bluuebunny/crossref_metadata_2025 huggingface dataset:
Aneurysmal Bone Cyst of the Distal Ulna in an Elderly Lady
Authors:   Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India., Jain Mantu , Pradhan Siddharth S ,   Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India., Khan Shahnawaz ,   Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India., Tripathy Sujit ,   Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India., KP Lubaib ,   Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India., Raj Kasthala Sanjay ,   Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India.
Published: November 2024

Introduction: Aneurysmal bone cyst (ABC) is a rare, benign, cystic, hemorrhagic expansile osteolytic lesion of unknown etiology resembling multiple intraosseous blood-filled spaces mostly seen in the first two decades of life. It accounts for <1% of all bone tumors and the usual sites are the metaphyses of the proximal and distal femur, proximal tibia, and posterior elements of the spine. Affection of other sites is unusual. Case: A 55-year-old female with a 5-month history of pain and swelling of distal ulna. She was operated on with curettage, bone grafting, and plating. At 1-year follow-up, she regained complete movements without any recurrence. Conclusion: In this article, we present a case of a primary ABC of distal ulna in an unusual age group of 55 years in a female. The clinical presentation, diagnosis, surgical management, and clinical outcome at 1 year are described. Keywords: Aneurysmal bone cyst, elderly, distal ulna.
Hand and Forearm Compartment Syndrome Secondary to Intravenous Infiltration
Authors:   Central Michigan University School of Medicine, 1632 Stone St, Saginaw, MI 48602,, Vyskocil Joseph , Sheu Jonathan ,   McLaren Flint Hospital, 401 South Ballenger Hwy, Flint, MI 48532., Telehowski Paul ,   McLaren Flint Hospital, 401 South Ballenger Hwy, Flint, MI 48532.
Published: November 2024

Introduction: Acute compartment syndrome (ACS) in the hand and forearm is an uncommon yet significant orthopedic crisis. The misplacement or migration of an intravenous (IV) catheter can cause fluid extravasation into interstitial tissues, which is a rare but known cause of ACS. Diagnosis of ACS is usually clinical, but this can be challenging in anesthetized or obtunded patients who are unable to communicate. Management involves emergent fasciotomies to relieve compartment pressures. Case Report: We present the case of a 64-year-old female who developed ACS in the hand and forearm following a carotid endarterectomy. The patient experienced significant swelling in her left hand and forearm due to an infiltrated IV catheter. The diagnosis was based solely on physical examination, as the patient was under anesthesia. Findings included swelling, tissue tension, and color changes suggestive of early ischemia. Emergent fasciotomies were performed to decompress the affected compartments. Conclusion: ACS resulting from iatrogenic fluid extravasation is a severe condition with a rare etiology. Prompt identification and surgical intervention are essential to reduce associated morbidity and mortality. In certain cases, the diagnosis must be made by physical examination alone. The rarity of this etiology necessitates heightened awareness among inpatients who have a limited ability to communicate. Keywords: Acute compartment syndrome, iatrogenic fluid extravasation, emergent fasciotomies.
Double Trouble No More: A Case Report of En-bloc Resection and Total Hip Replacement for Secondary Hip Osteoarthritis Due to Femur Neck Osteochondroma
Authors:   Department of Orthopedics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India,, S Abhijeeth , Siddarth Raghul ,   Department of Orthopedics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India,, Vanchi Pravin K ,   Department of Orthopaedics Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India., RV Raghav ,   Department of Orthopaedics Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India., Sundar Harish Kiran ,   Department of Orthopaedics Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India., Kumar M Mohan ,   Department of Orthopedics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India,
Published: November 2024

Introduction: Osteochondroma is a long bone benign tumor presenting at the metaphysis. Most of the occurrences are isolated lesions with very rare intra-articular extensions. Some occur as part of multiple hereditary exostoses. Isolated lesions are typically asymptomatic and diagnosed incidentally but, in some cases, present with bursa inflammation, pain, decreased range of motion and neurovascular deficit due to the mass effect of the tumor. Osteochondroma of the femur neck presents as an intra-articular pathology. Case Report: A 41-year-old lady presented with right inguinal pain and swelling for 7 years, with an associated decreased range of movements of the right hip. Clinical examination revealed gross bony hard swelling, non-tender, and no local warmth. ROM was restricted, particularly internal rotation with additional abduction contracture and anterior joint line tenderness. A plain radiograph revealed a bony mass over metaphyseal-diaphyseal swelling over the medial aspect of the proximal femur with loss of femur head morphology and joint space narrowing. MRI confirmed the lesion as osteochondroma and a provisional diagnosis of Sessile solitary osteochondroma with probable sarcomatous with secondary degenerative osteoarthritis of the right hip was made. The patient underwent right total hip replacement with wide excision of the entire proximal femur using a REEF stem. The samples sent for histopathology confirmed the diagnosis as osteochondroma with no sarcomatous changes. Over a 10-year period of follow up, the patient showed no evidence of recurrence with improvement of hip movements assessed by Modified Harris Hip Score. Conclusion: By planning and executing total hip replacement with REEF stem and wide excision of the tumor in a single sitting, both the progress of the tumor and the secondary degenerative arthritis were met with, in a single procedure. Keywords: Osteochondroma, total hip replacement, chondrosarcoma, osteoarthritis.
Two Stage Revision Total Hip Arthroplasty for Enterobacter Induced Periprosthetic Joint Infection in an Elderly Female: A Case Report
Authors:   Department of Orthopedic Surgery, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh,, Ahsan Pervez , Rahaman Md. Mostafizur ,   Department of Orthopedic Surgery, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh,, Jahan Israt ,   Department of Orthopedic Surgery, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh,, Asma Nusrat Sharmin ,   Department of Orthopedic Surgery, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh,, Paran Md. Shah ,   Department of Orthopedic Surgery, Ibn Sina Medical College and Hospital, Dhaka, Bangladesh,, Shaude Syed E ,   Department of Research and Development, International Network of Doctors Journal, Dhaka, Bangladesh.
Published: November 2024

