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Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of the Literature

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 19-21 | Bishnu Pokharel, Rosan Prasad Shah Kalawar, Ashish Kumar Goyal Author: Bishnu Pokharel [1], Rosan Prasad Shah Kalawar [1], Ashish Kumar Goyal [1] Department of Orthopaedics, BPKIHS, Dharan, Nepal. [2] Department of Orthopaedics and Joint Replacement Surgery, Indrparastha Apollo Hospitals, Sarita Vihar, New Delhi, […]

Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture- Dislocation with Extensor Tendon Injury

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 15-18 | Divyesh V. Bukalsaria, Sachin Kale, Prakash D. Samant, Arvind Vatkar, Sanjay Dhar, Prasad Chaudhari Author: Divyesh V. Bukalsaria [1], Sachin Kale [1], Prakash D. Samant [1], Arvind Vatkar [1], Sanjay Dhar [1], Prasad Chaudhari [1] [1] Department of Orthopaedic Surgery, D Y Patil […]

Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of the Literature

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture- Dislocation with Extensor Tendon Injury

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

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Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of the Literature

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 19-21 | Bishnu Pokharel, Rosan Prasad Shah Kalawar, Ashish Kumar Goyal

Author: Bishnu Pokharel [1], Rosan Prasad Shah Kalawar [1], Ashish Kumar Goyal

[1] Department of Orthopaedics, BPKIHS, Dharan, Nepal. [2] Department of Orthopaedics and Joint Replacement Surgery, Indrparastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
Address of Correspondence
Dr. Ashish Kumar Goyal
Senior Registrar; Department of Orthopaedics and Joint Replacement Surgery Indrparastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
Email: drgoyal41@gmail.com

Abstract

Introduction: Rupture of the anterior cruciate ligament (ACL) is a common injury in active people and one of the most common knee injuries in sports. Foreign body granuloma with concomitant infection is a rare complication in ACL surgery. Very few cases have been reported on it. We present a young patient with a chronic discharging sinus at a surgical site on the tibia in a diabetic patient and its successful management.

Case Report: A thirty-two-year-old male presented to us with a persistent discharging sinus at the surgical site following an Anterior Cruciate Ligament (ACL) reconstruction two years back. Since then, he developed wound infection at the incision site created for graft harvesting, which kept on discharging sero-purulent discharge even with several antibiotics and local dressing courses. There was no stiffness or instability in the knee. We did a follow-up arthroscopic evaluation of the joint and debridement of the wound. A portion of hamstring graft and non-absorbable suture with unhealthy granulation tissues were found subcutaneously during the surgery. A partially resorbed bioscrew with unhealthy granulation tissue was observed in the tibial tunnel. After thorough debridement of the site, the wound completely healed.
Conclusion: Surgical site infection and foreign body granuloma should be considered and treated accordingly if the patient presents with persistent discharging sinus at the surgical site in ACL reconstruction
Keywords: Anterior cruciate ligament reconstruction, ACL, Surgical site infection, Tibial tunnel.

References

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2) Weiss KS, Weatherall JM, Eick J, and Ross JR. (2017). Delayed Tibial Osteomyelitis after Anterior Cruciate Ligament Reconstruction with Hamstrings Autograft and Bioabsorbable Interference Screw: A Case Report and Review of the Literature. Case Reports in Orthopedics. 2017; 1-7. doi:10.1155/2017/6383526.
3) Barber FA. Complications of Biodegradable Materials. Sports Medicine and Arthroscopy Review. 2015; 23(3):149-155. doi:10.1097/jsa.0000000000000076.
4) Barber FA. Complications of biodegradable materials: anchors and interference screws. Sports Medicine and Arthroscopy Review. 2015;3(3):149–155.
5) Frank M, Schmucker U, David S, et al. Devastating femoral osteomyelitis after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthr. 2008;16: 71–74. https://doi.org/10.1007/s00167-007-0424-7.
6) McAllister DR, Parker RD, Cooper AE, Recht MP, and Abate J. Outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction. Am J Sports Med. 1999;27 : 562- 570.
7) Van Tongel A, Stuyck J, Bellemans J, and Vandenneucker H. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction: a retrospective analysis of incidence, management and outcome. Am J Sports Med. 2007; 35 : 1059 – 1063.
8) Numazaki H, Kobayashi H, Yoshida K, Hakozaki M, and Konno SI. Prolonged infection at the tibial bone tunnel after anterior cruciate ligament reconstruction. Fukushima J Med Sci. 2017; 63(2):121-125. doi:10.5387/fms.2017-02. 9) O’Neill BJ, Molloy AP, and McCarthy T. Osteomyelitis of the tibia following anterior cruciate ligament reconstruction. International Journal of Surgery Case Reports. 2013;4(2): 143-145. doi: https://doi.org/10.1016/j.ijscr.2012.10.020.
10) Chua CG and Zubair M. A Modified Technique To Treat Infected Tibial Tunnel Post ACL Reconstruction: A Case Report. Malaysian Orthopedic Journal. 2019;13supplA.

