Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by technical reasons. We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire, due to an incarcerated bone fragment at the nail tip, was inadvertently advanced across the knee. Forceful attempt of nail insertion caused this complication, which was probably attributed to nail design.
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Surgery
January 2025
Breast Surgery Unit, Veneto Institute of Oncology IOV, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.
Background: Intraoperative ultrasound-guided breast-conserving surgery guarantees real-time direct visualization of tumor and resection margins. We compared surgical, oncologic, and cosmetic outcomes between intraoperative ultrasound-guided breast-conserving surgery and traditional (palpation- or wire-guided) surgery across all breast cancer lesion types.
Methods: This prospective observational cohort study was conducted at the Veneto Institute of Oncology between January 2021 and October 2022.
JACC Case Rep
December 2024
Jesselson Integrated Heart Center, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Objective: This study sought to present the endovascular approach of transcatheter aspiration using the FlowTriever (Inari Medical) aspiration system for high surgical risk patients with right-sided infective endocarditis.
Key Steps: General anesthesia and transesophageal echocardiogram guidance; ultrasonography-guided femoral vein access, preclosure sutures, and insertion of a 24-F sheath; insertion of straight 24-F aspiration cannula over a stiff wire, parked in the superior vena cava; introduction of a 20-F curved cannula inside the 24-F cannula to create a telescopic assembly; accurate positioning using the right ventricle inflow/outflow projection in biplane mode; adjustment of the curved cannula radius by sliding the inner cannula in and out inside the mother cannula; manual aspiration of the vegetation; Postaspiration transesophageal echocardiogram assessment.
Potential Pitfalls: Avoid leaflet and annular injury and account for potential embolization.
JBJS Case Connect
January 2025
Department of Surgery, Plastic and Reconstructive Surgical Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Case: Wide resection of a synovial sarcoma of the anteromedial distal leg involving the dimetaphyseal tibia and posterior tibial tendon produced an 8.5-cm osseous defect. To keep the free flap from invaginating into the defect and prevent kinking of the anastomosis, six 1.
View Article and Find Full Text PDFJACC Clin Electrophysiol
January 2025
Section of Cardiac Pacing and Electrophysiology, Division of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA.
Background: In patients with mechanical aortic and mitral valves requiring catheter ablation of ventricular tachycardia (VT), a technique for access from the right atrium (RA) to the left ventricle (LV) via puncture of the inferoseptal process of the LV was previously described in a single-center series.
Objectives: This study sought to report the multicenter experience of VT ablation using this novel LV access approach.
Methods: We assembled a multicenter registry of patients with double mechanical valves who underwent VT ablation with RA-to-LV access.
J Clin Orthop Trauma
February 2025
Joints and Spine Clinic, Mahavir Nagar, Kandivali West, Mumbai, 400067, India.
Introduction: Numerous orthopaedic procedures including dynamic hip screw plating and various osteotomies require placement of a reference guide pin or K wire to direct bone cuts or for drilling screw holes. Appropriate positioning of these wires is a critical component of surgery. Irrespective of whether one is a seasoned surgeon or an apprentice, these wires often need repositioning and readjustment.
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