in Treatment of Giant Cell Tumour (GCT) - Retrospective Study." Romanian Journal of Orthopaedic Surgery and Traumatology 1, Supplement (2018): 29. http://dx.doi.org/10.2478/rojost-2018-0040.
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Abstract Introduction. Segmental or intralesional excision with curettage or complete resection can be one method of treatment for giant cell tumor (GCT), but the ideal filling material after curettage or resection remains controversial. The purpose of this retrospective study was to follow the latest results and complications regarding the recurrence or degradation of functional status that underwent cementation. Material and methods. We reported 24 cases with GCTs during the last 15 years. All the patients were treated by intralesional excision or segmental resection followed by acrylic cement filling with or no metal augmentation recurrence-free survival proportions were used to evaluate oncological outcomes. Other parameters including surgical complication, general condition, and radiological classification were analyzed. Results. We followed up 20 cases for at least five years postoperatory (from the 5th to the 9th year). The recurrence-free survival proportions showed that the recurrence rate in this group was for 4 patients (2 of them were at second surgery). 2 patients had degradation of implant cement fixation. Parameters including patients’ age, gender, tumor location, and radiological classification did not affect the surgeons’ treatments in cavity filling after GCT curettage. Conclusions. Cementation should be recommended because of easy usage, have long lasting better results, and the better local tumor control than other methods (ex: bone grafting). The risk of recurrence is low and is not related to the cementation and metal augmentation. The cost-benefit is also in favor of this technique.
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Tereshchenko, G. V., E. S. Ternovaya, L. N. Shelikhova та ін. "The thoracic air-leak syndrome (TALS): the frequency of occurrence and radiological signs in the structure of late non-infectious lung lesions in children after the allogeneic HSСT". Pediatric Hematology/Oncology and Immunopathology 18, № 2 (2019): 92–102. http://dx.doi.org/10.24287/1726-1708-2019-18-2-92-102.
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The thoracic air-leak syndrome (TALS) can be a presentation of late-onset noninfectious pulmonary complications in children with a chronic pulmonary graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation. We determined the frequency of occurrence of TALS in patients of the Center after HSСT in the period from January 2012 to December 2017. We have described the main X-ray signs of the Thoracic air-leak syndrome and manifestations of late onset noninfectious pulmonary complications in children. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. Parents patients agreed to use personal data in research and publications.
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Akberov, R. A., V. I. Morozov, and Zh S. Aynullov. "Clinical and radiological diagnosis of obstruction of the digestive tract in newborns and infants." Kazan medical journal 68, no. 1 (1987): 34–38. http://dx.doi.org/10.17816/kazmj95898.
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Obstruction of the digestive tract in newborns and infants is often characterized by vomiting, stool retention (meconium), abdominal bloating, visible increased peristalsis in the first hours of the disease. However, these symptoms are nonspecific and may be observed not only in surgical but also in somatic, therapeutic diseases: sepsis, otitis media, pneumonia, intestinal infections. Associated complications, often a combination of several malformations of the digestive tract, heart and, finally, late admission of the child to the surgical hospital significantly complicate the clinical diagnosis of congenital, acquired, functional and organic disorders of gastrointestinal tract patency.
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Kasture, Sarang P., Anna S. Walsh, Hari Sugathan, and Rakesh Dalal. "First Metatarsophalangeal Joint Fusion with Orthogonal Memory Staple Fixation." Foot & Ankle Orthopaedics 7, no. 1 (2022): 2473011421S0027. http://dx.doi.org/10.1177/2473011421s00272.
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Category: Midfoot/Forefoot Introduction/Purpose: First metatarsophalangeal joint (MTPJ) fusion is one of the most commonly performed procedure for painful symptomatic arthritis. The implants used for osteosynthesis are variable and depend on surgeon preference. The aim of this paper was to study the outcome of first MTPJ fusion surgery using fixation with orthogonal shape memory alloy (Nitinol) staples. Methods: 75 consecutive patients who underwent first MTPJ fusion with orthogonal memory staples were included in the study. All patients underwent surgery using standard surgical technique with fixation of the arthrodesis with two 20 mm shape memory alloy (Nitinol) staples (Memo staples, Ortho Solutions Inc). The first staple placed medially and the second staple placed dorsally in orthogonal plane. The arthrodesis surfaces were prepared and temporarily fixed with K wire. Once the position and bone approximation was confirmed satisfactory under image intensifier guidance, a flat staple bed was prepared with saw blade to make sure the staples are not proud after fixation. All patients also received standard postoperative care with heel weight bearing shoe for six weeks and follow-up at 3,6 and 12 weeks as standard regimen. Patient demography, time to clinical and radiological union, early/late complications, rate of non-union, revision surgery and implant removal were noted. Results: Average age was 64.6 years. 42 patients had severe radiologic arthritic changes while 27 patients had associated moderate to severe hallux valgus deformity. Five patients were known to have inflammatory arthritis. The average follow-up was 18.3 weeks. There were two early complication of superficial infection treated successfully with oral antibiotics. Average clinical union was 7.2 weeks and radiological union at 12 weeks. Five patients (6.6%) had radiological non-union of which four underwent revision surgery with plate fixation. One patient had delayed union while one had dorsal staple back-out but did not warrant removal. None required staple removal from hardware prominence. There was no significant difference in union or complication rates with regards to gender or presence inflammatory arthritis. Conclusion: This study demonstrates that the outcome of 1st MTPJ fusion with two memory staples in orthogonal position is comparable with other modalities of fixation in terms of rate of union and resurgery. It is safe, simple and easily reproducible technique. Besides, none of the patients in this series required implant removal for hardware related complications. This could be advantageous compared to fewer other modalities like plate fixation, though larger studies are needed to confirm it.
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Chataut, Dinesh, Prasoon Ghimire, Sundar Suwal, and Ajit Thapa. "Post COVID-19 Late Hemoptysis Managed with Bronchial Artery Embolization." Nepal Journal of Medical Sciences 7, no. 2 (2022): 59–62. http://dx.doi.org/10.3126/njms.v7i2.40420.
