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A weird thumb infection in a child: Could it be herpes? 一个孩子奇怪的拇指感染:可能是疱疹吗?
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.35
Kadir İsmail Dere, Kaan Gürbüz, F. Doğar
Two serotypes of the herpes simplex virus (HSV) have been identified that can infect any cutaneous site of the body. While HSV-1 most commonly causes gingivostomatitis and a subsequent recurrent labial herpes,[1] HSV-2 is most frequently associated with genital herpes.[2] Both infections are common, and almost all of their clinical presentations are well established. However, the clinical presentation of HSV infections of the hand is less well-described and less known in adults and even lesser-known in the pediatric age group.
单纯疱疹病毒(HSV)的两种血清型已被确定,可感染身体的任何皮肤部位。虽然HSV-1最常引起牙龈口炎和随后的复发性唇疱疹,但HSV-2最常与生殖器疱疹相关[1]。这两种感染都很常见,几乎所有的临床表现都是确定的。然而,手部HSV感染的临床表现在成人中较少被描述和了解,在儿科年龄组中更少被了解。
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引用次数: 0
Synovial chondromatosis in unusual locations treated with arthroscopy: A report of three cases 关节镜治疗特殊部位滑膜软骨瘤病:附三例报告
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.1
Mustafa Odluyurt, Özlem Orhan, Erdem Aras Sezgin, U. Kanatlı
Synovium holds proliferative properties which may in some cases result in abnormal production of small clumps or nodules of hyaline cartilage. These nodules eventually break free from synovial tissue in time and become loose bodies with varying sizes in the joint. While smaller bodies lead to locking symptoms in the joint, larger ones cause mechanical erosion of the cartilage. Knee is the most commonly affected joint followed by hip.[1] There are also reports about wrist, elbow and, far less commonly, shoulder and ankle joint involvement.[2-4] The classical approach would be arthrotomy and synovectomy, but owing to advancements in arthroscopic techniques and instrument design, arthroscopy has emerged as a viable option in recent years.[3,4] Although arthroscopy is a much less invasive technique with faster recovery Synovial chondromatosis (SC) rarely occurs in the shoulder and ankle joints. An intervention is necessary, as irreversible cartilage injury or transformation to chondrosarcoma may occur. Offering advantages such as faster recovery and lower rates of complication, arthroscopic techniques can be considered instead of open surgery. Herein, we describe three cases of SC, one in shoulder and two in ankle joints. Patients were young adult males and all underwent arthroscopic excision and two had synovectomy. At 18 months of follow-up there was no recurrence and no malignancy and symptoms were alleviated in all patients. In conclusion, arthroscopic removal of all loose bodies and synovectomy in primary SC can be regarded as a safe and effective treatment with low morbidity, rapid recovery, and good outcomes. Histological confirmation of the diagnosis is necessary as malignant transformation is possible.
滑膜具有增生特性,在某些情况下可能导致异常的小团块或透明软骨结节的产生。这些结节最终及时脱离滑膜组织,成为关节内大小不一的松散体。较小的身体会导致关节锁定症状,较大的身体会导致软骨的机械侵蚀。膝关节是最常受影响的关节,其次是髋关节也有关于手腕、肘部以及肩部和踝关节受累的报道,后者要少见得多。[2-4]经典的方法是关节切开术和滑膜切除术,但由于关节镜技术和器械设计的进步,近年来关节镜已成为一种可行的选择。[3,4]虽然关节镜检查是一种侵入性更小、恢复更快的技术,但滑膜软骨瘤病(SC)很少发生在肩关节和踝关节。干预是必要的,因为不可逆的软骨损伤或转化为软骨肉瘤可能发生。关节镜技术具有恢复速度快、并发症发生率低等优点,可以考虑代替开放手术。在此,我们描述了三例SC,一个在肩膀和两个在踝关节。患者均为年轻成年男性,均行关节镜切除,其中2例行滑膜切除术。随访18个月,无复发,无恶性肿瘤,所有患者症状均缓解。总之,关节镜下全松体切除联合滑膜切除术治疗原发性SC是一种安全有效、发病率低、恢复快、疗效好的治疗方法。由于可能发生恶性转化,组织学诊断的证实是必要的。
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引用次数: 0
Forty-year radiological follow-up of a patient undergoing bilateral developmental dysplasia of the hip surgery: A joint with remodeling capacity 一个接受双侧发育不良髋关节手术的患者的40年放射随访:一个具有重塑能力的关节
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.30
T. Tolunay, İ. Kaya, Şefik Murat Arıkan, H. Atalar
Developmental dysplasia of the hip (DDH) has a wide spectrum of deformities, from a mildly dysplastic hip to a severely dysplastic or fully dislocated hip.[1] There is still little information about the exact etiopathogenesis of DDH and many genetic, mechanical and environmental risk factors are effective in its development. Although the diagnosis of DDH is usually made at an early age, there may be cases diagnosed in adolescence or adulthood. In case of late diagnosis, the probability of complications increases exponentially in the long-term.[2]