Introduction: Periprosthetic joint infections (PJIs) present a growing challenging complication in joint surgeries, with increasing incidence and significant clinical implications. The complexity of PJIs lies in its interaction between microbes and the host immune response. While Enterobacter infections are rare in PJIs, they pose severe risks due to their resistance and virulence. PJIs burden healthcare systems and profoundly impact patients, especially those unable to access necessary treatments due to socioeconomic limitations, like our patient who had suffered from excruciating pain and immobility for 6 years. To the best of our knowledge, this is the first case report of its kind. Case Report: A 55-year-old woman presented to us with severe right hip pain for 10 years and recurrent swelling over the incisional site with discharging sinus and intermittent fever for 6 years. She underwent through a unipolar hemiarthroplasty due to right-sided femoral neck fracture 10 years back. Severe pain and recurrent infections led to functional limitations and deteriorating quality of life. History, clinical examination, serological, and radiological investigations confirmed the diagnosis. Two-stage revision total hip arthroplasty was performed. Regular follow-ups were done after the surgical procedure. After revision, she experienced no pain or recurrence of infection. Her Harris Hip Scores were 9 and 80 before and after two-stage revision surgery, indicating a favorable outcome. Conclusion: This case highlights the challenges of PJI management, especially in patients from poor socioeconomic condition. Despite obstacles, intervention with two-stage revision arthroplasty resulted in significant clinical and psychological improvement. Enhanced healthcare accessibility and tailored interventions are crucial for optimizing PJI outcomes. Keywords: Periprosthetic joint infection, revision total hip replacement, unipolar hemiarthroplasty, osteoporosis, Harris Hip Score.
“Intra-Articular Intrusion of Broken Patella Cerclage Wire and the Importance of Higher Imaging in Its Rescue” – A Case Report
Authors:   Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Sivaramakrishnan Adithyaa , C Sitsabesan. ,   Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Menon P Gopinath ,   Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Published: November 2024

Introduction: In this case report, we would like to discuss about a 51-year-old gentleman, who had underwent patella tension band wiring for transverse patella fracture 3 years ago and presented with a painful knee with broken cerclage wire with a fragment migrating into the joint. Case Report: The aim of the study was to highlight the importance of higher imaging (Computed tomography) in deciding whether the retrieval of the fragment can be attempted through a minimally invasive arthroscopic technique. Result: CT of the knee joint with 3D reconstruction was done and it showed the broken migrated fragment to be intra-articular and intracapsular. Hence, through conventional anteromedial and anterolateral arthroscopic ports, the broken fragment was completely removed with ease, followed by open removal of the remaining cerclage wire. Discussion: Breakage of patella cerclage wire is rare in clinical practice due to loss of follow-up and migration of the broken fragment is even more rarer with reportedly only six other cases in literature. In similar two cases, without higher imaging, arthroscopic retrieval of the broken fragment was attempted, where in one of the cases it was unsuccessful and they had to convert to an open procedure. Hence, this reiterates the significance of higher imaging to decide on the approach for a functionally better outcome to the patient with less morbidity. Conclusion: This particular case of broken fragment intrusion into the joint signifies the importance of higher imaging in deciding the surgical approach of its removal in the best possible way without cause higher morbidity to the patient and resulting in better functional outcomes. Keywords: Patella, tbw, cerclage, wiring, fracture, breakage.
Atypical Presentation of Bilateral Acromioclavicular Joint Cysts Extending Medially into the Trapezius Muscles: A Case Report and Literature Review
Authors:   Department of Orthopaedic Surgery and Traumatology, Centre Epaule Coude La Colline: Chem. Thury 7b, 1206 Geneva, Switzerland, Rodriguez Andres , Mombelli Shana ,   Department of Orthopaedic Surgery and Traumatology, Centre Epaule Coude La Colline: Chem. Thury 7b, 1206 Geneva, Switzerland, Cunningham Gregory ,   Department of Orthopaedic Surgery and Traumatology, Centre Epaule Coude La Colline: Chem. Thury 7b, 1206 Geneva, Switzerland
Published: November 2024