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SARS-COV-2 has been one of the most massive pandemics in modern history with typical radiological findings. As the follow up on patients who have survived this infection has been rising, newer studies have emerged detailing the long term sequelae of this disease and well as its complications. Few of the long term sequelae of COVID-19 pneumonia are lung fibrosis and bronchiectasis. Bronchiectatic changes in the lungs can lead to hemoptysis in the patient. We present you the case of a patient who recovered from COVID-19 pneumonia and presented with hemoptysis after 2 months secondary to bronchiectatic changes in lung fields. Patient underwent bronchial artery embolization as few studies have shown bronchial artery embolization to be effective and feasible management even on patients with history of COVID-19 pneumonia.
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Obada, Bogdan, Vlad-Alexandru Georgeanu, Ion-Andrei Popescu, Madalina-Gabriela Iliescu, Liliana-Elena Stanciu, and Bogdan Marian Caraban Caraban. "Late functional and radiological outcomes in recovery of patients with staged osteosynthesis for the tibial pilon fractures." Balneo and PRM Research Journal, Vol.14, no.3 (September 1, 2023): 593. http://dx.doi.org/10.12680/balneo.2023.593.
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Postraumatic rehabilitation represent a dynamic field, with specific protocols and technics. Our prospective study targets the tibial pilon fractures admitted in our clinic, to which a new treatment protocol was applied, consisting of two surgical steps, assesing in the end the results achieved at the discharge of the patient and later follow up. The study group consist of 196 patients (198 fractures), in the period 2019-2022. The average evaluation time was of 16 months. The most frequently applied osteosynthesis principle was staged osteosynthesis which consisted of first stage fibula plate osteosynthesis and external fixator tibia pilon, followed by minimally invasive or limited approach locked plate tibia pilon fixation. (64.14%) Olerud and Molander clinical score at more than one year after the last surgical intervention highlights good results: excellent results in the amount of 37% to 15% in the first lot, good results 52% to 29%, moderate success 7% to 39% and poor 4% to 17%. Two stage surgery protocol with external fixation in emergency and minimally invasive internal fixation with locked plate performed after the dissappearance of the local edema, as the second surgical step, allows anatomically correct articular reconstruction without skin complications, with decrease of arthitic late complications.
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Smolle, Maria A., Stefan F. Fischerauer, Silvia Zötsch, et al. "Long-term outcomes of surgery using the Ligament Advanced Reinforcement System as treatment for anterior cruciate ligament tears." Bone & Joint Journal 104-B, no. 2 (2022): 242–48. http://dx.doi.org/10.1302/0301-620x.104b2.bjj-2021-0798.r2.
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Aims The aim of this prospective study was to assess the long-term clinical, radiological, functional, and quality of life (QoL)-related outcome of patients treated with the synthetic Ligament Advanced Reinforcement System (LARS) device for anterior cruciate ligament (ACL) rupture. Methods A total of 41 patients who underwent ACL reconstruction with the LARS device (mean age 39.8 years (SD 12.1 ); 32% females (n = 13)) were prospectively included between August 2001 and March 2005. MRI scans and radiographs were performed at a median follow-up of 2.0 years (interquartile range (IQR) 1.3 to 3.0; n = 40) and 12.8 years (IQR 12.1 to 13.8; n = 22). Functional and QoL-related outcome was assessed in 29 patients at a median follow-up of 12.8 years (IQR 12.0 to 14.0) and clinically reconfirmed at latest median follow-up of 16.5 years (IQR 15.5 to 17.9). International Knee Documentation Committee (IKDC) and Tegner scores were obtained pre- and postoperatively, and Lysholm score postoperatively only. At latest follow-up, range of motion, knee stability tests, 36-Item Short Form Health Survey (SF-36), and IKDC scores were ascertained. Complications and reoperations during follow-up were documented. Results Cumulative complication rate was 66% (n = 27), with 11 developing within one year from surgery and 16 after one year (including five patients with both early and late complications). Ten graft failures (24%) and eight cases of reactive synovitis were observed (20%). All 11 patients with early complications and ten with late complications underwent reoperation (including five with another surgical procedure for early complications), amounting to a cumulative reoperation rate of 51% (n = 21). Revision ACL reconstruction was performed in one patient (2.4%). Median IKDC at latest follow-up was 89.7 (IQR 78.2 to 93.1), being significantly worse in the event of previous complications. Lachman test was positive in 56% (n = 15) of reconstructed knees. All norm-based SF-36 items were at or above median at latest follow-up, and did not differ depending on development of complications. Conclusion Despite good functional and QoL-related results in the long term, the cumulative complication rate of 66%, including graft failures and reactive synovitis, has to be viewed with great concern. Cite this article: Bone Joint J 2022;104-B(2):242–248.
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Eastley, Nicholas, Randeep Aujla, and Zeeshan Khan. "Radiographs late in the follow up of uncomplicated distal radius fractures: are they worth it? Clinical outcome and financial implications." Orthopedic Reviews 4, no. 2 (2012): 20. http://dx.doi.org/10.4081/or.2012.e20.
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Fractures of the distal radius are common. Displacement can quickly lead to secondary osteoarthritis. Early follow up radiographs are subsequently paramount to facilitate for early attempts at reduction. Developing callus eventually makes this impractical. In the absence of complications we propose that radiographs may become obsolete at the later stages of follow up. We investigate whether clinical deformity, range of wrist movement and grip strength are independent of radiographs taken later than 2 weeks into the follow up of uncomplicated cases. Local cases between May 2009 and December 2011 were reviewed. Devised criteria regulated case selection. Data was collected from radiological software and occupational therapy clinical notes. Fractures were placed in short or term follow up groups dependant on whether they were imaged later than 2 weeks into follow up. T-tests compared our outcomes measures between these groups. 138 cases were included; 77 short term; 61 long term. No cases reported visible clinical deformity. There were no significant differences between grip strength or range of wrist movement for the short and long term groups. No cases required intervention for late displacement. Although complications may justify delayed imaging, our results suggest radiographs late in the follow up of uncomplicated distal radius fractures have no impact on our outcome measures. Further studies are required to confirm this. Financial regulation means any potential benefits from the removal of these unnecessary radiographs should be recognised. Established radiological follow up regimes need to be devised.