发育性髋关节发育不良(DDH)具有广泛的畸形,从轻度的髋关节发育不良到严重的髋关节发育不良或完全脱位。[1]关于DDH的确切发病机制的信息仍然很少,许多遗传、机械和环境危险因素在其发展中是有效的。虽然DDH的诊断通常在早期做出,但也可能在青春期或成年期被诊断出来。如果诊断较晚,长期并发症的概率呈指数增长。[2]
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引用次数: 0
Transient cortical blindness due to cerebral fat embolism 脑脂肪栓塞引起的暂时性皮质性失明
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.43
Baki Doğan, S. Coskun, L. Niyaz
Fat embolism syndrome (FES) is a rare disorder most commonly manifested with respiratory insufficiency following long bone fractures or orthopedic surgery. The reported risk of FES following orthopedic trauma ranges between 1 to 30%.[1] The classical triad of FES includes respiratory insufficiency, neurological impairment, and petechial skin rash.[2] It usually occurs 24 to 72 h following the initial insult.[1] The clinical entity in which neurological signs and symptoms predominate is defined as cerebral FES (CFES). Neurological complications of CFES include ischemic or hemorrhagic strokes with focal neurological deficits, headache, apraxia, vision loss, seizures, convulsive and non-convulsive status epilepticus, autonomic dysfunction, acute encephalopathy, confusion, and coma.[3,4] Given the wide range of clinical signs and symptoms, the diagnosis depends on excluding other causes in high-risk patients with a history of trauma and surgery. Fat embolism syndrome (FES) is a disease that manifests with respiratory distress, neurological impairment, and petechial rash and develops due to embolization of fat particles into several organs after long bone fractures or orthopedic surgery. A 26-year-old male patient developed sudden vision loss 24 h after the tibial fracture. Except for visual acuity, other neurological and ophthalmological examinations were normal. He had transient cortical blindness due to central fat embolism secondary to dislocated tibia fracture. Although the major diagnostic criteria of FES include at least two skin, pulmonary and neurological involvements, cerebral fat embolism may occur alone without any additional organ involvement. Multiple brain fat embolism may lead to cortical blindness, which is usually transient.
脂肪栓塞综合征(FES)是一种罕见的疾病,最常见于长骨骨折或骨科手术后的呼吸功能不全。据报道,骨科创伤后发生FES的风险在1%至30%之间FES的典型三联征包括呼吸功能不全、神经损伤和点状皮疹它通常发生在最初的侮辱后24至72小时以神经系统体征和症状为主的临床实体被定义为脑性FES (CFES)。CFES的神经系统并发症包括缺血性或出血性中风伴局灶性神经功能缺损、头痛、失用症、视力丧失、癫痫发作、抽搐性和非抽搐性癫痫持续状态、自主神经功能障碍、急性脑病、意识不清和昏迷。[3,4]鉴于临床体征和症状范围广泛,对于有创伤和手术史的高危患者,诊断取决于排除其他原因。脂肪栓塞综合征(FES)是一种表现为呼吸窘迫、神经功能障碍和点疹的疾病,是由于长骨骨折或骨科手术后脂肪颗粒栓塞到几个器官而发展起来的。一位26岁男性患者在胫骨骨折24小时后突然失明。除视力外,其他神经及眼科检查均正常。由于胫骨脱位骨折继发的中枢性脂肪栓塞,他有过短暂的皮质性失明。虽然FES的主要诊断标准包括至少两种皮肤、肺和神经受累,但脑脂肪栓塞可能单独发生而不累及任何其他器官。多发性脑脂肪栓塞可导致皮质性失明,这通常是短暂的。
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引用次数: 0
Fourth metatarsal basis stress fracture after steroid use secondary to COVID-19 第4例新冠肺炎继发性类固醇使用后跖骨基底应力性骨折
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.62
Enver Kılıç, Olgun Bingöl, Atahan Durğal, G. Özdemir
Stress fractures are mostly seen in the tibia, fibula, navicular, and metatarsal bones in the lower extremities due to overuse injury. A 27-year-old male patient, working as a surgical resident in a tertiary referral hospital, presented with pain on the right foot and difficulty in weight bearing and walking. His symptoms developed approximately a month after being diagnosed with novel coronavirus disease 2019 (COVID-19) and receiving systemic corticosteroid treatment. His history revealed weight gain and excessive working hours. He was diagnosed with stress fracture of the fourth metatarsal basis and treated conservatively. In conclusion, possible muscle/tendon, and bone pathologies and stress fractures secondary to systemic corticosteroid use and increased body mass index should be kept in mind, while evaluating the complaints of patients who have had COVID-19 and have a history of systemic steroid use in daily orthopedic practice, considering the side effects of steroids on the musculoskeletal system.