Introduction: Acromioclavicular joint cysts represent a relatively rare clinical entity, often manifested as an enlarging mass adjacent to the acromioclavicular joint, which can raise concerns for a potential tumor. These cysts are identified for their association with shoulder pathology, particularly extensive rotator cuff tears, and present a diagnostic and therapeutic challenge for misdiagnosis as neoplastic masses. In this case, we are reporting on an unusual presentation of a patient presenting with a swollen mass in the left trapezius causing neck pain. The aim of this case presentation is to bring awareness to atypical locations of these acromioclavicular joint cysts that can be easily interpreted as a tumoral process in the neck due to the location of the mass. Acromioclavicular cysts remain infrequently reported in the literature. Case Report: We present the case of an 80-year-old male patient. On clinical examination, a soft and palpable mass over the trapezius was noted, with no signs of infection or inflammation. Plain radiographs showed advanced primary osteoarthritis of the glenohumeral joint with a preserved subacromial space. Magnetic resonance imaging of both shoulders showed that cystic masses were developed on both sides from the acromioclavicular joint and extended medially to the trapezius muscles. It was particularly large on the left side, with a diameter reaching up to 12 cm. The surgical intervention was carried out involving resection of the distal end of the clavicle through an open approach and resection of the neck of the cyst. Through a second incision at the dorsal level on the medial aspect of the trapezius, the cyst sac was identified and its subsequent resection was performed. Conclusion: The presented case of a rare location of bilateral ACJ cysts, treated successfully with cyst resection and ACJ decompression, illustrates a diagnostic and therapeutic challenge due to the atypical nature of the cysts’ presentation. This case aims to bring awareness about this pathology when confronted with a painless lump in the upper shoulder region, although far away from the joint in patients with complex shoulder or neck symptomatology. Keywords: Acromioclavicular cyst, neck mass, shoulder pain, acromioclavicular joint, rotator cuff tear, shoulder tumor.
Fixation of 3-Part Intra Articular Distal Radius Fracture with Combined Volar Plate and Dorsal Spanning Plate: A Case Report
Authors:   Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614., Lee Anderson , Rao Brian ,   Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614., Yatsonsky Dave ,   Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614., Behrens Kyle ,   Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614., Stokey Phillip J. ,   Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614., Ebraheim Nabil ,   Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH, 43614.
Published: November 2024

Introduction: The aim of this study is to illustrate a case in which the use of a dorsal spanning plate followed by volar plating may be indicated in the setting of a complex intra-articular distal radius fracture. Combined dorsal spanning plate and volar plating is a rare procedure reserved typically for comminuted fractures of the distal radius. This case highlights the first reported incidence in which a dorsal spanning plate of a distal radius fracture resulted in the volar displacement of the fragments, requiring subsequent volar plating. In the end, the outcome was favorable, as the follow-up imaging displayed good bone healing and union with minimal complications. Case Report: A 52-year-old male presented to the ED at our institution following a traumatic fall onto his left upper extremity. Radiographic imaging revealed fractures at the midshaft of the humerus as well as a very distal three-part intra-articular radius fracture. Due to the nature of the patient’s distal radius fracture, initial fixation with a dorsal spanning plate was planned. However, follow-up imaging 3 weeks postoperatively revealed volar displacement of his fracture, so the patient underwent open reduction internal fixation with a volar distal radius plate. Follow-up over the next few months displayed a union of the fracture fragments and the dorsal spanning plate was removed 4 months postoperatively with imaging showing no complications. Conclusion: We present this case to highlight the complication of volar displacement that may follow initial dorsal spanning plate fixation of a three-part intra-articular distal radius fracture that can be resolved with the addition of a volar plate, as well as possible indications for combined dorsal spanning plate and volar plate fixation of complex distal radius fractures at the time of initial fixation. Keywords: Distal radius, volar plate, spanning plate, fracture, comminution, intra-articular fracture.
Charcot’s Arthropathy of the Wrist: A Case Report
Authors:   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India,, Kiran V Ravi , Jayant Udit K ,   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India,, Krishna M L V Sai ,   Department of Orthopaedics, Aayush Hospitals, Eluru, India,, Rawat Sanjay Singh ,   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Raebareli, India., Ansari Tahir ,   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India,
Published: November 2024

