Bilateral trochanteric fractures of the femur in a patient with chronic renal failure

We report a spontaneous intertrochanteric fracture with bilateral avulsion of the greater trochanter in a patient with chronic renal failure.

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Résumé  Nous rapportons une cas de fracture intertrochantérienne spontanée avec avulsion bilatérale du grand trochanter chez un malade insuffisant rénal chronique.

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Accepted: 29 November 1999     

双侧锁骨外端骨折1例报告

2010年1月4日收治1例双侧锁骨外端骨折患者,男,34岁,主因外伤后双肩及头部疼痛1h入院。入院查体：神智清晰,血压110/80mmHg,头于右侧顶部有一5cm的头皮裂伤,边缘不齐,深达皮下层,出血。双侧瞳孔等大等圆,     

Bilateral anterior shoulder dislocation with bilateral fractures of the greater tuberosity: A case report

Bilateral anterior dislocation of the shoulders with fractures of both greater tuberosities is very rare. A 76-year-old woman sustained a bilateral anterior dislocation of her shoulders with fractures of the greater tuberosity on both sides after a fall on stairs. Her arms were abducted and externally rotated. Radiological examination revealed the bilateral anterior dislocation and also the bilateral fractures of the greater tuberosity. Prompt closed reduction followed by a 3 weeks immobilization and subsequent rehabilitation allows a good outcome. Results at one-year follow-up were satisfactory with normal range of motion and no redislocations occurring. To our knowledge, this is the first reported case of bilateral anterior shoulder dislocation associated with fractures of both greater tuberosities in elderly woman.     

Bilateral luxatio erecta humeri associated with a unilateral brachial plexus and bilateral rotator cuff injuries: a case report

Luxatio erecta humeri is an uncommon condition, and only 16 previous bilateral cases have been reported. We present a case of bilateral luxatio erecta humeri associated with unilateral brachial plexus injury and concomitant bilateral rotator cuff tear treated nonoperatively. Seven months after trauma the patient had a good recovery and was able to perform routine daily activities.     

Bilateral atypical femoral fractures in a patient prescribed denosumab — A case report

Atypical fractures of the diaphyseal femoral shaft have been reported in the literature at an increasing rate over the past few years. They have been observed mostly in patients who have been on prolonged courses of bisphosphonates, with no reported cases of atypical femoral fractures in those treated with other anti-resorptive medications.A 59 year old woman sustained an atypical fracture of her right femur in March 2013. She had a past medical history of rheumatoid arthritis and osteoporosis. She had been on alendronate but it was discontinued after five years in 1999. She received denosumab by subcutaneous injection in December 2012. At follow up, she complained of pain in her left femur and a radiograph revealed atypical appearances. She was admitted in June 2013 for prophylactic nailing of the left femur.To our knowledge, this is the first reported case of bilateral atypical femoral changes in a patient prescribed denosumab. Given that denosumab has been on the market for a short time period, we expect that the number of these cases will increase with time. We emphasise previous guidance that patients who present with new onset hip or thigh pain should be screened for atypical femoral fractures.     

Bilateral fractures of the epiphyses of the femur head in a child. A case report

The rare case of a traumatical epiphyseal fracture on both sides of the femoral neck is described. Its treatment and the process during the first year are presented. The general difficulties involved in children's femur-neck fractures are explained, basing on this case.     

进行性假性类风湿性发育不良症并双侧股骨髁上骨折1例

正患者,女,12岁。5岁开始逐渐出现行走不稳,左右摇摆,未予重视。2013年出现双髋关节疼痛,逐渐加重,5个月前发展为无法行走,需要坐轮椅。曾被诊断为"脑炎"、"先天发育异常"、"幼年性类风湿"等疾病,均未确诊,症状无改善。1 d前不慎从轮椅上摔下,双膝着地,双膝关节上方处剧烈疼痛,活动不能,为进一步治疗来我院就诊。急诊X线片(图1a,1b)示股骨远端及胫骨近端骨骺及干骺端扩大,双侧股     

Treatment of a neuroma-in-continuity of the peroneal nerve with nerve bypass grafts--a case report

Treatment of neuroma-in-continuity involves neurolysis or resection with interposition nerve grafting of the involved segment. These techniques may be complicated by loss of remaining conduction through axons that were intact prior to surgical neurolysis or grafting. The authors have shown previously that axonal regeneration occurs in an autologous bypass graft in the rat model. They applied this technique to a neuroma-in-continuity of the peroneal nerve of a 22-year-old woman who sustained an injury to the peroneal nerve after arthroscopic surgery, with excellent results. Nerve bypass may be the procedure of choice for treatment of neuroma-in-continuity.     

