Ortopedia Pediátrica
Permanent URI for this community
Browse
Browsing Ortopedia Pediátrica by Author "Arcângelo, J"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- Bilateral Hip Heterotopic Ossification with Sciatic Nerve Compression on a Paediatric Patient–An Individualized Surgical Approach: A Case ReportPublication . Nóbrega, JP; Jordão, P; Arcângelo, JBackground: Neurogenic heterotopic ossification is an acquired serious complication described in patients with central nervous system disorders and defined by bone formation in non-osseous tissue. Case summary: We present an unusual case of a 13-yr-old boy presenting with hip pain and severe gait impairment 5 mo after the diagnosis of hemiplegia following a spontaneous intracerebral haemorrhage. Computed tomography revealed bilateral heterotopic ossification of both the paretic and the non-paretic limbs, with entrapment of the sciatic nerve. The choice of surgical or nonsurgical management of such patients depends on the timing of diagnosis, the symptoms, and the extent of maturation of the ossified lesions. Surgical resection remains the only treatment with proven, evidence-based effectiveness. The choice of surgical approach largely depends on the location of the ossified lesions. Conclusion: We believe the plane of dissection presented is a satisfactory option for resection of a posteromedial mass and sciatic nerve release.
- Carpal Synovitis with Capitate Bone Tuberculosis in a ChildPublication . Grenho, A; Arcângelo, J; Jordão, P; Gouveia, CWe present a 10-year-old boy with 2-month duration non-traumatic wrist pain and inflammatory signs. Due to elevated inflammatory markers on blood tests, with an increase in radiocarpal and intercarpal joints synovial fluid and no bony lesions, the patient was submitted to wrist arthrocentesis for the suspicion of septic arthritis. The patient did not improve on conventional treatment, however. An MRI showed synovitis around the carpus and a lytic lesion of the capitate bone due to osteomyelitis. A biopsy was able to identify the causative agent as Mycobacterium tuberculosis, and the patient was treated with antibiotics. He improved significantly, with no pain and signs of normal capitate bone remodelling on the last radiograph.
- Pinckney Fracture: do Not Underestimate Trauma of the Distal Phalanx of the HalluxPublication . Nóbrega, J; Ovídio, J; Arcângelo, J; Campagnolo, JToe injuries are common in the emergency department and most of them are treated conservatively. In some circumstances, these injuries can present as a physeal fracture with concomitant soft-tissue injury affecting the nail bed and resulting in a hidden open fracture. To adequately treat these patients, a high index of suspicion is needed to diagnose and treat the open fractures and to prevent complications such as infection, osteomyelitis, malunion and premature physeal arrest.We report a case of a patient that was admitted to the hospital with a Salter-Harris type I fracture of the distal phalanx of the hallux. After confirming the diagnosis, antibiotic treatment was started and the fracture was reduced and fixed.The literature on this entity is sparse and most of the management protocols are based on its hand equivalent-the Seymour fracture, emphasising the low threshold for treating these lesions as an open fracture.
- Sacroileítis Piógena: Lecciones Aprendidas de una Serie de Casos AtípicosPublication . Arcângelo, J; Norte Ramos, S; Alves, P; Tavares, D; Gouveia, CPyogenic sacroiliitis (PSI) is a rare condition that amounts to 1% to 2% of all joint infections in the paediatric age group. Its diagnosis is often difficult and delayed due to its nonspecific signs, symptoms and physical findings. Also, the identification of the causative microorganism is frequently challenging due to a high proportion of negative blood cultures and the risks involved in joint aspiration in this site.