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We report the rare case of a double-layered lateral meniscus that was comprised of a normal meniscus and a ring-shaped accessory meniscus. An 11-year-old boy presented with left knee pain, and magnetic resonance imaging initially was interpreted as showing a horizontal meniscal tear. However, arthroscopic exploration revealed a double-layered meniscus. A superior accessory meniscus was fused with the inferior normal meniscus at the posterior horn and had more mobility compared with the normal meniscus. The ...
A 27-year-old right-hand-dominant National Football League (NFL) quarterback injured his right shoulder after falling with the elbow flexed and the shoulder flexed and slightly abducted. He noted an immediate onset of right anterior shoulder pain, but was able to continue playing and throwing without notable deficit. Magnetic resonance imaging of the chest revealed an isolated tear of the pectoralis minor tendon. The patient received nonoperative local treatment and was able to start as quarterback at the n...
We report the case of a pediatric terrible triad injury of the elbow consisting of an ulnohumeral dislocation, a radial neck fracture, and a coronoid chondral injury, which was diagnosed at 14 days following injury. We describe our surgical technique and provide details of the postoperative course, including the development of a rotational contracture following heterotopic ossification.
We describe 2 patients with no historical, examination, or imaging evidence of ischiofemoral impingement; they both developed hip abductor insufficiency and subsequent ischiofemoral impingement with progression that was confirmed by examination and advanced imaging.
A 30-month-old boy with a displaced medial condyle fracture and no history of an elbow dislocation was found to have an entrapped median nerve.
A 65-year-old woman sustained a closed segmental humeral shaft fracture with a complete radial nerve palsy. Radial nerve neurotmesis was found during acute surgical exploration and fixation. Treatment included a 2-cm shortening osteotomy of the humeral shaft and osteosynthesis in order to obtain a tension-free primary end-to-end repair of the radial nerve.
Protein S deficiency, a hypercoagulable thrombophilia, often results in venous thromboembolism. Nontraumatic compartment syndrome in a patient with protein S deficiency has not been well publicized. Herein, we present a rare case of nontraumatic compartment syndrome of the hand and the thigh in a 48-year-old woman with a known history of protein S deficiency; emergency fasciotomies were needed.
We present a case of a rare low-energy catastrophic failure of a carbon-fiber-reinforced polyetheretherketone tibial intramedullary nail at 10 weeks after placement in a 36-year-old man. We describe our experience with extraction of the device.
A 37-year-old woman presented with repetitive catching of the right knee 4 weeks after implantation of a 2-plug osteochondral autograft into the medial femoral condyle. The workup indicated that the symptoms were secondary to patellar engagement with the donor sites of the lateral aspect of the trochlea. She subsequently underwent osteochondral allograft implantation, resulting in painless, full range of motion with complete resolution of the mechanical symptoms.
Brachial plexopathy is a rare complication of nonoperatively treated clavicular fractures. We describe a 68-year-old man who presented with fracture-callus-induced acute brachial plexopathy and dynamic thoracic outlet syndrome after 9 weeks of nonoperative management for a clavicular fracture. He underwent fracture fixation with brachial plexus decompression via callus excision; intraoperative neuromonitoring was used to evaluate brachial plexus function. Postsurgery, his neurologic function recovered compl...
This report describes 2 cases of failed decellularized "off-the-shelf" Chondrofix (Zimmer Biomet) osteochondral allografts within a year after implantation in a 44-year-old man and a 50-year-old woman.
Congenital vertical talus (CVT) is a rare rigid flatfoot disorder with a rocker-bottom flatfoot appearance. It is characterized by hindfoot valgus and equinus, with associated midfoot dorsiflexion and forefoot abduction. We describe a patient who was born with dysmorphic features and subsequently was diagnosed with Beals contractural arachnodactyly. After the diagnosis of bilateral CVT was made, it was treated with a single-stage open reduction. There was a unilateral recurrence, which was treated with revi...
This case report describes the management of a chronic and symptomatic clavicle malunion with use of a 3-dimensional (3D)-printed model during the preoperative surgical planning.
A 19-year-old college baseball outfielder presented with a 3-month history of right shoulder pain. Radiographs, computed tomography, and magnetic resonance imaging showed a large osteochondral defect at the posterosuperior aspect of the glenoid. Arthroscopic evaluation identified an unstable fragment that was partially attached. Fixation of the osteochondral fragment was achieved with autogenous osteochondral plugs through a posterior arthrotomy. At 8 months after surgery, the patient was able to return to ...
Isolated patella absentia is an extremely rare phenomenon, with only a few published cases and even fewer follow-up reports. Nearly 40 years after the initial presentation of 2 brothers with bilateral congenital absence of the patella and the publication of a case report, we report the clinical and radiographic findings of their subsequent tibiofemoral osteoarthritis, which was treated with bilateral total knee arthroplasty.
A 49-year-old man presented with apprehension of a repeat dislocation after a left shoulder dislocation, which was accompanied by pain and restricted active range of motion of the shoulder. We performed an arthroscopic Bankart repair as well as an arthroscopic superior capsular reconstruction (ASCR) with fascia lata for the irreparable massive rotator cuff tear. Two years postoperatively, there was no shoulder pain or repeat dislocation; the range of motion had improved.
Management of Long-Term Complications in the Setting of Lateral Meniscal Deficiency After Saucerization of a Discoid Lateral Meniscus in an Adolescent Patient: A Case Report and Review of the Literature.
A 14-year-old adolescent with bilateral discoid menisci who had previously undergone discoid meniscal saucerization presented with pain and mechanical knee symptoms bilaterally. She had a torn left discoid lateral meniscus, a right lateral meniscal deficiency with an associated osteochondral defect, and valgus collapse of the right femur. She underwent successful repair of the left discoid meniscus as well as a femoral osteotomy, a meniscal transplant, and an osteochondral allograft transplantation in the r...
We present 2 cases of postoperative seroma formation following posterior cervical fusion with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2).
We utilized a novel staged approach for an adolescent with severe kyphoscoliosis; it involved 8 weeks of initial halo-gravity traction as well as implantation and expansion (every 2 weeks) of a magnetically controlled growing rod over 6 months, followed by spinal fusion. The patient was a 13-year-old girl with an untreated idiopathic deformity (thoracic scoliosis with a curve of 145° and kyphosis with a curve of 120°). No osteotomies other than inferior facetectomies were required at the final fusion, and...
Temporary Sternoclavicular Stabilization Using an Innovative Blocking Technique with Kirschner Wires for the Treatment of Posterior Sternoclavicular Joint Injury in Adolescent Patients: A Report of Two Cases.
A 15-year-old boy with a posterior physeal fracture-dislocation of the medial aspect of the clavicle and a 14-year-old boy with a posterior sternoclavicular joint dislocation were successfully treated with temporary sternoclavicular stabilization using an innovative blocking technique with Kirschner wires.
We present the case of a 10-year-old girl who sustained a transepiphyseal femoral neck fracture with posterior dislocation of the femoral epiphysis and an associated transverse posterior wall acetabular fracture, leading to complete separation of the capital femoral epiphysis. She underwent urgent operative intervention; she was followed for 13 years and achieved an excellent outcome.
We report a case of prominent venous dilation in the supraclavicular area with an underlying arteriovenous fistula following nonoperative management of a fracture in the medial third of the clavicle in an adult. The venous dilation indicated elevated venous pressures, likely caused by hypertrophic callus formation and/or fistula development.