Simultaneous bilateral hip fractures following a simple fall in an elderly patient: A case report

Bilateral fractured necks of femur are rare, particularly in the absence of high energy trauma or metabolic bone disease. We describe a case of an 89 year old man with no history of metabolic bone disease who presented with bilateral neck of femur fractures following a simple fall. Clinicians must be vigilant to ensure that bilateral neck of femur fractures are identified and treated appropriately.     

Bilateral pertrochanteric fractures with bilateral patellar fractures with missed medial process fracture of talus in a young adult: a case report and review of literature

Management of polytrauma patients is one the most difficult and challenging tasks for an orthopaedic surgeon, and it includes different aspects of intervention: emergent resuscitative care, early surgical care, post-operative care and delayed rehabilitative care. We report an interesting case of multiple skeletal injuries with a coexisting pattern of fractures of bilateral patellae with bilateral pertrochanteric fractures of femur with a missed talar fracture following a dashboard type of injury in a road traffic accident. We are not aware of a similar case reported in literature in the past. We highlight the management protocol in such a case and review the available literature regarding such a presentation.     

Bilateral achilles tendon ruptures in a patient with ochronosis: a case report

We report the case of a 67-year-old man with ochronosis who had bilateral Achilles tendon ruptures. We reconstructed the Achilles tendon using pull-out wiring for the right side and an anchoring system for the left side, and reinforced the repair site using the peroneus brevis tendon for both sides. He could walk without a cane at 3 months postoperatively. Tendon ruptures in patients with ochronosis should be treated as pathologic ruptures because histologic examination reveals that both ends of the ruptured tendon and the insertion site at the calcaneus have extensive black pigment depositions where homogentisic acid and its metabolites have accumulated, and there are no normal collagen bundles present. Even if an Achilles tendon rupture is clinically diagnosed as an acute injury, the ruptured Achilles tendon should be primarily repaired and reinforced with autologous tissue because there are a few viable cells at the ruptured site, and because the tendon ruptures mainly at the insertion site of the calcaneus. Although this is a preliminary report, the short-term result is good and the reconstructed sites have showed no rerupture.     

Pycnodysostosis presenting with bilateral subtrachanteric fractures: case report.

A 50-year-old woman had bilateral subtrochanteric fractures over a period of 9 months; both fractures were found to be in osteosclerotic femora. The patient was multiparous with 5 normal children. Since subtrochanteric fractures represent only 5 per cent of all femoral neck fractures the occurrence of bilateral subtrochanteric fractures in a relatively young woman suggested an unsuspected underlying disease. Clinical and laboratory investigations showed no evidence of systemic, metabolic, infective or malignant disease. The patient's short stature, peculiar facies in association with osteosclerosis in medullated long bones and typical radiographic findings: hypoplastic claviculae, absent ungual tufts of distal phalanges, hypoplastic paranasal sinuses, and obtuse mandibular angles suggested the proposed diagnosis of pycnodysostosis, a rare autosomal recessive osteosclerotic condition, that has been described in less than 50 cases, including only one Jew. Despite 2 technically difficult surgical hip operations, a 3-year follow-up showed good remedullarization of both fractured femora and no limitation in the patient's daily activities.     

Synovial cyst that compressed the peroneal nerve: case report

We report a case of synovial cyst that induced the compression of the peroneal nerve. The patient presented with foot drop and impossibility to stand on his right heel associated with numbness of anterolateral surfaces of the right shin and the dorsal surface of the foot within a 1-month period. Based on the clinical examination and electroneuromyography data, the compression of nerve by soft elastic mass was confirmed. We treated the patient by total microsurgical excision of the soft elastic mass adherent to the right peroneal nerve at the top third of the patient’s shin. Histological study revealed the cyst of synovial membrane. During the postoperative period, a force in extensors of the right foot was restored. On the seventh day, the patient began to step on his right heel, while the zone of tenderness and temperature hypoesthesia in the area of the peroneal nerve innervation remained.