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Goebel, Dietmar, and Wolfgang Schultz. "The Mayo Cementless Femoral Component in Active Patients with Osteoarthritis." HIP International 19, no. 3 (2009): 206–10. http://dx.doi.org/10.1177/112070000901900303.
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This prospective study reports the clinical and radiological results of a single-surgeon series using the Mayo conservative hip stem in a district hospital. 30 total hip arthroplasties were performed in 26 physically active patients. There were 18 women and 8 men, with a mean age of 57.4 years (range 36–79). 4 cases were bilateral. The operation was performed for severe primary or secondary osteoarthritis of the hip. Duration of follow-up ranged from 67–87 months (mean 81 months). There were no early complications relating to the surgical procedure. There was one case of traumatic fracture of the femur during rehabilitation, while late complications included two cases of late infection (4 months and 16 months after surgery) both revised in two-stage procedures. There was considerable improvement in Merle d'Aubigne score following surgery. There were no revisions for aseptic loosening, but we identified 2 implants with significant radiolucent lines and subsidence six years after the index operation. Neither patient experienced pain in the hip or restriction of activity. Therefore, the aseptic loosening survival rate was 100% (end point = revision operation). Taking radiological loosening as the end point survivorship was 93.3%. The use of the Mayo short stem component in active patients may preserve bone and enable subsequent revision operations to proceed using primary implants. Our results suggest that conservative designs of this type may be of benefit in selected individuals.
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KILINC, BEKIR ERAY, YUNUS OC, and RAMAZAN ERDEN ERTURER. "TREATMENT OF MIDSHAFT CLAVICLE FRACTURE WITH SUPERIOR PLATE PLACEMENT." Acta Ortopédica Brasileira 28, no. 2 (2020): 88–91. http://dx.doi.org/10.1590/1413-785220202802226166.
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ABSTRACT Objective: To evaluate the late clinical and radiological results of patients had locking plate anatomically compatible from superior surface and muscle cover on plate due to clavicle mid-region. Materials and Methods: Forty patients were included retrospectively. Patients had a routine right shoulder anterior posterior graph after examination. The results were assessed by returning to the patient's daily activities, Constant score, the Disability of the Arm, and Shoulder and Hand scoring, followed by radiological and clinical examination. Results: Fourteen (35%) patients were female and 26 (65%) were male. The mean age was 36.2 years. Twenty-six patients had right clavicle fracture and 14 patients had left. Twenty-three fractures were type 2B1 and 17 fractures were type 2B2. Mean follow-up time was 36.4 months. Radiologic union was at a mean of 9.1 ± 1.3 weeks. All patients had excellent results. The mean Constant score was 97.2 ± 1.8, the mean Disability of the Arm, and Shoulder and Hand score was 3.8 ± 2.4. Conclusion: It is possible to obtain complete union with high patient satisfaction by avoiding the complications and difficulties of the conservative treatment with the use of the anatomically compatible locking plates in superior fixation and our surgical dissection. Level of Evidence III, Retrospective Case controlled study.
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Gawali, Satish Raghunath, Gajanan Madhav Kathar, Pramod Vilas Niravane, and Mansoor Iqbal Bhosage. "Management of fracture of neck talus and clinical evaluation of results." International Journal of Research in Orthopaedics 2, no. 3 (2016): 80. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20162195.
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<p class="abstract"><strong>Background:</strong> Fracture of neck of talus is rare and serious injury with significant complication rate. The talus is involved in about 2% of all lower extremity injuries and about 5-7% of foot injuries. Talus neck fixation is associated with serious complications such as stiffness at ankle and subtler joint, AVN of body of talus, ankle arthritis and later on subtalar arthritis. The objective was to study and evaluate the operative treatment for talus neck fracture.</p><p class="abstract"><strong>Methods:</strong> All adult patients with talus neck fracture admitted in government medical college and hospital, Latur, Maharashtra, India from January 2006 to December 2015 were involved. There were 15 patients with 10 males and 05 females. Fractures were classified as per Hawkins classification and were treated with closed/open reduction and internal fixation with CC screws.</p><p class="abstract"><strong>Results:</strong> All patients were followed prospectively post operatively and clinical and radiological evaluation was done. Results were analyzed. We noted skin complications in 02 patients and rate of consolidation was 60-70%. The final follow-up examination included determination of the AHS score (ankle–hind foot scale) from the American orthopaedic foot and ankle society (AOFAS), range of motion evaluation and radiological analysis.</p><strong>Conclusions:</strong> Displaced talar neck fractures are a therapeutic challenge which has significant early and late complications. Despite of all excellent management, non-union rate in type III, and type IV Hawkins fracture is 85%; and AVN of body of talus is 90-95% due to inherent complications of cut off of blood supply which comes from talar neck. Types II, III, IV were associated with talar body dislocation which caused excessive pressure on soft tissues having significant soft tissue complications. Early anatomical reduction and stable fixation is of vital importance to achieve successful outcome.
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Türkoğlu, Saim, and Mesut Özgökçe. "A tumor-mimicking parasitic disease: Radiological Findings of Alveolar Echinococcosis." Journal of Research in Clinical Medicine 9, no. 1 (2021): 24. http://dx.doi.org/10.34172/jrcm.2021.024.
