Browse

You are looking at 1 - 10 of 2,044 items for :

  • Orthopaediatrics and Accident Surgery x
Clear All
Open access

R. Scott Kretchmar

Abstract

Loy and Morford focus on “agon” as an important window through which to understand human life and development. Competition in war and sport was culturally significant then, and it is culturally significant today, albeit in modified forms. In this commentary, I attempt to do two things – first, identify implications of some conceptual distinctions, and second, point out normative questions raised by the Loy/Morford analysis. I find it worthwhile to differentiate clearly between tests and contests. If the historical and sociocultural spotlight were turned on sporting “tests” rather than “contests”, that is, on trying to solve physically demanding problems well rather than trying to solve them better than at least one other party, then another story than the agonal account could be told. War would probably no longer serve as the best historical and prehistorical analogue for sport. Rather, it might be hunting. I add, that, on one hand, competitive sport is far less violent and, therefore, far more defensible today than it was previously. On the other hand, joy in playing is often sacrificed on the altar of any number of extrinsic rewards. Success, even gained by questionable means, replaces skill-based and virtue-generated achievement. This threatens the connection endorsed by MacIntyre between practices and virtues.

Open access

Cornelia Nitipir, Cristina Orlov-Slavu and Lucian Alecu

Abstract

The second most frequent malignant tumor of the bone after osteosarcoma, chondrosarcoma is subdivided in conventional type, mesenchymal, clear cell, and the dedifferentiated subtype. Each of these pathological entities has a particular clinical behavior. For most, surgery remains the sole valid option. However, efficient systemic therapy options for advanced and metastatic cases are scarce. This short review is aimed at describing the latest options presented by current literature in these cases. Most of the data is derived from preclinical trials, but some drugs were also included in clinical research as far as phase two trials. After reviewing this data, it could be concluded that the future in unresectable or metastatic chondrosarcoma is personalized medicine and that more specific biomarkers to aid the choice are necessary.

Open access

Bilgin Emre, Vincenten Cornelis, Kati Yusuf Alper, Kose Ozkan and Kalenderer Onder

Abstract

Bilateral extensor tendon ruptures of the knee are not uncommon. However, simultaneous ruptures of the patellar tendon (PT) and contralateral quadriceps tendon (QT) are relatively rare injuries. These ruptures are frequently associated with chronic renal failure and minor trauma. However, they can occur spontaneously in healthy individuals. In this case report, a 43-year-old male with chronic renal failure who sustained bilateral extensor tendon ruptures (right knee: QT rupture, left knee: PT rupture) following an alternating current electrical shock was reported. To our knowledge, simultaneous quadriceps and contralateral patellar tendon rupture following an electric shock have not been reported yet. Etiology, mechanism of injury and treatment options of this rare injury are discussed together with a thorough literature review.

Open access

Ejgil Jespersen

Abstract

When reading the masterpiece about “The Agon Motif” by John W. Loy and W. Robert Morford (2019), I was struck by their recurrent reference to the pursuit of honor in agonal sport contests, as it has become common sense to replace honor with dignity in modernity. I take the German social-philosopher Axel Honneth (1995) as a prime example of spelling out the replacement of honor with dignity in what he names “the struggle for recognition”. In a historical perspective, however, it looks like, that dignity can be understood as a distribution of honor rather than as an oppositional concept of honor. Recognition should not only be conceptualized at the categorical level, but also understood in terms of ‘comparative recognition’, which sorts members of a group into an intra-group hierarchy based on their relative merits and, thereby, pave the way for self-esteem (Mark, 2014). Furthermore, Honneth (2008) develops his concept of recognition to a two-level one by including a primordial recognition in terms of mimesis based upon his former concept of basic self-confidence. It is a kind of elementary responsiveness, which always and necessarily contains an element of involuntary openness or devotedness in the bodily-affective sphere. Therefore, I suggest taking mimesis as the precondition of honor into account and understanding dignity as a distribution of honor in the institution of modern sport.

Open access

Monica Cirstoiu, Alexandru Baros, Florina Paulet, Delia Gradinaru-Fometescu, Bogdan Șerban, Bogdan Cretu and Cătălin Cirstoiu

Abstract

This article analyses a series of 22 confirmed cases of ovarian cancer throughout a period of 14 months (January 2018 - February 2019), in which we assessed the incidence of osseous metastases, in correlation with their histological features. This retrospective study, based on medical imaging techniques, demonstrates that bone metastases are not uncommon in ovarian cancer.

Open access

Traian Ciobanu, Ioan Mihau Japie, Octavian Nutiu, Alexandru Papuc, Dragos Radulescu and Radu Radulescu

Abstract

Periprosthetic joint infection is the most common reason for a failed TKA, with a septic TKA reported rate of 1 to 4% of primary TKA patients. Septic TKA has a various number of treatment options which include chronic-suppressive antibiotics, irrigation and debridement, single or staged revision arthroplasty. The goal is to eradicate the periprosthetic joint infection and reimplant a sterile and fully functional total knee prosthesis. In case the infection becomes uncontrollable, there is only one option to eradicate the infection: knee arthrodesis or above-knee amputation.

