An 18-year-old college basketball player presented with continued ankle pain. A radiographic examination showed bilateral medial malleolus stress fractures. Considering the prolonged history and refractory nature of this injury, surgery was adopted as a treatment option. At surgery, the fracture site was percutaneously fixed using two cannulated double threaded screws. Surgery for each side was sequentially performed two months apart. Prompt bony healing was attained after surgery, and the patient could return to his previous sports level six months after the first surgery without subsequent recurrence.

Ryo Kanto

Shigeo Fukunishi

Takatoshi Morooka

Daisuke Seino

Takayuki Takashima

Shinichi Yoshiya

Juichi Tanaka

Double Threaded Screw Fixation for Bilateral Stress Fracture of the Medial Malleolus

This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before.

Girish N. Swamy

Conal Quah

Elmunzar Bagouri

Nitin P. Badhe

Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure

Osteopetrosis is a rare hereditary disease which is characterized by increased bone density. Bone resorption is insufficient or fails due to the osteoclast defect in osteopetrosis. Half of the patients are asymptomatic and diagnosed incidentally or based on the presence of fracture. Adult onset osteopetrosis usually presents with hip and proximal femoral fractures. Internal fixation can be performed; however, technical challenges may be experienced due to increased bone density. As in other fractures, nonunion or varus malunion of these fractures may occur. Although rare, osteopetrosis may complicate treatment of fractures in such patients. In this study, we aimed to present two new cases of ADO type II with an osteopetrotic femoral fracture along with the clinical and radiological findings in the light of a comprehensive literature review. Orthopaedics surgeons should be aware of intraoperative technical difficulties and possible postoperative complications during the follow-up period. Investigation would be beneficial for the diagnosis of osteopetrosis such the patient with fractures who has minor trauma history and increased bone density in radiography.

Ahmet Aslan

Yakup Barbaros Baykal

Emin Uysal

Tolga Atay

Vecihi Kirdemir

Metin L&#xfc;tfi Baydar

Nevres H&#xfc;rriyet Aydo&#x11f;an

Surgical Treatment of Osteopetrosis-Related Femoral Fractures: Two Case Reports and Literature Review

Highly cross-linked polyethylene has become the gold standard in total hip replacement for its wear resistance. Moderately crosslinked polyethylene is now available for total knee replacement (TKR), although concerns about reduced mechanical strength have prevented widespread adoption. The purpose of this report is to describe an unusual case where a patient underwent cruciate retaining TKR using a moderately crosslinked polyethylene tibial insert that went on to fracture twice in the same location across the primary and first revision surgery. The first tibial insert was 10&#x2009;mm thick and was implanted for 16 months. The second tibial insert was 15&#x2009;mm thick and was implanted for 11 months. Both fractured along the posterior aspect of the medial articular surface. The lack of a specific event leading to these fractures and the fact that they occurred twice in the same location in the same patient suggest that caution is still necessary regarding the introduction of crosslinked polyethylene for TKR surgery.

Matthew G. Teeter

James P. McAuley

Douglas D. Naudie

Fracture of Two Moderately Cross-Linked Polyethylene Tibial Inserts in a TKR Patient

Coracoid fractures are rarely seen fractures. In the shoulder girdle, coracoid process fractures generally accompany dislocation of the acromioclavicular joint or glenohumeral joint, scapula corpus, clavicula, humerus fracture, or rotator cuff tear. Coracoid fractures can be missed and the treatment for coracoid process fractures is still controversial. In this paper, a 34-year-old male manual labourer presented to the emergency department with complaints of pain and restricted movement in the left shoulder following a traffic accident. On direct radiographs and computerised tomography images a fragmented fracture was observed on the base of the coracoid process. In addition to the coracoid fracture, a mandibular fracture was determined. The patient was admitted for surgery on both fractures. After open reduction, fixation was made with a 3.5&#x2009;mm cannulated screw and washer. At the postoperative 6th week, bone union was determined. The patient returned to his previous occupation pain-free and with a full range of joint movement. In conclusion, in the current case of isolated fragmented coracoid process fracture showing minimal displacement in a patient engaged in heavy manual work, surgery was preferred as it was thought that nonunion might be encountered particularly because of the effect of forces around the coracoid.

Ali G&#xfc;le&#xe7;

Harun K&#xfc;tahya

Recep Gani G&#xf6;nc&#xfc;

Serdar Toker

Isolated Fracture of the Coracoid Process

Compartment syndrome of the arm is a rare event that can be subsequent to trauma or other pathological and physical conditions. At the arm the thin and elastic fascia may allow accumulation of blood more than in other districts, especially in patients undergoing anticoagulant therapy. We describe a rare case of an acute compartment syndrome of the arm after minor trauma with partial biceps brachii rupture in a patient with warfarin therapy and optimal value of INR. Prompt diagnosis
and surgical decompression helped to avoid the occurrence of complications with a satisfying recovery of arm function.

Paolo Titolo

Patrizia Milani

Bernardino Panero

Davide Ciclamini

Giulia Colzani

Stefano Artiaco

Acute Compartment Syndrome of the Arm after Minor Trauma in a Patient with Optimal Range of Oral Anticoagulant Therapy: A Case Report

Langerhans Cell Histiocytosis (LCH) is a rare neoplasm characterized by abnormal proliferation of histiocytic cells. In this case report, we describe a unique case of a 13-year-old boy who presented to the clinic with an insidious onset of mid-clavicular pain. The provisional radiologic diagnosis of Langerhans Cell Histiocytosis of the clavicle was confirmed by an incisional biopsy of the left mid-clavicle lesion. The patient&#x2019;s lesion was treated by curettage, bone grafting, and internal fixation, due to the presence of pathologic fracture. At the 2-year followup, the patient was asymptomatic, and the lesion showed complete resolution without recurrence. The case report highlights the characteristic features of Langerhans Cell Histiocytosis in an unusual location, the knowledge of which would help avoid delayed or missed diagnosis in the future.

Shital N. Parikh

Vishal R. Desai

Anita Gupta

Christopher G. Anton

Langerhans Cell Histiocytosis of the Clavicle in a 13-Year-Old Boy

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Case Reports in Orthopedics publishes case reports and case series related to arthroplasty, foot and ankle surgery, hand surgery, joint replacement, limb reconstruction, pediatric orthopaedics, sports medicine, trauma etc.

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Case Reports in Orthopedics - Table of contents 2014

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Case Reports in Orthopedics publishes case reports and case series related to arthroplasty, foot and ankle surgery, hand surgery, joint replacement, limb reconstruction, pediatric orthopaedics, sports medicine, trauma etc.

Case Reports in Orthopedics