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Background: Alveolar echinococcosis(AE) is a tumor-mimicking parasitic disease caused by Echinococcus multilocularis. We have aimed to present the radiological imaging findings of AE characterized by malignant features. Methods: The radiological findings of 20 patients were evaluated retrospectively; who were admitted to our hospital in the Van province in the years between 2014 and 2020 and who were diagnosed with AE. Of these patients, 30% had been operated due to a preliminary diagnosis of a tumor. The study was conducted retrospectively by examining the drawback radiological images of patients from the radiological data archiving system. The diagnosis of AE was confirmed when lesions manifested the following radiological imaging findings: irregular margins, no contrast uptake in dynamic contrast images or late peripheral enhancement, presence of calcifications, and contralateral lobe hypertrophy. Results: The mean age of the patients at the time of diagnosis was 50.95 (12-86) years. Of the patients, 15 (75%) were women and 5 (25%) were men. Typical histopathological and radiological imaging findings were present in 8 (40%) and 17 (85%) patients, respectively. Only 12 (60%) out of 20 patients had seropositivity by ELISA. The remaining 8 (40%) patients were seronegative. Conclusion: Radiological imaging examinations are essential in the diagnosis and the evaluation of the extent of the disease. Different radiological technic can be used to differentiate AE from other diseases. Early diagnosis is important for avoiding unnecessary or inadequate operations due to a misdiagnosis and for preventing potential complications.
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Cutolo, Carmen, Federica De Muzio, Roberta Fusco, et al. "Imaging Features of Main Posthepatectomy Complications: A Radiologist’s Challenge." Diagnostics 12, no. 6 (2022): 1323. http://dx.doi.org/10.3390/diagnostics12061323.
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In the recent years, the number of liver resections has seen an impressive growth. Usually, hepatic resections remain the treatment of various liver diseases, such as malignant tumors, benign tumors, hydatid disease, and abscesses. Despite technical advancements and tremendous experience in the field of liver resection of specialized centers, there are moderately high rates of postoperative morbidity and mortality, especially in high-risk and older patient populations. Although ultrasonography is usually the first-line imaging examination for postoperative complications, Computed Tomography (CT) is the imaging tool of choice in emergency settings due to its capability to assess the whole body in a few seconds and detect all possible complications. Magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice for delineating early postoperative bile duct injuries and ischemic cholangitis that may arise in the late postoperative phase. Moreover, both MDCT and MRCP can precisely detect tumor recurrence. Consequently, radiologists should have knowledge of these surgical procedures for better comprehension of postoperative changes and recognition of the radiological features of various postoperative complications.
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Devansh Mishra, Subhasis Ghosh, and Shubhamitra Chaudhuri. "Clinical characterization of post-surgical outcomes and associated risk factors of lipomyelomeningocele in Eastern India." Asian Journal of Medical Sciences 16, no. 4 (2025): 130–36. https://doi.org/10.71152/ajms.v16i4.4418.
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Background: Lipomyelomeningocele (LMMC), the most complex spinal lipoma and a common spinal malformation, can cause complications ranging from bladder dysfunction to significant neurological deficits. Therefore, prompt diagnosis and treatment are essential. Aims and Objectives: The study aims to determine post-operative complications, functional outcomes, and risk factors in LMMC patients. Materials and Methods: This prospective observational study included 40 LMMC patients who underwent surgery, regardless of age and sex. Demographic, clinical, pre-operative, radiological, intraoperative, and post-operative data were recorded. Patients were followed for 4 months to assess complications (early and late) and risk factors associated with them. Results: Of 40 patients, most were 0–3 years with male predominance (57.5%). The lumbosacral region (47.5%) was the most common anatomical site, and transitional lipoma was the most frequent type (40%). Detethering was performed in all 40 patients, with total lipoma excision achieved in 67.5%. Post-operative complications occurred in 42.5% (17 patients): 13 experienced early complications (cerebrospinal fluid leak [7], infection [4], wound dehiscence [2]), and four experienced late complications (neurological deficit [1], pseudomeningocele [3]). Clinically, 7.5% of patients had developed new neurological deficits. Factors associated with complications included: Age 3–6 years (P=0.02), A-positive blood type (P=0.01), lumbosacral/sacral location (P=0.014), dorsal/chaotic/terminal lipoma type (P<0.001), and partial lipoma excision with iatrogenic injury (P=0.001) using a patching technique (P=0.001). Post-operative proning reduced the risk of complications (P<0.001). Conclusion: Our study demonstrates that detethering with complete lipoma excision, dural closure using glue, and post-operative proning improve outcomes and reduce post-operative complications in LMMC patients.
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Asan, Ziya, Sercan Eroglu, Aydan Koysuren, and Sezai Durmaz. "Evaluation of Karnofsky Performance Scale as a Postsurgical Prognosis Criteria in Chronic Subdural Hematoma Cases: Discordance Between Clinical and Radiological Outcomes." International Clinical Neuroscience Journal 10 (January 1, 2023): e3. http://dx.doi.org/10.34172/icnj.2023.03.
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Background: Chronic subdural hematoma (CSDH) may cause neurological deficits as well as adverse effects on the patient’s general health status. Although CSDH cases are diagnosed in the advanced age group with a very high rate, clinical findings may not be related only to CSDH. The aim should be related to clinical recovery rather than radiological recovery for these cases. We aimed to evaluate Karnofsky’s score as a measurement criterion of postoperative clinical outcomes in patients with CSDH. Methods: Cases operated for the diagnosis of CSDH were defined retrospectively. The cases that had been operated with this diagnosis were identified by examining the institution database records. Karnofsky scores equivalent to clinical status were performed by examining patient files. Karnofsky scoring before the symptomatic period was determined and compared with the Karnofsky score belonging to the late postoperative period. The clinical and radiological findings of the preoperative and postoperative periods were compared. Independent samples t test was used to reveal the difference between the two groups. Results: Data of 184 cases were evaluated. Seventy-three cases were operated on the left, 51 cases on the right, and 60 cases bilaterally with the diagnosis of CSDH. Burrhole exploration was performed in 119 cases, and a craniotomy was performed in 65 cases. Although a significant decrease in hematoma thickness was detected radiologically in cases operated with the craniotomy method, a more significant improvement was observed in Karnofsky’s score in cases operated with the burrhole method. In younger patients, improvement in Karnofsky’s score was significantly higher. Conclusion: The main aim should be to improve clinical status rather than radiological improvement in the treatment of CSDH cases. In the surgical treatment of these cases, it is possible to encounter a high rate of complications depending on age. It is possible to evaluate the postoperative status rationally with Karnofsky scoring. According to the preoperative Karnofsky scoring, deciding on the surgical technique may help reduce complications.