We report the case of a 63-year-old patient who in 2009 underwent TKA, the 1 year follow-up showed periprosthetic infection. At first stage, the prosthetic implants were removed and a solid cement spacer was shaped to occupy the remaining space. In 2011, after achieving complete clinical and biological remission of the infection, the cement spacer was removed and LCCK revision prosthesis was inserted.

In 2013 reinfection occurred leading to removal of the prosthetic implants and reinsertion of an antibiotic impregnated cement spacer.

Since the patient suffered significant bone loss and the local conditions were unfavorable, being prone to infection, there were 2 options to evaluate: knee arthrodesis or above knee amputation. We chose knee arthrodesis using Ilizarov external fixation technique.

Many surgical techniques are available to achieve knee arthrodesis: internal fixation with plates or intramedullary nails and external fixation. The Ilizarov method is a very effective technique that could be taken into consideration when knee arthrodesis is required.

Open access

Daniel Ion, Dan Nicolae Păduraru, Florentina Mușat, Octavian Andronic and Alexandra Bolocan

Abstract

The clinical signs and symptoms of an acute in increase intraabdominal pressure (IAP) are subtle, especially in the conditions of the polytraumatized patient. Thus, abdominal compartment syndrome (ACS) can brutally occur and can have a major impact on the body’s main organs and systems. The purpose of our research was to identify the influence of intraabdominal pressure, intra-abdominal hypertension, and abdominal compartment syndrome, in the evolution of polytraumatized patients. Our study analyzed the patients admitted in the IIIrd Department of General Surgery of University Emergency Hospital in Bucharest between 1st of January 2010 and 31st of December 2018. The value of intraabdominal pressure, on admission, correlated with the risk of IAH/ ACS in patients with abdominal trauma - being major causes of morbidity and mortality. IAP monitoring should become a mandatory part of the management plan for patients with abdominal trauma.

Open access

Monica Cirstoiu, Octavian Munteanu, Oana Bodean, Florina Paulet, Bogdan Șerban, Bogdan Cretu and Cătălin Cirstoiu

Abstract

This report represents an analysis of 19 confirmed cases of breast cancer throughout a period of 14 months (January 2018 - February 2019), in which we assessed the incidence and sites of osseous metastases, in correlation with their histopathologic classification. This retrospective analysis is based on medical imaging techniques (X-ray radiography and nuclear medicine functional imaging).

Open access

Ramona Dobre, Dan Niculescu, Gheorghe Popescu, Adrian Barbilian, Cătălin Cîrstoiu and Cătălina Poiană

Abstract

Introduction: Hip fracture is the most severe consequence of osteoporosis and an important cause of excess mortality in the elderly.

Objective: We aimed to evaluate the in-hospital mortality rate after osteoporotic hip fracture in patients treated surgically or functionally in specialized centers in Bucharest.

Materials and methods: We calculated the in-hospital mortality rate in 745 patients (540 women [72.48%], with a mean age of 79.1 ± 11 years), surgically or functionally treated for fragility hip fracture over a 12 months period.

Results: Average length of hospitalization was 18.12 days. In hospital mortality rate was 5.36% (n=40, women 60%). An important risk factor associated with mortality was age, p=0.001. The male sex was also a risk factor with a mortality rate of 7,8% (n=16), compared to 4.44% in women, p<0.005, with OR of 1.57. Out of the 40 patients, 57.5% had a femoral neck fracture, 35% intertrochanteric, and 5.5% atypical fracture in absence of bisphosphonates. 7.5% had previous fragility fractures. 85% of the patients had a history of one or more cardiac pathologies (34.28% with atrial fibrillation), 57.5% underwent surgical intervention (n=23) with an average day of intervention of 8.82 after admission. None of the patients had an osteoporosis treatment before the event and on average 3.73 medications with an increased risk of falling and fracture.

Conclusion: In-hospital mortality rate after hip fracture remains high; probably this being related to the high comorbidity associated with male sex and increased age as risk factors.

Open access

Alexandru Papuc, Ioan Mihai Japie, Traian Ciobanu, Octavian Nutiu, Dragos Radulescu and Radu Radulescu

Abstract

The GCT is an aggressive benign tumor with metastatic potential, most often within the lungs in 2-3% of the patients. It makes about 5% of total bone tumors and about 15% of total benign bone tumors.

The maximum incidence occurs between 30 and 40 years old, most frequently affecting the long bones epiphysis (distal femur, proximal tibia, and distal radius).

We report the case of a 50-year-old female, with no previous medical history, admitted in the emergency department (ED) for significant pain and functional impairment of the left knee. Clinical examination and imaging tests established the diagnosis of distal femoral tumor.

The patient underwent surgical segmental resection of the tumor within oncological limits and subsequent arthroplasty with cemented modular tumoral prosthesis was performed.

Even if the GCT is a benign tumor, it has an aggressive behavior and malignancy potential with an important impact on quality of life. Due to localization, this type of tumor can quickly manifest clinically, which allows an early diagnosis and a less invasive surgical technique.