应力性骨折多见于下肢的胫骨、腓骨、舟骨和跖骨,原因是过度使用损伤。27岁男性患者,在三级转诊医院担任外科住院医师,表现为右脚疼痛,负重和行走困难。他的症状是在被诊断患有2019年新型冠状病毒病(COVID-19)并接受全身皮质类固醇治疗后大约一个月出现的。他的病史显示体重增加,工作时间过长。他被诊断为第四跖骨基底应力性骨折并接受保守治疗。总之,在评估患有COVID-19并在日常骨科实践中有全身性类固醇使用史的患者的投诉时,应考虑到类固醇对肌肉骨骼系统的副作用,同时应牢记可能的肌肉/肌腱、骨骼病理和应力性骨折继发于全身皮质类固醇使用和体重指数增加。
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引用次数: 0
Nonunion of anterior inferior iliac spine avulsion fracture 髂前下棘撕脱性骨折不愈合
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.58
Erdem Şahin, Fatih Durgut, Ali İhsan Tuğrul
Avulsion fractures of the pelvis are usually observed in the skeletally immature population, particularly those who are involved in sports. Sprint running, sudden accelerating, and decelerating are the most common activities leading to avulsion fracture. This condition is more common in males than in females.[1] The occurrence mechanism of these fractures is sudden and strong contraction of the muscle attached to the apophysis.[2]
骨盆撕脱性骨折通常见于骨骼发育不成熟的人群,特别是那些参与体育运动的人群。短跑、突然加速和减速是导致撕脱性骨折最常见的活动。这种情况在男性中比在女性中更常见。[1]这些骨折的发生机制是附着在棘突上的肌肉突然而强烈的收缩。[2]
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引用次数: 0
A novel fluoroscopy positioning for proximal femoral fixation in the lateral decubitus position 一种新型的侧卧位股骨近端固定的透视定位方法
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.63
M. Ekici, Ali Eray Günay, Murat Kahraman, E. Uluyardımcı, Durmuş Ali Öçgüder
The incidence of osteoporosis and proximal femoral fracture (PFF) of the geriatric population has been increasing with the increasing population in the world and the prolongation of life span.[1,2] Osteosynthesis is seen as the first choice in the patient group who can tolerate surgical intervention. Proximal femur nail (PFN) and dynamic hip screw (DHS) are often used for this purpose. Reduction of the fracture and placement of the lag screw in the most appropriate position play an important role in the success of both methods.[3] To meet these conditions, it is necessary to obtain an appropriate anteroposterior (AP) and lateral fluoroscopy view.
随着世界人口的增加和寿命的延长,老年人群骨质疏松症和股骨近端骨折(PFF)的发病率呈上升趋势。[1,2]对于能够耐受手术干预的患者,植骨术被视为首选。股骨近端钉(PFN)和动态髋螺钉(DHS)常用于此目的。骨折复位和将螺钉置入最合适的位置对两种方法的成功都起着重要作用。[3]为了满足这些条件,有必要获得适当的正位(AP)和侧位透视视图。
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引用次数: 0
Primary hydatid cyst in the medial thigh 大腿内侧原发性包虫囊肿
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.59
Ş. Çepni, Y. Erdoğan, A. Şahin, İbrahim Bozkurt, Umut Öktem, E. Uluyardımcı
The human body is an intermediate host for Echinococcus granulosus (E. granulosus), which is the most common cause of hydatid disease. This type of parasite mostly affects the liver and lungs. Primary involvement of subcutaneous tissue is extremely rare. A 51-year-old female presented with the complaint of swelling on the upper medial right thigh. On ultrasonography, a cystic lesion with thick walls, approximately 50¥90 mm in size, was observed approximately 8.5 mm from the skin within the muscle planes in the medial section of the right thigh. Entry was made over the mass from the medial thigh and the mass was totally excised. The histopathological diagnosis was confirmed as hydatid cyst. No pathological findings consistent with hydatid cyst were determined in the liver or other systems. In particular, in areas of endemic hydatid disease, it must be kept in mind that these types of atypical localizations, other than in the liver and lungs, can be encountered in many different anatomic regions.