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Tomasino, Andre, Harry Gebhard, Karishma Parikh, Christian Wess, and Roger Härtl. "Bioabsorbable instrumentation for single-level cervical degenerative disc disease: a radiological and clinical outcome study." Journal of Neurosurgery: Spine 11, no. 5 (2009): 529–37. http://dx.doi.org/10.3171/2009.6.spine08838.
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Object The authors present the radiological and clinical outcome data obtained in patients who underwent single-level anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and/or disc herniation; bioabsorbable plates were used for instrumentation. The use of metallic plates in ACDF has gained acceptance as a stabilizing part of the procedure to increase fusion rates, but when complications occur with these devices, the overall effectiveness of the procedure is compromised. As a possible solution, bioabsorbable implants for ACDF have been developed. This study investigates the feasibility and radiological and clinical outcomes of the bioabsorbable plates for ACDF. Methods The radiological and clinical outcomes of 30 patients were investigated retrospectively. All patients presented with cervical radiculopathy or myelopathy and underwent single-level ACDF in which a bioabsorbable anterior cervical plate and an allograft bone spacer were placed at a level between C-3 and C-7. Radiological outcome was assessed based on the fusion rate, subsidence, and Cobb angle of the surgical level. Clinical outcome was determined by using a visual analog scale, the Neck Disability Index, and the Odom criteria. Results There were no intraoperative complications, and no hardware failure was observed. No signs or symptoms of adverse tissue reaction caused by the implant were seen. Two reoperations were necessary due to postoperative blood collections. The overall complication rate was 16.7%. After 6 months, radiographic fusion was seen in 92.3% of patients. Subsidence at 11.3 ± 7.2 months was 3.1 ± 5.8 mm (an 8.2% change over the immediately postoperative results), and the change in the sagittal curvature was –2.7 ± 2.7°. The visual analog scale score for neck and arm pain and Neck Disability Index improved significantly after surgery (p < 0.001). Overall at 19.5 months postoperatively, 83% of the patients had favorable outcomes based on the Odom criteria. Conclusions Absorbable instrumentation provides better stability than the absence of a plate but graft subsidence and deformity rates may be higher than those associated with metal implants. There were no device-related complications, but adverse late effects cannot be excluded. The fusion rate and outcome are comparable to the results achieved with metallic plates. The authors were satisfied with the use of bioabsorbable plates as a reasonable alternative to metal, avoiding the need for lifelong metallic implants.
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Omar Taher ,, Avin, Imad Khaleel ,, Anjam Rawandozy ,, and Firas Abdulla. "Outcome of Multilevel Anterior Cervical Discectomy and Fusion without Plating." Diyala Journal of Medicine 25, no. 2 (2023): 72–89. http://dx.doi.org/10.26505/djm.v25i2.1052.
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Background: Multilevel anterior cervical discectomy and fusion (ACDF) procedure had traditionally been associated with plating, however, the increase in cost and complications associated with plating led us to investigate results of multilevel ACDF with polyether ether ketone (PEEK) cages without plating and study complication and fusion rates.
 Objective: To evaluate the clinical and radiological outcome of patients underwent multilevel Anterior Cervical Discectomy and Fusion (ACDF) using polyether ether ketone (PEEK) cage with no plating.
 Patients and Methods: Sixty patients underwent multilevel Anterior Cervical Discectomy and Fusion (ACDF), Surgical approach, using Polyether Ether Ketone (PEEK) cages with synthetic bone graft material with no plating. Their mean age was 48 year. All patients were evaluated clinically and radiologically for a mean time of one year. Assessment done comparing early and late post-operative cervical spinal x-rays for cage subsidence and migration. Improvement in axial neck and radicular pain were assessed using the Visual Analogue Score (VAS). Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS), A p value of ≤ 0.05 was considered statistically significant.
 Results: Sixty patients underwent Anterior Cervical Discectomy with Fusion (ACDF) through Cloward approach. F:M ratio was 1:1. Two levels were operated in 75% of patients, while in 25% three levels were operated. The majority 85% underwent operation at C5-6 level, least operated levels were C3-C4 and C6-C7 36.7% and 66.7% underwent operation at C4-C5 level. None underwent operation at C2-C3 level. There was significant improvement in axial neck pain with VAS decreasing from 6 to 2, radicular pain improved from 7 to 2. Only one patient (1.7%) showed radiological subsidence of 3 mm after 6 months of operation with no further progression, cage slippage was observed in 2 patients (3.3%) by 1 mm in both cases but no radiological progression. All patients (100%) showed good fusion.
 Conclusion: Multilevel ACDF with PEEK cages without plating showed to be safe option and provided good fusion rates and clinical outcome in our patients.
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Omar Taher, Avin, Imad Khaleel, Anjam Rawandozy, and Firas Abdulla. "Outcome of Multilevel Anterior Cervical Discectomy and Fusion without Plating." Diyala Journal of Medicine 25, no. 2 (2023): 72–89. http://dx.doi.org/10.26505/djm.25027380316.
