The American journal of orthopedics
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Fractures of the tibial tubercle are infrequent injuries in adolescents. A combined injury of the tibial tubercle and patellar ligament is an even more rare event. The literature includes only a few case reports of this injury pattern. In this article, we describe another case and a repair technique and try to increase awareness of this combined injury.
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To investigate the accuracy of intra-articular injection of the basal joint and to determine the rate of soft-tissue extravasation of injected material in successful intra-articular injection, we injected the basal joint of 30 hands with radiopaque dye (with fluoroscopy guiding needle placement in 8 cases) and then used fluoroscopy to check injection accuracy. Results were recorded depending on the location of the injected dye on fluoroscopic examination. ⋯ This study's accuracy rate for intra-articular injection of the basal joint is comparable to the rates reported for injection of larger joints. There is a relatively high soft-tissue extravasation rate for successful intra-articular injection.
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We used a hand surgeon's 1978-1994 pathology reports to retrospectively review the incidence, preoperative and postoperative diagnoses, and presenting signs and symptoms of benign nerve tumors. Twenty-four (11.5%) of our series of 208 soft-tissue tumors of the hand and the forearm were benign nerve tumors. Nerve tumors were the third most common tumor after giant cell tumors of tendon sheath and inclusion cysts. ⋯ In the literature, incidence of benign nerve tumors is much lower (ie, 1%-5%), and preoperative diagnosis consistently incorrect in our study. Incidence of neurologic symptoms (numbness, paresthesia) as presenting symptoms was higher in our study than previously documented. Although benign nerve tumors are most often located on the volar surface of the hand, 25% of the lesions we found were on the dorsal surface of the fingers.
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Postoperative medical complications after total hip arthroplasty (THA) and total knee arthroplasty (TKA) may occur in patients of any age. However, percentage of adverse events increases with increasing patient age and can cause significant morbidity and even mortality. It is important that the orthopedist identify risk factors and symptoms and be knowledgeable in the treatment of nonsurgical postoperative complications. Nonsurgical complications after THA and TKA include pulmonary embolism, fat embolism syndrome, pneumonia, myocardial infarction, postoperative delirium, cerebrovascular accident, urinary retention, urinary tract infections, and deep vein thrombosis.