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“Traumatic loss of the talus treated with talar body prosthesis and total ankle arthroplasty
No full textTotal talar dislocation is a rare injury1-6 that usually occurs as a result of a high-energy continuation of extreme supination forces causing lateral subtalar dislocation or extreme pronation forces causing medial subtalar dislocation7. Most of these injuries are open and are associated with a high rate of postreduction complications, such as persistent infection (reported in up to 89% of patients2), shearing osteochondral fractures (45%3), osteonecrosis (33% to 50%1,8,9), and severe degenerative arthritis. Prompt closed or open reduction of the talus, when possible, is the recommended treatment, in combination with soft-tissue débridement of open injuries. However, the high rate of complications has led many authors to suggest that primary excision of the talus or tibiocalcaneal arthrodesis1,2,4,5,11 should be performed instead. Tibiotalar or pantalar arthrodesis has been recommended for any cases of osteonecrosis or arthritis that develop later.
Primary open dislocation with loss of the talus ("missing talus")2, however, necessitates the performance of either a tibiocalcaneal arthrodesis or a resection arthroplasty, which is difficult to create and maintain. Both procedures often produce unwanted effects on the foot, particularly in young patients, because of loss of function of the peritalar joints.
To avoid the necessity of performing these procedures and to preserve ankle function, the implantation of a talar body prosthesis has been proposed15. Because the long-term survival of such an implant, especially in active individuals, is not known, a total ankle arthroplasty coupled with a talar prosthesis fixed to the calcaneus and the navicular may be an alternative solution.
We describe the case of a forty-five-year-old man in whom total ankle arthroplasty and insertion of a talar body prosthesis were performed in an effort to preserve ankle mobility. Our patient was informed that data concerning the case would be submitted for publication
Trattamento della sindrome di Civinini-Morton con neurolisi percutanea medianten alcoolizzazione con fenolo
No full text
Primary retroperitoneal acinar cell cystadenoma
No full textIn this report, we describe a case of hitherto unreported primary retroperitoneal acinar cell cystadenoma that morphologically and immunophenotypically resembled pancreatic acinar cell cystadenoma. Pancreatic acinar cell cystadenoma is a very uncommon benign lesion characterized by acinar cell differentiation, the evidence of pancreatic exocrine enzyme production, and the absence of cellular atypia. Our case occurred in a 55-year-old woman presenting a 10-cm multilocular cystic
lesion in the retroperitoneum thought to be a mucinous cystic neoplasm. At laparotomy, the cystic mass, which showed no connection with any organ, was completely resected with a clinical diagnosis of cystic lymphangioma. The diagnosis of retroperitoneal acinar cell cystadenoma was based on the recognition of morphological acinar differentiation, the immunohistochemical demonstration of the acinar marker trypsin, and the absence of cellular atypia. These peculiar features can be used in the differential diagnosis with all the other cystic
lesions of the retroperitoneu
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