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Background: Multilevel anterior cervical discectomy and fusion (ACDF) procedure had traditionally been associated with plating, however, the increase in cost and complications associated with plating led us to investigate results of multilevel ACDF with polyether ether ketone (PEEK) cages without plating and study complication and fusion rates. Objective: To evaluate the clinical and radiological outcome of patients underwent multilevel Anterior Cervical Discectomy and Fusion (ACDF) using polyether ether ketone (PEEK) cage with no plating. Patients and Methods: Sixty patients underwent multilevel Anterior Cervical Discectomy and Fusion (ACDF), Surgical approach, using Polyether Ether Ketone (PEEK) cages with synthetic bone graft material with no plating. Their mean age was 48 year. All patients were evaluated clinically and radiologically for a mean time of one year. Assessment done comparing early and late post-operative cervical spinal x-rays for cage subsidence and migration. Improvement in axial neck and radicular pain were assessed using the Visual Analogue Score (VAS). Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS), A p value of ≤ 0.05 was considered statistically significant. Results: Sixty patients underwent Anterior Cervical Discectomy with Fusion (ACDF) through Cloward approach. F:M ratio was 1:1. Two levels were operated in 75% of patients, while in 25% three levels were operated. The majority 85% underwent operation at C5-6 level, least operated levels were C3-C4 and C6-C7 36.7% and 66.7% underwent operation at C4-C5 level. None underwent operation at C2-C3 level. There was significant improvement in axial neck pain with VAS decreasing from 6 to 2, radicular pain improved from 7 to 2. Only one patient (1.7%) showed radiological subsidence of 3 mm after 6 months of operation with no further progression, cage slippage was observed in 2 patients (3.3%) by 1 mm in both cases but no radiological progression. All patients (100%) showed good fusion. Conclusion: Multilevel ACDF with PEEK cages without plating showed to be safe option and provided good fusion rates and clinical outcome in our patients. Keywords: Cervical spondylosis, Multilevel ACDF, ACDF without plating, Subsidence, Migrati on.
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Biggi, Stefano, Stefano Divano, Riccardo Tedino, Andrea Capuzzo, Stefano Tornago, and Andrea Camera. "Tibial Tubercle Osteotomy in Total Knee Arthroplasty: Midterm Results Experience of a Monocentric Study." Joints 06, no. 02 (2018): 095–99. http://dx.doi.org/10.1055/s-0038-1661338.
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Purpose Difficult primary total knee arthroplasty (TKA) and revision TKA may be high demanding, especially during joint exposure. Aim of this article is to evaluate the clinical and radiological outcomes of a series of patients, who underwent TKA and revision TKA, where tibial tubercle osteotomy (TTO) was performed. Methods We retrospectively reviewed a cohort of 79 consecutives TKAs where TTO was performed. Patients were assessed clinically and radiographically at their last follow-up (mean, 7.4 ± 3.7 years). Clinical evaluation included the Knee Society Score (KSS), the pain visual analogue scale (VAS), and range of motion. Radiological assessment included the evaluation of radiolucent lines, osteolysis, cortical bone hypertrophy, time of bone healing of the TTO fragment, and the hardware complication. Results KSS raised from 40.7 ± 3.1 to 75 ± 4.3 (p < 0.0001). Knee flexion increased from 78.7 ± 9.9° to 95.0 ± 9.5° (p < 0.0001), and VAS improved from 7.9 ± 0.9 to 3.8 ± 1 (p < 0.0001). No signs of loosening or evolutive radiolucency lines were found. Osteolytic areas around the stem were detected. No significant association was found between the implant design and the outcomes, while aseptic loosening showed significantly better results. Complications were: 4 painful hardware, 3 late periprosthetic infections, 1 extension lag of 5°, and 3 flexion lag. Conclusion Our experience suggests the use of TTO to improve the surgical approach in difficult primary TKA or revision TKA. A precise surgical technique leads to good results with low risk of complications. Level of Evidence Level IV, therapeutic case series.
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Kocharyan, A. M., M. A. Amkhadova, E. V. Ivanova, G. A. Delokian, and D. A. Antonov. "Methods for diagnosing neuropathy of the inferior alveolar nerve." Medical alphabet 1, no. 1 (2023): 33–38. http://dx.doi.org/10.33667/2078-5631-2023-1-33-38.
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Neuropathy of the inferior alveolar nerve (IAN) is one of the urgent problems of dentistry and neurology. The article is devoted to the issues of early and late diagnosis of neuropathy IAN by clinical, radiological and functional diagnostic methods. Evaluating the study of 22 patients over the course of a year, we came to the conclusion that early diagnosis is the most informative and qualitative. In this regard, the development of a diagnostic technique for neuropathy IAN will reduce the time and improve the quality of treatment, as well as significantly reduce the consequences of complications.
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Khassoui, Amine El, Mohamed Naoufal Idrissi Bahre, Driss Tahiri, Tarik Salama, and El Mouhtadi Aghoutane. "Posterior Sternoclavicular Dislocation in Children: A Case Report." Journal of Orthopaedic Case Reports 13, no. 12 (2023): 98–102. http://dx.doi.org/10.13107/jocr.2023.v13.i12.4094.
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Introduction: Sternoclavicular dislocation (SCD) occurs very rarely in children. There is different clinical manifestations that reflect the direction of displacement; diagnosis is difficult, especially if the dislocation was initially unnoticed. We will report this case while conducting a review of the literature to evaluate and adapt our management. Case Report: We report the case of a 12-year-old boy who presented with a right posterior SCD after a trauma occurring 24 h earlier at a sports activity. Clinical examination and radiological investigations by X-ray and computed tomography scan leads to diagnosis. He underwent an orthopedic closed reduction treatment without complications at 24 months of follow-up. Conclusion: Management of posterior sternoclavicular dislocation is different between teams, with a tendency to use orthopedic reduction in case of fresh dislocation and absence of complications. Late diagnosis and management, as well as the presence of complications, may be difficult and life-threatening (due to vascular or tracheal compression). Keywords: Sternoclavicular dislocation, posterior displacement, child, sports, orthopedic treatment.
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Tankshali, Kirtan, Dong-Whan Suh, Jong-Hun Ji, and Chang-Yeon Kim. "Mid-term outcomes of bony increased offset-reverse total shoulder arthroplasty in the Asian population." Clinics in Shoulder and Elbow 24, no. 3 (2021): 125–34. http://dx.doi.org/10.5397/cise.2021.00087.
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Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up.Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with a minimum of 2 years of follow-up were enrolled. We evaluated the preoperative and postoperative clinical outcomes, radiological outcomes (notching and loosening), and complications of BIO-RSA at the last follow-up. In addition, we divided these patients into notching and not-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients between the two groups.Results: Visual analog scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles, and Simple Shoulder Test scores improved significantly from preoperative (average: 5, 39.43, 16.22, 3.94) to postoperative (average: 1.71, 78.91, 28.34, 7.8; p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20/38 patients (53%). In the comparison between notching and not-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications were three metaphyseal fractures and one inferior screw malposition. Postoperative complications included one heterotopic ossification, one scapula neck stress fracture, one humeral stem loosening, and one late infection.Conclusions: BIO-RSA resulted in improved clinical outcomes at mid-term follow-up in the Asian population. Although better cosmesis and advantages of glenoid lateralization were observed, we observed higher rates of scapular notching compared to previously reported rates in BIO-RSA studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.