Introduction: Charcot arthropathy is a myriad of osseous degenerative changes that can affect theoretically any joint of the body. The pathophysiology of this condition is based on microtrauma, leading to the deterioration of articular nerves. The most common cause in the upper extremity is syringomyelia. Case Report: A 64-year-old male patient presented with painless right wrist swelling and deformity. His radiographs showed degenerative changes in radiocarpal and intercarpal joints. Magnetic resonance imaging of the brain and cervical spine demonstrated Type II Chiari malformation and syringomyelia, and neurological evaluation revealed myelopathy. Conclusion: Charcot arthropathy of the wrist, an exceedingly rare condition, is a diagnosis of exclusion. The common causes of arthritis of the wrist such as Rheumatoid arthritis and tuberculosis must be ruled out. When a patient presents with wrist Charcot arthropathy thorough neurological examination must be done. Diabetes mellitus, tabes dorsalis, and leprosy are the other frequently cited causes that must be looked for. Keywords: Charcot arthropathy, wrist, syringomyelia.
Pediatric AC Joint Fracture Dislocation: Arthroscopy-assisted Reduction and Internal Bracing
Authors:   Department of Orthopedic Surgery, Bangalore Shoulder Institute, Bangalore, Karnataka, India., Nair Ayyappan V , Thampy J Sreejith ,   Department of Orthopedic Surgery, Bangalore Shoulder Institute, Bangalore, Karnataka, India., Rambhojun Maythilisharan ,   Department of Orthopedic Surgery, Bangalore Shoulder Institute, Bangalore, Karnataka, India., Bharadwaj Bharath ,   Department of Orthopedic Surgery, Bangalore Shoulder Institute, Bangalore, Karnataka, India., Yoo Yon-Sik ,   Department of Orthopedic, camp 9 orthopaedic center , Dongtan , South Korea., Khan Prince Shanvas ,   Department of Orthopedic, apollo adlux hospital, Kochi, kerala
Published: November 2024

Introduction: Acromioclavicular joint injuries are common injuries around shoulder and comprise around 9–12% and are rare in pediatric population. Many surgeries have been described which include open stabilization, arthroscopic assisted, or complete arthroscopic. We describe our technique of arthroscopic-assisted fixation in AC joint acute injuries, in which we arthroscopically pass fiber tape and tunnels across coracoid base and clavicle to stabilize the upward forces, followed by double breasting for AC joint with fiber tape to balance the horizontal forces. Case Report: A 9-year-old female kid with a history of falls with left shoulder pain and diagnosed with fracture dislocation of the left ac joint. The patient in beach chair position. Arthroscopically, fibertape was passed through a drill hole near to cc ligament and cinch loop was done through it and around coracoid. With a mini-incision, AC joint further stabilized. Conclusion: Similar case reports are very few and arthroscopic management of same is nearly none. Advantages of our procedure are relatively low cost of the implant, and no anchors or metal implants at AC joint to avoid impingement. Open AC joint stabilization addresses the disc in joint. Disadvantages are a long learning curve. Keywords: Pediatric AC joint, acromioclavicular joint dislocation, arthroscopic AC joint, AC joint internal bracing, acute AC joint dislocation.
Angiolipoma of Cuboid Bone: A Rare Case Report
Authors:   Department of Orthopaedics, Dr. Muthus Hospital, Coimbatore, Tamil Nadu, India., Dhakshinamurthi Yogadeepan , Meignanaguru Muthusaravakumar ,   Department of Orthopaedics, Dr. Muthus Hospital, Coimbatore, Tamil Nadu, India., Srinivasan Deepak ,   Department of Orthopaedics, Dr. Muthus Hospital, Coimbatore, Tamil Nadu, India., Shetty Ganesh Ramesh ,   Department of Orthopaedics, Dr. Muthus Hospital, Coimbatore, Tamil Nadu, India., Thamizhpandiyan Piriyan ,   Department of Orthopaedics, Dr. Muthus Hospital, Coimbatore, Tamil Nadu, India.
Published: November 2024

Introduction: Angiolipomas are benign small soft tissue rubbery tumors common between the age group of 20 and 30. They are very common in the extremities and neck. It is composed of adipose tissues and blood vessel components. Case Report: We report a case of 82-year-old lady with complaints of right foot pain. She was diagnosed to have a sclerotic lesion over the cuboid. Biopsy revealed angiolipoma which is a very rare tumor in bone. The patient underwent intralesional curettage along with cortico-cancellous bone grafting. Conclusion: Although angiolipoma is very rare in bone, its occurrence should not be excluded. It can rarely occur in old age and it has to be carefully evaluated and managed to prevent recurrence. Keywords: Angiolipma, curettage, cuboid, cortico-cancellous graft.
Aggressive Giant Cell Tumor of Proximal Tibia Treated with Resection and Arthrodesis using Limb Reconstruction System – A Case Report
Authors:   Department of Orthopaedics, FIMS Hospital, Coimbatore, Tamil Nadu, India,, Arul Xavier Alwin Surya , Loganathan Karthik ,   Department of Orthopaedics, Government Stanley Medical College, Chennai, Tamil Nadu, India.
Published: November 2024

