Simultaneous ipsilateral proximal interphalangeal and metacarpophalangeal dislocation of the fifth phalanx: A case report

We propose, analyze and demonstrate the optoelectronic phase-locking of optical waves whose frequencies are chirped continuously and rapidly with time. The optical waves are derived from a common optoelectronic swept-frequency laser based on a semiconductor laser in a negative feedback loop, with a precisely linear frequency chirp of 400 GHz in 2 ms. In contrast to monochromatic waves, a differential delay between two linearly chirped optical waves results in a mutual frequency difference, and an acoustooptic frequency shifter is therefore used to phase-lock the two waves. We demonstrate and characterize homodyne and heterodyne optical phase-locked loops with rapidly chirped waves, and show the ability to precisely control the phase of the chirped optical waveform using a digital electronic oscillator. A loop bandwidth of ∼ 60 kHz, and a residual phase error variance of < 0.01 rad^2 between the chirped waves is obtained. Further, we demonstrate the simultaneous phase-locking of two optical paths to a common master waveform, and the ability to electronically control the resultant two-element optical phased array. The results of this work enable coherent power combining of high-power fiber amplifiers—where a rapidly chirping seed laser reduces stimulated Brillouin scattering—and electronic beam steering of chirped optical waves

Open reduction and percutaneous pinning for medial condyle fractures of elbow in children: is it a risk for complications?

Background: There are limited cases of humerus medial condyle fracture in the literature treated by open reduction and percutaneous pinning. This study presents cases treated by open reduction and percutaneous pinning and discussed the problems reported in the literature.Methods: Nine cases were treated by open reduction and percutaneous pinning between 2006-2014. These cases were followed for nonunion, avascular necrosis, range of motion, nerve lesion and infection for 15.3 months (range 11 to 18 months).Results: No non-union, avascular necrosis, iatrogenic nerve lesion or infection developed in our cases. All patients gained full range of motion.Conclusions: This study presents that surgical technique and early timing of surgery prevents the complications

A rare cause of deep peroneal nerve palsy due to compression of synovial cyst – Case report

AbstractINTRODUCTIONSynovial cyst is a rare cause of compression neuropathy and its differential diagnosis can be misleading.PRESENTATION OF CASEThis article presents clinical, radiological, and histological findings of deep peroneal nerve palsy due to compression of a synovial cyst in a 30-year-old patient admitted with sudden drop foot.DISCUSSIONFocal nerve entrapment in lower extremity due to synovial cystis a rare entity. Differential diagnosis is important. Surgical excision is the main treatment method with high success rate.CONCLUSIONSynovial cyst compression which can be treated easily with surgical excision should be considered in rapidly progressed drop foot

Rupture of the meniscofibular ligament

The meniscofibular ligament is an anatomically defined ligament of the knee in humans. However, there are no data regarding the prognosis following injury to this ligament. Our case was a 42-year-old man who presented at our clinic with pain of the lateral side of his left knee. MRI of his left knee revealed the rupture of the meniscofibular ligament. The mechanism of injury was consistent with anatomical and mechanical studies of the meniscofibular ligament. The patient was treated conservatively for 1 year, but his pain did not resolve completely. A case series of patients with the same injury is required to establish an effective treatment for this rare injury

Necrotizing leukocytoclastic vasculitis mimicking necrotizing fasciitis: a case report

There are several subtypes of necrotizing leukocytoclastic vasculitis, which are classified according to their morphological features in biopsy specimens using immunofluorescence microscopy. Necrotizing leukocytoclastic vasculitis is limited to the skin, predominantly that of the lower extremities, and usually spares the palms and soles. The most common skin manifestation is palpable purpura. Other skin manifestations include maculopapular rash, bullae, papules, nodules, ulcers and livedo reticularis. There is no specific laboratory test to determine the diagnosis. There are various diseases presenting with these nonspecific symptoms, and a rapid differential diagnosis must be conducted, because the appropriate differentiation and diagnosis markedly influence the treatment strategy and survival of patients. In this study, we report a case of necrotizing leukocytoclastic vasculitis presenting with internal organ involvement and symptoms of necrotizing fasciitis, with emphasis on the clinical differentiation

Thyroid papillary carcinoma presenting with femoral neck metastasis: a case report

Thyroid carcinoma is relatively uncommon, accounting for 2% of all cancers. Although they usually present as a neck lump, occasionally they may be presented with a distant metastasis. In this study, a 65 year-old woman was referred to our clinic with a pain on her left hip at both rest and walking. A lytic area at the inferior femoral neck was found with plain radiography. To clarify the characteristics of the lesion, left hip magnetic resonance imaging (MRI) had been performed displaying 3×5 cm hyperintense lesion extending from medial part of the left femoral neck to the left femoral head. Laboratory findings were normal. An open biopsy had then been performed from the left femoral neck with a suspicion of a metastatic tumor. After Immunohistochemical assesment diagnosis was consistent with metastatic thyroid papillary cancer. Proximal femoral resection with clear margins were achieved by proximal femur tumor endoprosthesis.  In conclusion, papillary thyroid cancer have an excellent prognosis and doesn’t tend to metastese. But rarely, as seen in our case it can even present with syptoms of metastasic disease. Management strategy is the same as other solitary bone metastasis. Papillary thyroid cancer must be kept in mind as a differential diagnosis in solitary bone metatasis

Clinical and radiological evaluation of fracture union in pathologic fractures after closed intramedullary nailing and adjuvant radiotherapy: A retrospective study

Introduction/Objective. Pathologic fractures are devastating complications in metastatic bone disease. Treatment of these condition varies, and includes systemic therapies and surgical interventions. Lack of evidence still exists for standardized care. The aim of this study is to analyze radiological healing response and clinical outcomes after intramedullary nailing (IMN) and adjuvant radiotherapy in complete pathologic fractures of femur or humerus Methods. A total of 19 patients who presented with pathological fracture were retrospectively reviewed. Data regarding demographic characteristics, clinical outcomes and radiologic images were obtained from hospital records. All patients in this cohort were treated with closed, unreamed IMN and adjuvant radiation treatment. Results. Pain relief and full range of motion was obtained in all patients. The mean postoperative Musculoskeletal Tumor Society scores at last follow-up were 69% (range 50?85). All patients demonstrated complete radiographic healing between 2 and 6 months. Only one patient required reoperation for refracture at the tip of the nail which was revised with a longer nail. Conclusion. Our study demonstrated that pathologic fractures managed with closed unreamed IMN and adjuvant multifractional 20 Gy dose radiotherapy yielded good clinical outcomes with complete radiologic response regardless of patient?s life expectancy, adjuvant treatments and overall condition. Closed unreamed IMN was also associated with decreased surgical time in these high-risk patients