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Angad, Kumar Choudhury, and Kumar Singh Dilip. "A Hospital-Based Outcome Assessment of Submuscular Plating for Diaphyseal Long Bone Fractures: An Observational Study." International Journal of Current Pharmaceutical Review and Research 15, no. 08 (2023): 173–78. https://doi.org/10.5281/zenodo.12548726.
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AbstractAim: The aim of the present study was to evaluate the functional and radiological outcomes of paediatric femurdiaphyseal fracture treated with locking compression plate.Material & Methods: The clinical, radiological and functional results of Submuscular plating were evaluated in50 patients operated in between the duration jan 2018 to December 2019 for fracture shaft humerus, shaft offemur and shaft of tibia. All the surgeries were carried out by a single surgical team at Department oforthopaedics, Jawahar Lal Nehru medical college and Hospital, Bhagalpur, Bihar, India.Results: Among the study group, 34 were males, and 16 were females. There was a male preponderance. Theyoungest age among patients was six years old and the oldest age was 14 years old. The average age was 10.60(2.08) years. Right side fractures 28 (56%) were more compared to left side fractures 22 (44%). Considering themode of injury, road traffic accident accounted for 58%, other injuries like fall during playing sports were seenin 18%, fall from height accounted for 8%. For types of fractures, 18 (36%) fractures were transverse, 12 (24%)fractures were comminuted, 16 (32%) fractures were oblique, and 4 (8%) fractures were spiral. In our study, theaverage union time in group one was 10.5 weeks. Early complications in the form of superficial infection werein 2 patients. Late complications in the form of thigh pain in 6 patients. Cases of knee stiffness and delayedunion were in 3 patients each. The functional outcomes were evaluated and 45 (90%) were excellent, 4 (8%)were satisfactory and 1 (2%) were poor.Conclusion: Once properly planned and executed correctly the submuscular plating for diaphyseal long bonefractures is one of the reliable treatment modality. It is minimally invasive technique that allows earlymobilization with satisfactory radiological and functional outcome with minimal complications.
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Odetunde, Odutola Israel, Oluwatoyin Arinola Odetunde, Adesoji Oludotun Ademuyiwa, et al. "Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management." International Journal of Nephrology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/345298.
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Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide.
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Drobniewski, Marek, Andrzej Borowski, Magdalena Krasińska, Piotr Kozłowski, and Marek Synder. "Fracture of the Femoral Stem as a Rare Complication of Total Hip Arthroplasty. Cases Report." Ortopedia Traumatologia Rehabilitacja 20, no. 4 (2018): 313–26. http://dx.doi.org/10.5604/01.3001.0012.6465.
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The aim of this paper is to present the femoral stem fracture as a rare complication of total hip arthroplasty and describe further management in such cases. We present 5 cases of stem fracture in the Mittelmeier prosthesis which occurred from 8 to 29 years after the primary procedure. In three cases, the primary hip arthroplasty was performed due to dysplastic coxarthrosis. The remaining two patients had idiopathic and post-traumatic coxarthrosis. The four female patients underwent revision hip arthroplasty with stem replacement. One patient refused surgical treatment and has been followed up at the outpatient clinic. Annual clinical and radiological examination is an approved method for detecting late complications Hip arthroplasty should be performed at specialised centres where relevant prostheses and instruments are used. A transfemoral approach and the use of revision stems anchored in the femoral shaft is a method of choice for revision procedures performed due to stem fractures.
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Akel, Rhea, Iskandar Daou, Dany Jamal, Elham Hobeika, Rany Aoun, and Georges Nawfal. "Deadly Aspiration Pneumonia Secondary to Superior Mesenteric Artery Syndrome." Case Reports in Gastrointestinal Medicine 2024 (February 7, 2024): 1–4. http://dx.doi.org/10.1155/2024/5055948.
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Superior mesenteric artery syndrome (SMAS) is a rare and unusual disease, suspected clinically and confirmed radiologically. It represents a duodenal obstruction secondary to the impingement of the third portion of the duodenum between the abdominal aorta (AA) and the superior mesenteric artery (SMA) due to decreased intraabdominal fat. High morbidity and mortality rates are linked to missed or late diagnosis that can lead to complications, such as gastric perforation and gastric hemorrhage. We present the case of a 33-year-old man who was not previously known to have a SMAS, who presented to the emergency department with signs of septic shock, complaining of fever and respiratory symptoms for several days. Investigations showed aspiration pneumonia secondary to an upper gastrointestinal obstruction with signs of SMAS on a computed tomography (CT) scanner. Acute and rapid deterioration led to cardiac arrest and death. Through this article, we highlight the importance of early and correct diagnosis of SMAS which can sometimes be challenging, since no number is strictly diagnostic and radiological images must be interpreted in light of the clinical history and physical examination.
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Mutibah Ali, Al-essi, Binkhamis Lujain Salah, Aljohani Samah Mohammed, and Alzahrani Nora Mohammad. "Late Presentation of Early-onset Sarcoidosis: A Case Report." Journal of Advanced Pediatrics and Child Health 7, no. 1 (2024): 001–6. http://dx.doi.org/10.29328/journal.japch.1001061.
