Computational Models of Material Interfaces for the Study of Extracorporeal Shock Wave Therapy

Extracorporeal Shock Wave Therapy (ESWT) is a noninvasive treatment for a variety of musculoskeletal ailments. A shock wave is generated in water and then focused using an acoustic lens or reflector so the energy of the wave is concentrated in a small treatment region where mechanical stimulation enhances healing. In this work we have computationally investigated shock wave propagation in ESWT by solving a Lagrangian form of the isentropic Euler equations in the fluid and linear elasticity in the bone using high-resolution finite volume methods. We solve a full three-dimensional system of equations and use adaptive mesh refinement to concentrate grid cells near the propagating shock. We can model complex bone geometries, the reflection and mode conversion at interfaces, and the the propagation of the resulting shear stresses generated within the bone. We discuss the validity of our simplified model and present results validating this approach

Hip screw lateral migration with no cut-out or non-union implication: a case report

Hip screw migration of peritrochanteric fracture fixation devices is a described complication in English literature. Medial migration occupies the majority of these cases whereas lateral migration is rare. We report the case of an 85-year-old woman whose intramedullary osteosynthesis of a trochanteric fracture was complicated by hip screw lateral migration. Mobilization was not influenced and no cut-out or non-union was detected. The migrated hip screw was easily removed and the discomfort vanished. The need for adequate surgical technique and radiographic examination after re-injuries even if the patient remains ambulatory is emphasised

Deep wound infection after a trochanteric fracture internal fixation presenting with hip dislocation: a case report

We report a rare case of posterior hip dislocation after a low energy trauma. The patient sustained a trochanteric fracture in the same hip six months ago, which was fixed using a sliding hip screw and had healed. At surgery a deep wound infection was found and a methicillin-resistant Staphylococcus epidermidis (MRSE) was cultured. After thorough debridement, an excisional arthroplasty was decided. The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done. In three years follow-up the patients presented with a fully functional hip without any signs of infection. Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality. Infection eradication and a second stage arthroplasty can be life and limb saving

Intra-articular knee haemangioma originating from the anterior cruciate ligament: a case report

<p>Abstract</p> <p>Introduction</p> <p>Synovial haemangioma is a rare intra-articular benign tumour, which may arise from any synovium-lined surface, but particularly in the knee joint. Synovial haemangioma originating from the anterior cruciate ligament has not been reported previously.</p> <p>Case presentation</p> <p>A 34-year-old man presented with a history of intermittent knee pain, locking and swelling.</p> <p>Conclusion</p> <p>Knee intra-articular haemangioma, a very rare benign tumour, is often misdiagnosed. Magnetic resonance imaging is effective in detecting this lesion and should be performed in cases of persistent knee swelling and pain.</p

Pulsed Radiofrequency Lesioning of the Axillary and Suprascapular Nerve in Calcific Tendinitis

The patient was a 45-year-female who presented with pain at right shoulder and right upper arm. The patient suffered from right shoulder and arm pain for 3 years and had pain management which was performed using medication and conservative management after she had been diagnosed with calcific tendinitis. However, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed right axillary nerve and suprascapular nerve block through pulsed radiofrequency. Two months after the procedure, the shoulder pain gradually subsided with the size reduction of the calcified nodule and she needed no more pain management

Case Report Traumatic Floating Clavicle: A Case Report and Literature Review

Bipolar fracture dislocations of the clavicle are rare injuries, usually the result of high-energy direct trauma. Since the original description by Porral in 1831, only a handful of individual case reports and case series by Beckman and Sanders have been reported in the literature. Management of these injuries has remained controversial ranging from nonoperative to aggressive surgery. We report on the case of a young army cadet who had a fracture of the lateral end of the clavicle, with an anterior dislocation of the sternoclavicular joint. Despite being planned for surgery, at the patients request, it was decided to manage the lesion conservatively with graded physiotherapy. At one-year follow-up, he had full pain-free, functional range of movement of the shoulder. This young high demand patient had a good outcome with conservative management, despite going against the current trend towards surgical treatment. We present this case with a review of the literature, highlighting the various management options for this rare lesion