人体是细粒棘球绦虫(棘球绦虫)的中间宿主,而细粒棘球绦虫是导致包虫病最常见的原因。这种寄生虫主要影响肝脏和肺部。原发性累及皮下组织极为罕见。51岁女性,主诉右大腿内侧上部肿胀。超声示右大腿内侧肌平面内距皮肤约8.5 mm处可见一囊性病变,壁厚约50 ~ 90 mm。从大腿内侧的肿块上方进入,肿块被完全切除。组织病理学诊断为包虫病。肝脏或其他系统未见与包虫病一致的病理表现。特别是,在地方性包虫病地区,必须记住,除了在肝脏和肺部之外,这些类型的非典型定位可以在许多不同的解剖区域遇到。
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引用次数: 0
Wrist arthritis and drug-related malignant melanoma in an ankylosing spondylitis patient: An unusual and rare case report 强直性脊柱炎患者的手腕关节炎和药物相关恶性黑色素瘤:一个不寻常和罕见的病例报告
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.48
N. Ziroğlu, A. Kirat, T. Birinci
Ankylosing spondylitis (AS) is a chronic inflammatory disease that is the most frequent and severe subtype of seronegative spondyloarthropathies.[1,2] It typically affects the axial joints, most notably the sacroiliac joints; however, other sites of involvement, including peripheral joints and extra-articular manifestations, are also observed.[3-5] Pharmacological management of AS includes disease-modifying anti-rheumatic drugs (DMARDs) such as anti-tumor necrosis factor (TNF) agents to control the disease progression. However, patients with AS may still present impairments accompanied by pain and decreased function and quality of life (QoL).[1-4] In some cases, the systematic effect of AS disease and Ankylosing spondylitis (AS), which is a chronic inflammatory disease, is the most frequent and severe subtype of seronegative spondyloarthropathies. Although it typically affects the axial skeleton, the spine, peripheral joints, and entheses are frequently involved as well as extra-articular manifestations. In this case report, we present the clinical picture of malignant melanoma on the plantar surface of the foot, which is a rare side effect of anti-tumor necrosis factor therapy, as well as wrist arthritis, a very rare manifestation of AS. In addition, it dramatically illustrates how devastating AS can be for peripheral joints, while demonstrating the impact of arthroplasty and arthrodesis procedures on the patient's functional status.
强直性脊柱炎(AS)是一种慢性炎症性疾病,是血清阴性脊柱炎中最常见和最严重的亚型。[1,2]它通常影响轴关节,最明显的是骶髂关节;然而,其他受累部位,包括外周关节和关节外表现,也可以观察到。[3-5] AS的药理学治疗包括抗风湿药物(DMARDs),如抗肿瘤坏死因子(TNF)药物来控制疾病进展。然而,AS患者仍可能出现伴随疼痛、功能下降和生活质量(QoL)的损伤。[1-4]在某些情况下,AS病和强直性脊柱炎(AS)的系统性影响是血清阴性脊柱关节病中最常见和最严重的亚型,强直性脊柱炎是一种慢性炎症性疾病。虽然它通常影响中轴骨骼,但脊柱、外周关节和髋部也经常受累以及关节外表现。在本病例报告中,我们介绍了一种罕见的抗肿瘤坏死因子治疗的副作用,即足底表面恶性黑色素瘤的临床表现,以及手腕关节炎,这是一种非常罕见的as表现。此外,它戏剧性地说明了AS对周围关节的破坏性,同时证明了关节置换术和关节融合术对患者功能状态的影响。
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引用次数: 0
Congenital aplasia of the scaphoid bone 先天性舟状骨发育不全
Pub Date : 2022-01-01 DOI: 10.52312/jdrscr.2022.51
H. Çetin, Ali Bülent Baz, Ömer Faruk Kılıçaslan, A. Yapar
Congenital aplasia of the scaphoid bone without thumb or radial hypoplasia is a rare condition. In the literature, there are seven case reports of congenital scaphoid aplasia without other congenital abnormalities, but none of them are current. Scaphoid hypoplasia and aplasia have been defined with syndromes such as radial hemimelia, absence of thumb, vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula, renal anomalies, and limb abnormalities (VACTERL), Holt-Oram syndrome (heart defects and upper extremity anomalies), and thrombocytopenia-radius anomalies (TAR). This is a very rare case diagnosed in the pediatric age group with hypoplasia of the biceps brachii ipsilateral to scaphoid aplasia. Herein, a 12-year-old boy with unilateral scaphoid agenesis is presented, and its clinical and imaging findings as well as the treatment are discussed.
先天性舟骨发育不全而无拇指或桡骨发育不全是一种罕见的情况。在文献中,有7例先天性舟状骨发育不全无其他先天性异常的报道,但没有一例是目前的。舟骨发育不全和发育不全的症状包括:桡骨半瘫、拇指缺失、椎体缺损、肛门闭锁、心脏异常、气管食管瘘、肾脏异常和肢体异常(VACTERL)、Holt-Oram综合征(心脏缺陷和上肢异常)和血小板减少-桡骨异常(TAR)。这是一个非常罕见的病例诊断在儿童年龄组与肱二头肌发育不全同侧舟状骨发育不全。本文报告1例12岁男孩单侧舟状骨发育不全,并讨论其临床和影像学表现以及治疗方法。
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引用次数: 0
期刊
Joint Diseases and Related Surgery Case Reports
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