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Background: Early-onset sarcoidosis is a rare systemic inflammatory granulomatous disease, distinguished by onset before the age of 4 and notably lacking pulmonary involvement. Unfortunately, the condition often shows clinical features similar to juvenile idiopathic arthritis, resulting in the misdiagnosis of numerous patients. This case report delves into the challenges associated with the delayed diagnosis of early-onset sarcoidosis, with a particular focus on the diagnostic methods employed to address this delayed recognition. Case presentation: A 15-year-old girl presented with a history of recurrent fever since infancy, accompanied by rash, arthritis, and joint deformity. Previously misdiagnosed with juvenile idiopathic arthritis, she underwent management with steroids and methotrexate, yielding no improvement. The diagnosis of early-onset sarcoidosis was made during adolescence based on serial examinations, comprehensive laboratory and radiological evaluations, and subsequent histopathology findings. Presently, the patient is receiving treatment with low-dose steroids and biologic therapy (Tocilizumab) and experiencing no disease progression. Conclusion: This case report underscores the importance of considering early-onset sarcoidosis in the differential diagnosis of pediatric patients exhibiting persistent arthritis from an early age. Early detection and treatment are crucial in averting complications and enhancing the overall quality of life.
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Krasnoselskyi, M.V., F.V. Hladkykh, H.V. Kulinich, and V.S. Sevastianova. "Clinical-laboratory portrait of patients with cervical cancer with late radiation toxicity due to radiation therapy." Medicni perspektivi 24, no. 4 (2019): 121–33. https://doi.org/10.26641/2307-0404.2019.4.189603.
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According to the National Cancer Registry of Ukraine, cervical cancer ranks second among cancer morbidity, in women of reproductive age and the first place (14.1% of all cases) in the mortality from malignant neoplasms in women aged 18-29, and in aggregate almost 1.7 thousand women die from this pathology in Ukraine annually. Radiation therapy plays a leading role in the treatment of this pathology. In turn, an increase in the survival rate after the course of combined treatment leads to an increase in the absolute number of patients with adverse effects of treatment, in particular, late radiation toxicity (LRT). A retrospective analysis of 254 case histories of patients with malignant cervical neoplasms (127 patients with late radiation toxicity and 127 patients without late radiation toxicity) was conducted. Depending on the nature of the genesis of the late radiation toxicity, it has been found that inflammatory changes occurr in 95.3% of patients (atrophic cystitis, radiation recticite, radial enterocolitis, radiation retropsychoiditis, etc.); in 32,3% – late radiation toxicity of fibrotic genesis (intrapulmonary radiation, ureter stenosis, fibrosis of the skin and subcutaneous tissue of the irradiation fields, etc.); in 25.2% – degenerative late radiation toxicity (radial ulcers, fistulas, etc.) and 30.7% – hematologic late radiation toxicity. The comparative analysis of clinical and laboratory parameters of patients before and after radiotherapy with regard to cervical cancer has shown that prognostic factors of late radiation toxicity such as increase in hematocrit and fibrinogen indices deserve attention. It has also been established that the presence of laboratory signs of a cytolytic syndrome (increased levels of aspartate aminotransferase, urea and total protein) in patients with cervical cancer prior to radiation therapy can be a prerequisite for the formation of late radiation toxicity. In addition, it has been shown that the presence of concomitant aggravating diseases of the endocrine system, blood system, musculoskeletal system, nervous system and digestive system is statistically significantly (p<0,05) increases the risk of LRT in patients with cervical cancer by 20,2; 7.0; 2.3; 1.8 and 1.6 times respectively.
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Pizzuti, Giada, Yolanda Quijano, Emilio Vicente, and Riccardo Caruso. "First-reported case of vaginal late recurrence of Wilms tumor treated with complete pelvic exenteration." BMJ Case Reports 16, no. 11 (2023): e256270. http://dx.doi.org/10.1136/bcr-2023-256270.
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Late relapses of Wilms tumour are extremely uncommon but still represent possible events. Even more rarely Wilms tumours present as extrarenal neoplasms, for which it could be difficult to diagnose and treat them promptly.We present a unique case of late recurrence of Wilms tumour 16 years after the primary diagnosis, with location in the gynaecological system. The relapse presented as a vaginal mass, and it gradually raised up to involve the majority of pelvic organs. We accurately studied the tumour extension, even realising a 3D preoperative reconstruction, and we managed to evaluate the patient with a multidisciplinary team involving general surgeons, urologists, gynaecologists and plastic surgeons. We finally decided for an extended surgical approach and realised a complete pelvic exenteration. Three months after surgery, the patient is in a good general condition, without major surgical complications and with no radiological signs of pelvic tumour relapse.
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MUSHTAQ, AMIR, MOHSIN FAYAZ, ABDUL RASHID BHAT, et al. "Comprehensive Analysis of Craniopharyngioma: Epidemiology, Clinical Characteristics, Management Strategies, and Role of Radiotherapy." Cancer Diagnosis & Prognosis 4, no. 4 (2024): 521–28. http://dx.doi.org/10.21873/cdp.10358.
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Background/Aim: Craniopharyngiomas pose challenges in diagnosis and management due to their rare occurrence and diverse clinical manifestations. This study aimed to provide a comprehensive analysis of cranio-pharyngioma, including its epidemiological trends, clinical presentations, radiological characteristics, surgical interventions, and the role of radiotherapy. Patients and Methods: A retrospective observational study was conducted on 23 patients diagnosed with craniopharyngioma at our hospital from August 2017 to July 2019. Data regarding demographics, clinical presentation, radiological findings, surgical interventions, and adjuvant therapies were collected and analyzed. Results: Craniopharyngiomas exhibited a bimodal age distribution, with peaks in childhood and late adulthood. Clinical presentations varied between pediatric and adult patients, with headache and nausea/vomiting predominant in children, and visual disturbances and hypogonadism more common in adults. Radiological imaging revealed predominantly suprasellar localization and varying tumor consistency. Surgical resection was the primary treatment modality, with post-operative complications including diabetes insipidus and cerebrospinal fluid leak. Histological analysis showed distinct subtypes, with the adamantinomatous subtype predominant in children and the papillary subtype in adults. Adjuvant radiotherapy was administered in cases of incomplete resection or tumor recurrence. Conclusion: This study provides comprehensive insights into the epidemiology, clinical characteristics, radiological features, surgical interventions, and role of radiotherapy in craniopharyngioma management. Understanding these aspects is crucial for tailoring optimal treatment strategies and improving patient outcomes in this complex clinical scenario.