Simultaneous bilateral tibal tubercle avulsion: A rare fracture

Tibial tuberosity avulsion is a rare fracture in adolescence.Due to the shear forces on the immature epiphysis. Thirteenyears old girl was admitted to the emergency departmentwith knee pain and tenderness in both knees afterjumping from a height of about one meter. İn examinationshe had tenderness and swelling over both tibial tuberosities.The patient could not do active knee extension. TypeIIA fracture on the left and type IIIA fracture on the rightknee were detected. For the patient’s fractures, closedreduction and fixation with 3 smooth Kirschner wires wasperformed. After immobilization in long-leg brace for threeweeks the brace was removed and she include in therehabilitation program. In this report, we discuss similarcases in the literature and the results of the treatment appliedto our patient.Key words: Tuberositas tibia, avulsion fracture, percutaneouspinnin

Closed posteromedial dislocation of ankle in a 12 year-old boy: a case report

Ankle fractures and fracture dislocations are common injuries in orthopaedic practice however pure ankle dislocation without an associated fracture is extremely rare. There are a few cases reporting such a lesion in the literature. Also this injuries are generally open high energy trauma injuries. Closed treatments are reported to be effective and ligament injuries are generally not reported. In this study, we report a closed pure posteromedial ankle dislocation with anterior talofibular ligament rupture and its treatment and outcome in a 12 year-old boy. We think that this is an extremely rare lesion

An abnormally displaced scaphoid fracture: a case report

Scaphoid fractures are generally known to be difficult to diagnose and difficult to heal. In some reports, up to 40% of scaphoid fractures were reported to be missed at initial presentation. Clinical examinations and plain radiographs are generally poor at identifying scaphoid fractures immediately after injury. In this study we report a scaphoid fracture that has no difficulty in diagnosis because of a very strange and abnormal displacement

Transverse Carpal Ligament and Forearm Fascia Release for the Treatment of Carpal Tunnel Syndrome Change the Entrance Angle of Flexor Tendons to the A1 Pulley: The Relationship between Carpal Tunnel Surgery and Trigger Finger Occurence

Purpose. The appearance of trigger finger after decompression of the carpal tunnel without a preexisting symptom has been reported in a few articles. Although, the cause is not clear yet, the loss of pulley action of the transverse carpal ligament has been accused mostly. In this study, we planned a biomechanical approach to fresh cadavers. Methods. The study was performed on 10 fresh amputees of the arm. The angles were measured with (1) the transverse carpal ligament and the distal forearm fascia intact, (2) only the transverse carpal ligament incised, (3) the distal forearm fascia incised to the point 3 cm proximal from the most proximal part of the transverse carpal ligament in addition to the transverse carpal ligament. The changes between the angles produced at all three conditions were compared to each other. Results. We saw that the entrance angle increased in all of five fingers in an increasing manner from procedure 1 to 3, and it was seen that the maximal increase is detected in the middle finger from procedure 1 to procedure 2 and the minimal increase is detected in little finger. Discussion. Our results support that transverse carpal ligament and forearm fascia release may be a predisposing factor for the development of trigger finger by the effect of changing the enterance angle to the A1 pulley and consequently increase the friction in this anatomic area. Clinical Relevance. This study is a cadaveric study which is directly investigating the effect of a transverse carpal ligament release on the enterance angle of flexor tendons to A1 pulleys in the hand

Can ursodeoxycholic acid be considered as an alternative treatment for postmenopausal osteoporosis?

Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to bone fracture. Bone tissue undergoes constant remodeling. Under the physiologic conditions, bone formation and resorption are in a fair balance. After the third decade of life, bone resorption exceeds bone formation and leads to osteopenia and, in severe situations, osteoporosis. The result is fragile bones and an increased risk for fracture with even minimal trauma. Postmenopausal osteoporosis is thought to result from gonadal (ie, estrogen) deficiency. Estrogen deficiency have been reported to make decrease in 1-25 vitamin D, PTH levels and also calcium absorbsion and increased of some cytokines (ie. IL-1, TNF-alpha) may cause. it was noticed that Ursodeoxycholic acid (UDCA) may descrease these cytokines and increase fractional calcium absorbsion . Consequently, we hypotesize that UDCA might be useful Postmenopausal osteoporosis.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Medical photography: Principles for orthopedics

WOS: 000335057400001PubMed ID: 24708703Background: Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. Purpose: This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Methods: Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. Results: In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions. Conclusions: Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established

Nebivolol Might be Beneficial in Osteoporosis Treatment: A Hypothesis

Nebivolol is a β-blocker that is highly selective for β1-adrenergic receptors with vasodilating properties. This property can be attributed to an endothelial release of nitric oxide (NO). It has been reported that nebivolol also reduces intracellular oxidative stress. There are some studies conducted in humans and animal models which have shown that NO is an important regulator of bone metabolism. However, oxidative stress and antioxidant systems may play important roles in the pathogenesis of osteoporosis. In this paper, we hypothesized that nebivolol may have beneficial effects via nitric oxide and antioxidant action in osteoporosis treatment