Introduction: Giant cell tumors (GCTs) are one of the most aggressive benign tumors of the bone. For tumors around the knee joint, excision with preservation of joint movement is preferred. Resection arthrodesis or an amputation might be necessary sometimes. Case Report: In this case study, we report a 23-year-old female who had an aggressive osteolytic lesion of the proximal tibia with articular breach. The biopsy revealed an aggressive GCT. Conclusion: Then the patient was managed with resection arthrodesis with fibular strut graft, limb reconstruction system, and augmentation plating. The limb reconstruction system was removed after the union was achieved. Keywords: Giant cell tumors, resection, arthrodesis, limb reconstruction system.
Bilaterally Symmetrical Serratia Osteomyelitis of Distal Third Radius in an Adolescent Female with Sickle Cell Disease: A Rare Case Report
Authors:   Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India., Lakhani Karan R , Chaudhary Sumedh D ,   Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India., Mendhe Chittanand ,   Department of Orthopaedics, Indira Gandhi Government Medical College and Mayo Hospital, Nagpur, Maharashtra, India., Phuphate Akshay ,   Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India.
Published: November 2024

Introduction: Osteomyelitis as a condition in adolescents is difficult to diagnose as it is. In patients with sickle cell disease, the diagnosis is even more difficult due to the occurrence of Vaso occlusive crisis which being the most common acute clinical manifestation of sickle cell disease in bone may mimic osteomyelitis. No single clinical presentation, laboratory result, or imaging finding can definitively distinguish these diagnoses. Case Report: A 15-year-old female presented to the outpatient department with mild pain and swelling in both forearms persisting for the past 3 months. Radiographs revealed predominantly diaphyseal expansile osteolytic lesions in the bilateral distal third radius with periosteal reaction along with a small radiolucent area in the right distal radius. She was subsequently admitted for further assessment. On the 3rd day of admission, pus pointing was noted on the volar aspect of the right forearm while the left side only had bony swelling. Surgical intervention (debridement with saucerization) was performed on both sides. Pus culture (collected intraoperatively) showed Serratia marcescens as the causative organism. Culture-sensitive antibiotics were administered intravenously for 3 weeks followed by oral antibiotics for 3 weeks. At 1-year follow-up near complete resolution of bony lesions with full range of motion in both upper limbs was noted. Conclusion: Subacute osteomyelitis may present with just bony swelling without significant pain or fever and can present a diagnostic dilemma, a high index of suspicion is important to rule out other conditions and diagnose osteomyelitis in such cases. Unusual organisms like Serratia can cause osteomyelitis in immunodeficient patients like those with sickle cell disease. Appropriate management in the form of thorough surgical debridement, saucerization, and appropriate antibiotics can lead to complete resolution of the infection with good clinical results. Keywords: Osteomyelitis, sickle cell disease, bilateral, serratia marcescens.
Management of Cervical Spine Metastasis from Renal Cell Carcinoma: A Rare Case Report with an Overview
Authors:   Department of Spine Surgery, Zydus Hospitals and Healthcare Research Private Limited, Ahmedabad, Gujarat, India, Macwan Anson Albert , Patel Nevish ,   Department of Spine Surgery, Zydus Hospitals and Healthcare Research Private Limited, Ahmedabad, Gujarat, India, Modi Yashvi ,   Department of Spine Surgery, Zydus Hospitals and Healthcare Research Private Limited, Ahmedabad, Gujarat, India, Modi Hitesh ,   Department of Spine Surgery, Zydus Hospitals and Healthcare Research Private Limited, Ahmedabad, Gujarat, India
Published: November 2024

Introduction: Renal cell carcinoma (RCC) accounts for 2–3% of adult malignant tumors, often metastasizing to bones, especially the spine. Spinal metastasis has a poor prognosis, but solitary spinal tumors have better outcomes with targeted chemotherapy, radiotherapy, and newer surgical approaches. Due to RCC’s high vascularity and resistance to treatments, en bloc vertebrectomy with anterior and posterior fixation is the gold standard for solitary lesions. This case report discusses a young man with C-7 cervical vertebrae metastasis, causing right upper limb weakness and severe neck pain. Case Report: A 43-year-old male presented with 4 weeks of neck pain (visual analogue scale score 7) radiating to the right upper limb, with tingling and numbness. Examination showed C7 tenderness, decreased power (4/5) in C7 and C8, and 50% reduced sensation. MRI revealed a metastatic hyperintense lesion at C7 causing collapse, anterior and posterior cortex bulging, anterior thecal sac indentation, and left neural foramen narrowing. He underwent anterior cervical thoracic exploration (C6-T1) with partial sternotomy, tumor excision, C7 corpectomy, cord decompression, MESH cage insertion, and anterior cervical plate fixation, followed by posterior C5–C6 lateral mass and T1–T2 pedicle screw fixation. Neurological power in C7–C8 improved from 4/5 to 5/5, and sensation reduction improved from 50% preoperatively to 10% at 12 weeks. Conclusion: Advancements in primary disease treatment necessitate evolving strategies for cervicothoracic metastasis. Combining extensive anterior and posterior techniques is now standard, enhancing patient quality of life through effective support and stabilization. Early diagnosis and referral are essential for pain relief and preventing neurological deficits and cord compression. Total en bloc vertebrectomy, the gold standard for solitary spinal metastasis, should include pre-operative embolization to reduce intraoperative bleeding. Prognosis relies on timely diagnosis, histological grading, and a comprehensive approach incorporating both medical and surgical treatments. Keywords: Renal cell carcinoma, spinal metastasis, en bloc, vertebrectomy, cervical vertebrae metastasis, anterior and posterior fixation.
Isolated Left Extensor Hallucis Longus Palsy Secondary to Deep Peroneal Nerve Injury in a 15-Year-Old Boy: A Case Report
Authors:   Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287,, Avendano John P , ElNemer William ,   Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287,, Cha Myung-Jin ,   Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287,, Erkilinc Mehmet ,   Department of Orthopaedic Surgery, Washington University in St. Louis, 1 Barnes Jewish Hospital Plaza, St. Louis, MO 63110, Lee Rushyuan Jay ,   Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287,
Published: November 2024

