The American journal of orthopedics
-
Chronic plantar fasciitis is a major health care problem worldwide and affects nearly 10% of the US population. Although most cases resolve with conservative care, the numerous treatments for refractory plantar fasciitis attest to the lack of consensus regarding these cases. ⋯ This is the first report of a plantar fascia partial release guided by ultrasonic energy delivered by a percutaneously inserted probe under local anesthesia. The procedure appears to be a safe, effective, well-tolerated treatment for a condition that is refractory to other options.
-
We conducted a study to biomechanically compare 4 tibial hamstring tendon fixation devices commonly used in anterior cruciate ligament reconstruction. Quadrupled human semitendinosus-gracilis tendon grafts were fixed into porcine tibias using 4 separate fixation devices. For each device, 10 specimens were tested (1500-cycle loading test at 50-200 N). ⋯ Mean load to failure was highest for Intrafix (656 N), then WasherLoc (630 N), Delta (430 N), and Retroscrew (285 N). The Intrafix device demonstrated superior strength in the fixation of hamstring grafts in the tibia. WasherLoc was close behind.
-
Review Case Reports
Subtrochanteric femur fracture after removal of screws for femoral neck fracture in a child.
Displaced femoral neck fractures are rare in children and are associated with a high rate of complications. Subtrochanteric fractures after cannulated screw fixation of femoral neck fractures in adults are well recognized, and there are several reports on the topic. However, there are no reports on complications related to hardware or subtrochanteric fractures after removal of the screws in the treatment of femoral neck fractures in children. Here we report the case of a 10-year-old boy who sustained a subtrochanteric fracture after the screw removal and healing that followed a femoral neck fracture.
-
Soft-tissue sarcomas are rare and often confused for more common and benign disorders during diagnosis. Chronic expanding hematomas are particularly difficult to distinguish from soft-tissue malignancy. We describe the case of a morbidly obese patient with a chronic expanding hematoma in the distal posterior thigh whose definitive treatment was delayed 6 months because of her pregnancy status and inability to lie prone for open biopsy.
-
Midfoot sprains in the National Football League (NFL) are uncommon. There are few studies on midfoot sprains in professional athletes, as most studies focus on severe traumatic injuries resulting in Lisfranc fracture-dislocations. We conducted a study to evaluate midfoot sprains in NFL players to allow for better identification and management of these injuries. ⋯ Successful return to play can be achieved with nonoperative management for grade 1 injuries within 1 week and grade 2 injuries within 5 weeks. However, severe injuries with frank diastasis that require operative management will necessitate a more significant delay in return to play. Either way, most NFL athletes will have a successful NFL career after their midfoot sprain injury.