Neck fracture of a cementless forged titanium alloy femoral stem following total hip arthroplasty: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Fractures of the neck of the femoral component have been reported in uncemented total hip replacements, however, to our knowledge, no fractures of the neck of a cementless forged titanium alloy femoral stem coated in the proximal third with hydroxy-apatite have been reported in the medical literature.</p> <p>Case presentation</p> <p>This case report describes a fracture of the neck of a cementless forged titanium alloy stem coated in the proximal third with hydroxy-apatite.</p> <p>Conclusion</p> <p>The neck of the femoral stem failed from fatigue probably because of a combination of factors described analytically below.</p

Forefoot plantar multilobular noninfiltrating angiolipoma: a case report and review of the literature

<p>Abstract</p> <p>Background</p> <p>Soft tissue tumors of the feet are uncommon and there have been very few reports of large series in the literature. These tumors continue to present the clinician with one of the most difficult problems in medicine.</p> <p>Case presentation</p> <p>We present a case of a large multilobular noninfiltrating angiolipoma at the plantar surface of the forefoot. Only three cases occurring at the foot have been previously described. We report this new case due to unusual location of the tumor, the long duration (25 years) of its existence and the unique surgical approach for the tumor excision.</p> <p>Conclusion</p> <p>Surgical excision is the treatment of choice and adjuvant radiotherapy is indicated in select cases.</p

The direct cost of "Thriasio" school screening program

<p>Abstract</p> <p>Background</p> <p>There is great diversity in the policies for scoliosis screening worldwide. The initial enthusiasm was succeeded by skepticism and the worth of screening programs has been challenged. The criticisms of school screening programs cite mainly the negative psychological impact on children and their families and the increased financial cost of visits and follow-up radiographs. The purpose of this report is to evaluate the direct cost of performing the school screening in a district hospital.</p> <p>Methods</p> <p>A cost analysis was performed for the estimation of the direct cost of the "Thriasio" school-screening program between January 2000 and May 2006. The analysis involved all the 6470 pupils aged 6–18 years old who were screened at schools for spinal deformities during this period. The factors which were taken into consideration in order to calculate the direct cost of the screening program were a) the number of the examiners b) the working hours, c) the examiners' salary, d) the cost of transportation and finally e) the cost of examination per child.</p> <p>Results</p> <p>During the examined period 20 examiners were involved in the program and worked for 1949 working hours. The hourly salary for the trainee doctors was 6.80 euro, for the Health Visitors 6.70 euro and for the Physiotherapists 5.50 euro in current prices. The cost of transportation was 32 euro per year. The direct cost for the examination of each child for the above studied period was calculated to be 2.04 euro.</p> <p>Conclusion</p> <p>The cost of our school-screening program is low. The present study provides a strong evidence for the continuation of the program when looking from a financial point of view.</p

Melatonin the "light of night" in human biology and adolescent idiopathic scoliosis

Melatonin "the light of night" is secreted from the pineal gland principally at night. The hormone is involved in sleep regulation, as well as in a number of other cyclical bodily activities and circadian rhythm in humans. Melatonin is exclusively involved in signalling the 'time of day' and 'time of year' (hence considered to help both clock and calendar functions) to all tissues and is thus considered to be the body's chronological pacemaker or 'Zeitgeber'. The last decades melatonin has been used as a therapeutic chemical in a large spectrum of diseases, mainly in sleep disturbances and tumours and may play a role in the biologic regulation of mood, affective disorders, cardiovascular system, reproduction and aging. There are few papers regarding melatonin and its role in adolescent idiopathic scoliosis (AIS). Melatonin may play a role in the pathogenesis of scoliosis (neuroendocrine hypothesis) but at present, the data available cannot clearly support this hypothesis. Uncertainties and doubts still surround the role of melatonin in human physiology and pathophysiology and future research is needed

Arthrodesis of the first metatarsophalangeal joint: The “when and how”

Arthrodesis of the first metatarsophalangeal (MTP) joint has been established as the “gold standard” for the treatment of several first ray disorders, due to its perceived efficacy and the consistently reported good results in the literature. Arthrodesis is a commonly performed procedure for the treatment of end stage arthritis, rheumatoid arthritis with severe deformity, selected cases of severe hallux valgus (with or without signs of degenerative joint disease), as well as a salvage procedure after failed previous operation of the first ray. The goals of a successful 1st MTP arthrodesis are pain alleviation and deformity correction in order to restore a comfortable gait pattern and to improve shoe wear. Several techniques have been reported with several proposals regarding the preparation of the articular surfaces and the method of definitive fixation. As with any given surgical procedure, various complications may occur after arthrodesis of the 1st MTP joint, namely delayed union, nonunion, malunion, irritating hardware, etc

Late Hip Arthroplasty Infection Caused by Listeria monocytogenes in a Non-Immunocompromised Patient

Background: Prosthetic joint infections caused by Listeria monocytogenes are uncommon. Such infections usually occur in patients with malignant disease, diabetes mellitus, chronic kidney disease, or liver disease or in elderly or immunocompromised patients. Case Report: We describe a non-immunocompromised 78-year-old male with hip infection caused by L. monocytogenes 11 years after arthroplasty. Eight years postoperatively, revision of the acetabular prosthesis was performed. Two months after that operation, the patient presented with fever, severe left hip pain, inability to bear weight, and painful restriction of left hip motion; the incision site was tender and erythematous. Joint fluid aspirate yielded L. monocytogenes and Staphylococcus epidermidis. Staged revision of the arthroplasty was performed. A gentamicin-loaded polymethylmethacrylate spacer was implanted, and the patient received ampicillin. At the second-stage operation, the cement spacer was removed, and a cement-less total hip arthroplasty was implanted. Postoperative recovery was uneventful, and two years later, the patient has had no joint problems. Conclusions: Predisposing conditions and co-morbidities usually are required for L. monocytogenes infection. Listeria is fastidious and is not a recognized laboratory isolate or hospital contaminant; routine cultures therefore may be negative. In approximately one-half of the reported cases, the prosthetic joint infections were treated successfully by two-stage revision surgery plus long-term antibiotic therapy. In most cases, ampicillin and gentamicin are the first choice. Cephalosporins are rarely effective

Pioneer Female Orthopedic Surgeons as Role Models

Maud Forrester-Brown in the United Kingdom (1921), Marika Daniilidou in Greece (1932), Ruth Jackson in the United States (1932), Loris Figgins in Australia (1957), and Lvalina Burger in South Africa (1993) all chose to specialize in orthopedics. Although there are dynamic female leaders in orthopedic surgery, the field continues to present obstacles to women. Role models, mentors, and exposure to the field have been lacking for women. Although improvements have occurred in the past few decades, further changes are necessary to attract, develop, and retain qualified female candidates

Skeletal Muscle Metastasis of a GIST: A Case Report and Review of the Literature

Gastrointestinal stromal tumors (GISTs) are the most common malignant mesenchymal tumors of the gastrointestinal tract. The most common sites of metastasis are the liver and the peritoneum, whereas metastasis to soft tissue is rare. The authors present the case of a 78-year-old male with a soft tissue metastasis of a GIST and the current literature is reviewed