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Segmental bone loss is a challenging condition to manage, and some of the techniques employed are difficult for patients to tolerate and involve lengthy treatment and rehabilitation times. The Masquelet technique is a two-stage bone grafting technique used to treat segmental bone defects. The technique has primarily been described for bone defects averaging 5.5cm in length. This technique's advantages include protection against autograft resorption, relative maintenance of graft position, and prevention of soft-tissue interposition. We present a case report of a male who achieved successful bone defect union utilizing the Masquelet technique for a right femoral shaft infected non-union with a resultant 20cm bone defect.
This is a case report of a 28-year old male who presented to our clinic for evaluation and treatment for a segmental bone defect secondary to a right femur fracture with non-union after infection. The patient had been in a motor vehicle collision. Our patient was interested in limb salvage surgery and declined bone transport. Given the significant size of his defect, we opted to treat him utilizing the Masquelet technique. He went on to have a successful union of his defect with associated increased subjective quality of life and functionality.
The Masquelet technique is a useful limb salvage treatment for patients with segmental bone defects, including large defects of 20cm in length.
The Masquelet technique is a useful limb salvage treatment for patients with segmental bone defects, including large defects of 20 cm in length.
OFTs are tumors with low malignant potential. They represent 10 to 15% of all epithelial tumors of the ovary. Their mean age of occurrence is less than 10years than that of carcinomas.
a 29-year-old female patient, second gesture, with no particular pathological history, consulted for pelvic pain occurring during a pregnancy of 8 SA+5days. The examination showed an abdominal-pelvic mass lateralized to the left with an enlarged uterus. Abdomino-pelvic ultrasound showed an evolving mono-fetal pregnancy of 10weeks of amenorrhea, with two right and left latero-cystic solid formations measuring successively 4×4.3cm and 8.99×8.25cm. Pelvic MRI showed a left latero-uterine solid-cystic mass measuring 8.1×6.1×7cm. An exploratory laparotomy was performed after the 16th week of amenorrhea revealed a left solid cystic ovarian mass of 10cm. selleckchem A left adnexectomy was performed with a right ovarian biopsy, peritoneal biopsy, epiploic biopsy and peritoneal cytology. The pathology report confirmed a borderline serous tumor l mass discovered in the peripartum period, for which imaging plays an indispensable role in orienting the diagnosis.
The occurrence of OFT remains rare during pregnancy, which justifies the exploration of any adnexal mass discovered in the peripartum period, for which imaging plays an indispensable role in orienting the diagnosis.
Combined limb-sparing surgery and radiation therapy are considered the standard of care for higher grade soft tissue sarcomas (STS) of the extremities. The risk of post-radiation fracture after this treatment modality is well known, but still underestimated, and can end in serious long-term secondary problems years later.
We reviewed the records of three patients with pathological femur fractures years after wide local excision of an STS of the proximal lower extremity. All patients received more than 50Gy (Gy) to the entire femur circumference. During surgery, all patients had bone exposure, and in two patients with stripping of the periosteum. The median time from surgery to fracture was 116months (range from 84 to 156months). The median age at the time of diagnosis was 66years old. Despite standard operative fracture treatment, all three patients developed a non-union. One patient later died due to uncontrolled pulmonary metastasis independent from the femoral non-union. In the second case, an exarticuth severe complications.
The most common foot and ankle deformity from injury to the nervous system is equinocavovarus. This deformity comprises of equinus, cavus, varus, and adduction of the forefoot which leads to pain and poor stability in stance phase of gait. Treatment for this condition is difficult regarding literature limitation of the neurogenic clubfoot management. We reported a 18-year-old female with neglected right neurogenic clubfoot treated with 2 stage deformity correction.
A 18-year-old female presented with crooked right foot since birth. It caused pain, especially during walking and standing for a long time and resulted in occasional skin infection on the bottom of the foot. However, currently she could walk in limping gait without walking aid. The patient was born aterm 39weeks through caesarean delivery due to severe preeclampsia. There was delayed development of walking at 2years and 9months. Previously, she had history of spina bifida and undergone surgery in 2001. Afterward, she underwent VP shunt surgery. Physical examination demonstrated cavus varus, tenderness of the right foot, and limited ankle motion. The patient was diagnosed with neglected right neurogenic clubfoot and underwent two stage deformity correction consisting of Achilles tendon lengthening using Z-plasty, total talectomy, and tibiocalcaneal arthrodesis followed by posteromedial release, tendon lengthening (Tibialis posterior, FDL, FDB) and plantar fascia release.
Two stage deformity correction can be successful in patients with neglected neurogenic clubfoot. Further studies are required to investigate the safety and efficacy of such procedure in neurogenic clubfoot.
Two stage deformity correction can be successful in patients with neglected neurogenic clubfoot. Further studies are required to investigate the safety and efficacy of such procedure in neurogenic clubfoot.
Numerous complications can occur after a surgery, but gossypiboma is undoubtedly the most unwanted and undesirable complication of a procedure for any surgeon with legal implications. Once suspected, the minimally invasive surgical approach should be considered for its management.
An adult P
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female presented to the surgery OPD with a painless abdominal mass which progressively increased in size in the past 4months. She underwent emergency surgery for a ruptured ectopic pregnancy 6months back at some other health centre. On computed tomography scan of the abdomen, a well-defined heterogenous cystic lesion of size 9.8cm×9.2cm×7cm was noted intraperitoneally. Few air foci with a hyperdense tubular structure within the lesion were seen, suggestive of a retained surgical sponge with its radio-opaque marker also visualised. The retained sponge was successfully retrieved by the laparoscopic approach.
Traditionally, the open approach for the removal of the sponge was more accepted compared to the laparoscopic approach.
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