Introduction: Nerve palsies are potential consequences of fractures that can result in temporary loss of muscular function. Nerve palsies have not been extensively described in the context of tibial tubercle fractures in the pediatric population. Although the symptoms accompanying nerve palsies concern patients, evidence suggests that non-operative management often results in full functional recovery over time. Our case contributes to the available literature to demonstrate this point, even when neurologic deficits seem abnormally prolonged. Case Presentation: We describe a case of isolated left extensor hallucis longus (EHL) palsy in a 15-year-old African American male patient, who initially presented to our institution’s emergency department with a left knee injury. While playing basketball, he sustained a left proximal fibular shaft fracture with a displaced tibial tubercle. Open reduction and internal fixation were performed to stabilize the tibial fracture; however, he developed an EHL palsy that persisted for 3 months postoperatively. Nerve conduction studies found substantial left peroneal neuropathy. The patient received physical therapy throughout this time. With nothing other than non-operative management, he recovered full function 7 months after the initial injury with no further complications. Conclusion: We are aware of only 3 other published reports of isolated EHL palsy, each with unique causes. Our report may be one of the first documented cases of a tibial tubercle fracture with peroneal nerve palsy resulting in an isolated EHL deficit. It is important for clinicians and patients to be aware that even prolonged nerve and muscular deficits can be expected to resolve with non-operative management. Keywords: Extensor hallucis longus, peroneal nerve palsy, tibial tubercle fracture
A Prospective Case Series – Study of Neck of Femur Fractures in Elderly Patients with Pre-operative Urinary Tract Infection in Rural India
Authors:   Department of Orthopaedic, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India., Patil V Sandeep , Adithya N ,   Department of Orthopaedic, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India., Narendra B S ,   Department of Orthopaedic, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India., Varun V ,   Department of Orthopaedic, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, Karnataka, India.
Published: November 2024

Introduction: The annual incidence of fractured neck of femur in the elderly continues to rise year after year. Longer lifespan also contributes to the increase in the incidence of fracture neck of femur. Contributing factors include genetic factors, reduced bone mineral density, physical inactivity, aging population, and environmental factors such as diet and vitamin D levels. Urinary tract infections (UTIs) are common in elderly population, especially females with associated risk factors such as diabetes mellitus, obesity, malnutrition, immunosuppression, and malignancies. Case Report: A series of 10 cases of either gender above 55 years with fractured neck of femur associated with UTI were included in the study. All patients were clinically assessed for UTI supported with laboratory evidence of urine cultures followed by medical management for control of UTI, before surgery. Patient was operated using cemented modular bipolar prosthesis with antibiotic bone cement for femoral stem implantation only after the infection was under control. Conclusion: Diagnosis and control of UTI are of utmost importance before operating patients with fracture neck of femur with hemiarthroplasty. Keywords: hemiarthroplasty, pre operative urinary tract infection, cemented bipolar prosthesis, posterior hip approach ,neck femur fracture
Transient Osteoporosis of Hip as a Part of “Long COVID-19”: A Case Series
Authors:   Department of Orthopaedics, P D Hinduja Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim (West), Mumbai, Maharashtra, India., Agarwala Sanjay , Vijayvargiya Mayank ,   Department of Orthopaedics, P D Hinduja Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim (West), Mumbai, Maharashtra, India., Upadhyay Avinashdev ,   Department of Orthopaedics, P D Hinduja Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim (West), Mumbai, Maharashtra, India.
Published: November 2024

Introduction: Transient osteoporosis of the hip (TOH) presents with symptoms such as groin pain, discomfort, and the presence of bone edema detected on magnetic resonance imaging (MRI) scans. We have observed an increase in the occurrence of TOH in patients following the COVID-19 pandemic. Case Report: In this series, we present four cases of TOH that developed after COVID-19 infection. The average cumulative dose of prednisolone exposure in these cases was 788 mg (range 300–1050 mg). The mean duration between diagnosis and COVID-19 infection was 102 days (range 90–123 days). The average duration from the resolution of symptoms to the initiation of bisphosphonate therapy was 98 days (range 90–120 days). Conclusion: Bisphosphonate therapy appears to be an effective pharmacological treatment for TOH, providing rapid pain relief and shortening the disease’s natural course. This study demonstrates positive outcomes, including normalized MRI results and no progression to avascular necrosis, suggesting bisphosphonates as a promising management option for TOH patients. Keywords: Transient osteoporosis of hip, bisphosphonates, long COVID-19.
"England was simply a world": George Lamming's The Emigrants as Cultural Decolonization
Authors: Ozawa Shizen
Published: November 2024

