The Klippel-Trenaunay syndrome (KTS) is a congenital disorder resulting from a mesodermal abnormality, characterised by cutaneous capillary haemangiomas, hypertrophy of bone and soft tissues and varicose veins. The presence of intracranial aneurysms has rarely been described, while oesophageal duplication has not been reported previously. We describe a patient with the KTS with both there additional abnormalities, which could be explained by a postulated mosaic gene abnormality.
Introduction As the reverse total shoulder arthroplasty (RTSA) surgery has dramatically increased in the last few decades, many complications have followed through. The periprosthetic fracture, at the moment, is still a subject of debate in the orthopedic world. In this monocentric study, along with a literature review of periprosthetic humeral fractures, we would present our institutional experience with the treatment of periprosthetic humeral fractures with a posterior humeral approach, posterior cortex plate fixation, anterior strut allograft, screws, and cerclage wires. Materials and Methods Our study consisted in a prospective monocentric study based on 18 patients, with a mean age of 75.3 years (range 64–88), all following a reverse shoulder total arthroplasty (RTSA). Postoperative follow-ups were taken at 1, 6, and 12 months with objective measurement of shoulder motion and strength, while clinical outcome measures were assessed using the American Shoulder and Elbow Surgeons (ASES score) and visual analog scale (VAS) for pain. Together with that, we performed a literature review focused on the management of periprosthetic humeral fractures after shoulder arthroplasty. Results All fractures consolidated without complication at a mean 4.2 months (range 3–6). At final follow-up, the average active shoulder flexion was 88° (range 62–129°), active abduction 73° (range 52–91°) and active external rotation 22° (range 3–56°). The average ASES score was 73 (range 59–97), while average VAS score was 1.1 (range 0–3). Discussion Surgical treatment of periprosthetic humeral fractures following a shoulder arthroplasty remains a hard challenge for every surgeon, and their treatment must consider fracture’s location, displacement, and local bone quality. Conclusions The posterior approach with a posterior plate placement and anterior strut allograft, which is appliable only in case of a B or C type fracture according to Worland classification, could be a good treatment option for periprosthetic humeral fractures.
Nowadays total hip arthroplasty (THA) is widely considered the operation of the century in orthopedic and traumatological fields. Despite this fact, instability and dislocation after THA are a common reason for revision surgery. The purpose of this prospective study is to evaluate the preliminary clinical and radiological results of a novel dual mobility cup. We evaluated 32 consecutive cases of patients who underwent THA using a novel dual mobility cup—with holes in the cup, a modular metallic inlay and a crosslinked polyethylene. All of them were considered at risk of instability of the implant due to primary or concomitant diagnosis. The preoperative Harris hip score was 54.7 on average. At a minimum 2 years follow-up, the mean HHS raised up to a mean value of 88.4; this improvement was statistically significant (p < 0.0001). None of the patients enrolled in this study sustained a postoperative dislocation at a mean follow-up of 39.6 months. Furthermore, no patients sustained modular liner dissociation or an intraprosthetic dislocation. As such, survivorship free from dislocation was 100% at both 2 and 5 years. This study demonstrates that the modular dual mobility (DM) socket provides dual articulation, larger jump distance, and greater range of motion before impingement, which significantly reduce the rate of dislocation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.