Full Femoral Osteomyelitis Caused by Fusobacterium nucleatum in an Immunocompetent Adult: A Case Report.

Case: We present a 46-year-old man who developed a full femoral osteomyelitis caused by Fusobacterium nucleatum. The subtle presentation of the infection and the late onset of appropriate antibiotic treatment caused a devastating bone quality of the full femur.

Conclusions: A successful outcome was obtained with surgical debridement, antibiotics, and return to weight bearing guided by a laboratory and radiographic scale specially designed to avoid pathologic fractures toward his full functional recovery.

Walking ability after stroke in patients from Argentina: predictive values of two tests in subjects with subacute hemiplegia.

[Purpose] This study aimed to determine the predictive values of the trunk control test (TCT) and functional ambulation category (FAC) for independent walking up to 6 months post stroke. [Subjects] Twenty-seven subjects with hemiplegia secondary to a unilateral hemisphere stroke were included. [Methods] The protocol was started at 45 days post stroke, with the TCT and FAC as walking predictors.

Wheelchair axle position effect on start-up propulsion performance of persons with tetraplegia.

This repeated measures study assessed the changes in speed, acceleration, stroke frequency, and shoulder range of motion (ROM) associated with different wheelchair axle positions in people with chronic cervical (C) 6 tetraplegia. Our main hypothesis is that the up and forward axle position is the most conducive to wheelchair propulsion, increasing speed and acceleration with a lower stroke frequency. In a chronic spinal cord injury (SCI) unit, we measured the speed, acceleration, stroke frequency, and shoulder ROM in four different axle positions in eight subjects with C6 SCI.

Progressive Gorham disease of the forearm.

Gorham's-Stout disease is a rare but potentially debilitating disease consisting of massive bone osteolysis and bone resorption associated with vascular proliferation and increased osteoclastic activity. Although it can present in a wide variety of forms, it typically involves bones formed by intramembranous ossification such as the skull, pelvis, and scapula. It can occur spontaneously or after trauma.

Trans-iliac removal of bullet fragments from the sacroiliac joint.

The need for removal of intra-articular bullet fragments is well documented in the literature. Arthroscopy and arthrotomy are the preferred methods to access large superficial joints; however, these methods cannot be effectively used to access the sacroiliac joint. Its relationship to vital soft tissues and its convoluted joint anatomy make it almost impossible to explore even under open methods.

An in vivo rabbit model for cartilage trauma: a preliminary study of the influence of impact stress magnitude on chondrocyte death and matrix damage.

Objective: This study was designed to evaluate the postimpact response of the articular cartilage in the rabbit knee after a single traumatic episode.

Design: A novel servo-controlled Rabbit Impact Test System (RITS) was developed to apply a well-defined trauma to the femoral condyle in the rabbit knee. The RITS was first used in an in vitro study to determine an appropriate stress to cause cartilage damage without bone fracture.

Anatomic location of the peroneal nerve at the level of the proximal aspect of the tibia: Gerdy's safe zone.

Background: Injury to the peroneal nerve is one of the most serious complications in orthopaedic surgery. Because percutaneous procedures at the level of the proximal aspect of the tibia are becoming increasingly popular, it is critical to have a thorough knowledge of the trajectory of the peroneal nerve and its main branches at the level of the proximal aspect of the tibia. This anatomic study was conducted in an attempt to (1) define the anatomy of the common peroneal nerve and its branches in a three-dimensional fashion and (2) identify an anatomic landmark on the surface to help define a safe area that is void of the main nerve and its branches.

Subtrochanteric fracture after cannulated screw fixation of femoral neck fractures: a report of four cases.

Subtrochanteric fractures after screw or pin fixation of femoral neck fractures are a recognized complication. No literature is available on this complication after fixation using the recently popularized cannulated screws. We present our experience in treating four of these complications.

Bilateral Monteggia fractures.

The current concepts of anatomic and stable fixation followed by early mobilization in Monteggia fractures have clearly resulted in improvements in treatment and outcome. Bilateral Monteggia fractures are unusual and to the best of our knowledge have not been the subject of any reports in the literature. In this case report, we describe the operative technique for treating bilateral Monteggia fractures and the common pitfalls associated with this treatment.

Expression and activation of the BMP-signaling components in human fracture nonunions.

Background: The potential use of bone morphogenetic proteins (BMPs) to promote bone-healing is of great interest to orthopaedic surgeons. Although the complex mechanism leading from the local presence of BMP (whether endogenous or exogenous) to bone formation is increasingly understood, limited information is available as to whether endogenous BMPs, their receptors, or other molecules involved in their signal transduction, such as Smad1, are present or disappear during the development of fracture nonunions. The purpose of the present study was to determine, by immunohistochemical analysis, whether BMPs, BMP receptors, or Smad1 disappear from tissues during the development of a fracture nonunion.

Open reduction and internal fixation of humeral nonunions : a biomechanical and clinical study.

Background: Several studies have compared different methods for fixation of the midpart of the humeral shaft, but there are only scattered data regarding which type of plate construct provides the best fixation for humeral nonunion. The objectives of this study were (1) to obtain objective data on the performance of four different plate constructs used for fixation of humeral nonunion, and (2) to report our clinical experience with plate fixation of thirty-seven nonunions of the midpart of the humeral shaft.

Methods: In the first part of the study, four plate constructs were compared in a Sawbones model.

Endoscopy for anterior pelvis fixation.

The objectives of this study are to describe the anatomic findings relative to anterior pelvic endoscopy, determine the potential use of endoscopy for reduction and fixation of fractures of the anterior pelvic ring, and report two illustrative cases performed using this method. Using the windows described, endoscopy permits placement of plates and screws on top of the symphysis pubis, reduction of internally displaced fragments, and performance of percutaneous procedures that do not harm anatomic structures.

MRI assessment of the posterior acetabular wall fracture in traumatic dislocation of the hip in children.

Traumatic hip dislocations associated with posterior wall fractures of the acetabulum in the pediatric population are in general a consequence of high-energy trauma. After expeditious reduction, instability mandates for further diagnosis and intervention. Plain radiographs or computerized tomography (CT) scans can misjudge the involvement of the posterior wall of the acetabulum due to the partially calcified nature of the pediatric bone.