Abstract: While the significance of George Lamming's second novel The Emigrants (1954) as a ground-breaking work of Black British literature is widely acknowledged, my essay re-examines the novel as a serious exploration of the possibility of cultural decolonization for West Indians. In particular, I consider the implications of the psychological turmoil of some characters after their arrival in England, as well as the connections between the different phases of their emigration. The emigrants' voyage destabilizes their worldview and allows them to start forming a West Indian identity, which Lamming deems a crucial starting point for cultural decolonization. Yet their collective psychological strain, which partly results from their shocking encounter with racism in England, reveals that internalized colonial values still deeply condition their mindsets and obstruct further development of cultural decolonization. The novel's ending, however, subtly points to the emergence of a new solidarity based on a clearer understanding of the cultural conditioning in question. In highlighting both a certain degree of liberation of the mind and the enormous difficulty in achieving it, The Emigrants elaborates a torturous yet crucial stage of cultural decolonization.
Dalit Writing in English: A Dalitification of the History of Indian Writing
Authors: Punia Aarushi
Published: November 2024

Abstract: This essay makes a pedagogical intervention in the theorisation of Indian writing in English (IWE). It asserts that postcolonial studies and anthologies of IWE have deliberately excluded Dalit writing, which narrates the caste discrimination experienced by the majority of the Indian population. It proves the discipline of IWE—the writing and its study—has been hegemonised by upper-caste writers and academics who disregard the historical presence and literary worth of Dalit writing. This essay proposes that Dalit writing in English (DWE) should be viewed as an independent area of study. It traces the history of Dalit writing through three waves in conjunction with Indian politics and argues that DWE achieved the "Dalitification" of English by challenging Brahmanical control over the language and introducing caste into the reading and writing of English from a Dalit perspective.
"Lacking Members of Play": Sexual/Textual Politics in J. M. Coetzee's Foe
Authors: Murdoch Albany
Published: November 2024

Abstract: This essay considers the divide between two camps of critics responding to the use and potential abuse of a white woman narrator in J. M. Coetzee's Foe (1986) and finds within the novel a critique of contemporaneous feminist discourses. I identify a rhetoric of rape deployed by the novel's protagonist, Susan, against the mute ex-slave, Friday, and consider its effect on Susan's ability to mediate between oppressed and dominant groups, represented by Friday and the author—(De)Foe—respectively. Ultimately, I argue that Susan's curiously masculine sense of desire complicates the charge that Coetzee is simply appropriating the voice of a woman, finding instead that he utilises Susan's attempted penetration into Friday's silence to demonstrate the faults of a second-wave feminism that exploits various categories of otherness.
Whiteness and the Animal Question: Revisiting Coetzee's Postapartheid South Africa
Authors: Brings Rebecca
Published: November 2024

Abstract: Scholars such as Evan Mwangi argue that postcolonial animal studies is all too often considered through white environmentalist perspectives, a point exemplified by the critical focus on white perspectives provided by writers such as J. M. Coetzee, Barbara Gowdy, and Lauren Beukes. Such focus bestows the authority to care for African natures to (white) Western visions of worldmaking. Mwangi's criticism suggests the white environmental discourses that have informed prominent readings of Disgrace (1999). The uncritical discourse of animal welfare in the post-colony has ties to apartheid governance and its rhetorical legacy. Through a comparative reading of Coetzee's Disgrace , the rhetoric of euthanasia used by animal welfare organizations, and contemporary reporting on the state of the animal, I outline a historical centering of white environmentalism—in particular welfarism—in institutional South African discourses about the animal. In opposition to assertions that the animal becomes a vehicle of redemption for the main character, David Lurie, and other redemptive readings of white characters in the novel such as Bev Shaw, I suggest that Disgrace reveals the legacies of white nationalist imaginaries that continue to undergird state and institutional environmental discourses in South Africa. The purportedly humane ideologies of animal population control and welfare perpetuate white interests. Disgrace reveals the tension between institutional expressions of care and the forceful integration of postcolonial nations into global markets, which sustain colonial legacies of white worldmaking.
(Im)Possibilities of Development: Women and the Paradox of Growth in the Malaysian Novel
Authors: Saxena Vandana
Published: November 2024

