Platypnoea-orthodeoxia after left total knee replacement.

Platypnoea-orthodeoxia syndrome (POS) is a rare disorder characterised by both dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position, with improvement in the supine position. We report an unusual case in which an 82-year-old woman developed severe hypoxaemia with POS after left total knee replacement. A significant difference in alveolar-arterial blood gas oxygen tension was demonstrated, and hypoxaemia failed to respond to 100% oxygen supply.

Ruptured hepatocellular carcinoma disguising as heterotopic pregnancy.

The incidence of hepatocellular carcinoma (HCC) in pregnancy is rare but is typically aggressive, with a 1-year survival rate of 23%. One of the complications of HCC is spontaneous rupture, resulting in haemoperitoneum. A 36-year-old pregnant Chinese immigrant who was positive for hepatitis B virus and in her first trimester presented to the emergency department of Wyong Hospital, Hamlyn Terrace, New South Wales, Australia, with severe epigastric and right upper quadrant pain and haemodynamic instability.

Foot Pressure Changes Before and After Ankle Fusion: A Pedobarograph Study.

We performed a case-control study with the purpose of establishing the pressure patterns in the soles of the feet of patients with ankle osteoarthritis, determining whether the pattern changed after treating the arthritis with ankle joint fusion (arthrodesis), and whether the change is significant. We also studied the benefits of ankle fusion with respect to the Short-Form 36-item Health Survey and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale. The study included 18 participants (9 in the study group and 9 in the control group) to reach statistical significance with a 95% confidence interval (CI).

Cervicofacial and mediastinal emphysema complicating tooth extraction in an elderly patient: a preventable complication.

Subcutaneous emphysema is widely documented in the literature and well known by doctors and dentists. However, subcutaneous emphysema following tooth extraction is not very common.We report the case of a 72-year-old female who presented to the emergency department of the Bunbury Hospital in Bunbury in the state of Western Australia in Australia, with subcutaneous emphysema of the face and neck with extension into the mediastinum, following a complicated tooth extraction in 2016.

Early Results of Minimally Invasive Percutaneous Plate Osteosynthesis for Fractures of the Distal Tibia: A Retrospective Case Series and Review of the Literature.

Minimally invasive percutaneous plate osteosynthesis was developed on the concept that preservation of the soft tissue envelope during surgical management of distal tibial fractures is of paramount importance. We report on our early experience using this technique over a 1-year period with 14 such injuries that were treated by a locking compression plate via minimally invasive surgery. The surgical reduction was excellent in most of the cases and all fractures healed uneventfully.

Outcome of ankle arthrodesis using a transfibular approach.

Variable union rates in ankle arthrodesis using different surgical techniques have been reported in the biomedical literature. However, the advantages of a transfibular approach with sagittal splitting of the fibula have not been widely reported, even though the technique is well known and even described in surgical textbooks. We analyzed outcomes in our practice for all patients who underwent ankle arthrodesis.

An unusual etiology for adult-acquired flatfoot.

Rupture of the tibialis posterior tendon is widely believed to result from trauma in the presence of preexisting degenerative changes. We report a case of adult-acquired flatfoot in an otherwise healthy 19-year-old man who sustained a fracture of the medial malleolus.

Popliteal block with transfibular approach in ankle arthrodesis: a case series.

Introduction: Ankle arthrodesis is primarily undertaken to control severe pain in the ankle joint. Immediate postoperative pain is usually treated using oral analgesics, intravenous opiates and regional anaesthesia. The outcomes of ankle fusion, including patient satisfaction studies, are well documented in the literature.