The American journal of orthopedics
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Review Case Reports
Complicated acromioclavicular joint cyst with massive rotator cuff tear.
An acromioclavicular (AC) joint cyst is an unusual presentation of full-thickness rotator cuff tears in patients with degenerative changes of the AC joint. It is important to understand the relationship between AC joint cysts and rotator cuff tears because there is a high recurrence rate if the cyst is treated without addressing the rotator cuff tear. ⋯ We present 2 cases involving an infected AC joint cyst with a massive rotator cuff tear caused by simple cyst excision. When patients have an AC joint cyst, physicians should consider the following points: (1) There is the possibility of an underlying rotator cuff tear, (2) Surgical treatment is indicated for a symptomatic cyst, (3) Aspiration and simple cyst excision are not recommended, because of the potential for postoperative complications such as recurrence, a draining sinus, and infection, and (4) Lateral clavicle resection should be performed if there is an irreparable rotator cuff tear.
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Review Case Reports
Treatment of postoperative infection after posterior spinal fusion and instrumentation in a patient with neuromuscular scoliosis.
According to the literature, patients with neuromuscular scoliosis have a higher rate of infection after spinal fusion. No randomized controlled trials have been completed to assess the optimal treatment and related outcomes for patients with infections after posterior spinal fusion. In this article, we examine the data and report a case in which a vacuum-assisted closure (VAC) device was used as definitive treatment for a deep wound infection after posterior spinal fusion and instrumentation in a patient with neuromuscular scoliosis. ⋯ The wound VAC was used for more than 2 months, until skin closure was complete. The deep polymicrobial wound infection was treated successfully and definitively with a wound VAC. This case report suggests that good long-term outcomes can be achieved with use of a wound VAC for definitive closure, with possible avoidance of other secondary surgeries requiring skin grafts or flaps for wound closure.