Abstract: Though women figure prominently in the discourses of postcolonial nations that concern development, these discourses position women in a way that vacillates between tradition, which needs to be preserved, and modernization, essential for "catching up" to the developed or so-called first world. This article approaches the ambivalence surrounding the question of women and development through the lens of literature. It turns to two turn-of-the-century novels, Chuah Guat Eng's Echoes of Silence (1994) and Yang-May Ooi's The Flame Tree (1998), to problematize the depiction of the "Third World" woman and development in colonial and postcolonial Malaysia. The article explores the coloniality embedded within narratives of growth of the women protagonists against the backdrop of the developing nation—and highlights when the conditions for women underwent far-reaching changes, for instance, at the end of colonial rule, when women became a part of an independent social and political nation, and persistent structures of marginalization and discrimination resulted in decreased opportunities for women. The article's focus on Malaysian Chinese writers foregrounds the colonial constructions of race and gender that Malaysia inherited from the colonizers, which continues to shape the lives of postcolonial subjects. The two novels provide a glimpse of the problems underlying the developmental agendas in postcolonial nations and call for a shift in the understanding of development—from a prescriptive sense of "how it should be for the third-world women" to a consideration of national and global frameworks of development that limit the choices and agency of women.
A Greek American Cold Warrior: George E. Phillies and the Greek Civil War, 1946–1949
Authors: Lialiouti Zinovia
Published: November 2024

Abstract: George E. Phillies, a prominent Greek American and chairman of the Justice for Greece Committee, was an ardent anticommunist who took an interest in themes of growing importance in American public debates of the late 1940s: the Greek Civil War (1946–1949) and US intervention in Greece as inaugurated by the Truman Doctrine (1947). Phillies's social status, hybrid identity, and networking with American and Greek elites were decisive for his emergence as an influential cold warrior at a crucial period for both US-Greek relations and US strategy in the Cold War. His public role was important in the legitimization of the Truman administration policy toward Greece. He used his ties to Greece to construct a supposedly factual account of the Greek Civil War that undermined alternative narratives and criticism of US actions. Phillies represents a case of ethnic anticommunism. His discourse highlights the hybrid, transatlantic dimension of Greek American identity in the mid-twentieth century and the interaction between ideological and ethnic conceptions of identity. His case is revealing for the role of anticommunism in the identity formation process and integration practices among migrants in post-World War II American society.
Culinary Complexities in Turkey and Greece: On Food, Nation, and Identity in the Aegean
Authors: Örs İlay Romain
Published: November 2024

Abstract: Relations between Greece and Turkey are often imagined in binary terms. A common question typifies such bilateral thinking: Is baklava Greek or Turkish? Popular discussions attaching national labels to select dishes present food as a site for showcasing competitive and stereotypical conceptualizations of identity. In Greece and Turkey, cuisines have been integral elements of nation-building processes that display forms of gastronationalism, which can be traced in debates over the origins of food items that take place in everyday discourse or on international platforms. Challenging such formulations based on "methodological nationalism," which restricts the analysis of cultural processes to those conducted by nation-states, the proposed perspective of "culinary complexities" both underlines the difficulty of containing cultural processes within the confines of nation-states and recognizes recent trends regarding food as a realm in which to express regional identifications that defy and diversify dualities between Turkey and Greece in the shared social ecology of the Aegean.
Freedom's Course: Hegel's Concept of World History and the Greek War for Independence (1821–1831)
Authors: Ruprecht Louis A.
Published: November 2024

Abstract: A little-remarked aspect of Hegel's lecture courses on the philosophy of world history is that he delivered them five times during a nine-year period (1822–1831) that aligns almost perfectly with the years of the Greek War for Independence. If Hegel was tracking the French and Haitian Revolutions while writing The Phenomenology of Spirit , then he may have been similarly tracking the Greek Revolution when delivering these lectures. What Hegel had done conceptually in 1807 in his Phenomenology of Spirit , he now intended to do historically in this lecture course: namely, to theorize the historical course of human freedom. Since these lectures represent the first text of Hegel's to be translated into English (in 1857), and since they had been translated into Italian even earlier (1840), Hegel's contention that freedom from domination was the moral aim of world history would provide philosophical support for abolitionist and other emancipatory freedom movements in Europe and the Americas. Equating domination by tyrants with slavery would also inspire national independence movements from Greece to Italy and New Spain. Hegel's romantic account of Greece's emancipation from domination, in antiquity and the present, seemed to speak in favor of such nationalist uprisings. At the same time, his concern with the devolution of the French Revolution left him ambivalent about revolution as a political praxis. His lectures would strike both notes as the Greek Revolution unfolded.
During haptic communication, the central nervous system compensates distinctly for delay and noise
Authors: Eden Jonathan , Ivanova Ekaterina , Burdet Etienne
Published: November 2024

Physically connected humans have been shown to exploit the exchange of haptic forces and tactile information to improve their performance in joint action tasks. As human interactions are increasingly mediated through robots and networks it is important to understand the impact that network features such as lag and noise may have on human behaviour. In this paper, we investigated interaction with a human-like robot controller that provides similar haptic communication behaviour as human-human interaction and examined the influence and compensation mechanisms for delay and noise on haptic communication. The results of our experiments show that participants can perceive a difference between noise and delay, and make use of compensation mechanisms to preserve performance in both cases. However, while noise is compensated for by increasing co-contraction, delay compensation could not be explained by this strategy. Instead, computational modelling suggested that a distinct mechanism is used to compensate for the delay and yield an efficient haptic communication.