How to Cite this article: Pokharel B, Kalawar RPS, Goyal AK | Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of The Literature | Trauma International | January-June 2021; 7(1): 19-21.

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Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture- Dislocation with Extensor Tendon Injury

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 15-18 | Divyesh V. Bukalsaria, Sachin Kale, Prakash D. Samant, Arvind Vatkar, Sanjay Dhar, Prasad Chaudhari

Author: Divyesh V. Bukalsaria [1], Sachin Kale [1], Prakash D. Samant [1], Arvind Vatkar [1], Sanjay Dhar [1], Prasad Chaudhari [1]

[1] Department of Orthopaedic Surgery, D Y Patil Medical College and Research Centre, Navi Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Divyesh Vinod Bukalsaria,
Resident Physician, Department of Orthopaedic Surgery, D Y Patil Medical College and Research Centre, Navi Mumbai, Maharashtra, India.
E-mail: divyeshbukalsaria7@gmail.com

Abstract

Compound fracture-dislocations of proximal carpal bones are very rare. We report a 54-year-old male, laborer, who sustained a compound Gustilo Anderson type III-A dorsal wound with trans styloid, trans-scaphoid, peri-lunate dislocation with an extensor tendon injury. The patient underwent primary scaphoidectomy with Lunocapitate fusion with extensor tendon repair. On follow-up after 3 months, the patient had partial recovery of range of motion around the wrist without any significant discomfort.

Keywords: Compound fracture-dislocation, Primary proximal row carpectomy, Trans-styloid trans scaphoidperilunate dislocation

References

1. Ali, Nadeem, et al. “Compound Transstyloid, Transscaphoid, Perilunate Fracture Dislocation.” Journal of the Scientific Society, vol. 40, no. 2, 2013, p. 111., doi:10.4103/0974-5009.115485.
2. Herzberg, G., and D. Forissier. “Acute Dorsal Trans-Scaphoid Perilunate Fracture-Dislocations: Medium-Term Results.” Journal of Hand Surgery, vol. 27, no. 6, 2002, pp. 498–502., doi:10.1054/jhsb.2002.0774.
3. Calandruccio, James H., et al. “Capitolunate Arthrodesis with Scaphoid and Triquetrum Excision.” The Journal of Hand Surgery, vol. 25, no. 5, 2000, pp. 824–832., doi:10.1053/jhsu.2000.16364.
4. Oehmke, M. J., et al. “The Blood Supply of the Scaphoid Bone.” Journal of Hand Surgery (European Volume), vol. 34, no. 3, Dec. 2009, pp. 351–357., doi:10.1177/1753193408100117.
5. Mayfield, Jack K. “Patterns of Injury to Carpal Ligaments.” Clinical Orthopaedics and Related Research, & NA; no. 187, 1984, doi:10.1097/00003086-198407000-00006.
6. Herzberg G, Comtet JJ, Linscheid RL, et al. Perilunate dislocations and fracture-dislocations: a multicenter study. J Hand Surg Am.1993;18:768–79.
7. Herzberg, G., and D. Forissier. “Acute Dorsal Trans-Scaphoid Perilunate Fracture-Dislocations: Medium-Term Results.” Journal of Hand Surgery, vol. 27, no. 6, 2002, pp. 498–502., doi:10.1054/jhsb.2002.0774.
8. Herzberg, G., et al. “Perilunate Dislocations and Fracture-Dislocations: A Multicenter Study.” The Journal of Hand Surgery, vol. 18, no. 5, 1993, pp. 768–779., doi:10.1016/0363-5023(93)90041-z.
9. E. Hagert, M. Garcia-Elias, S. Forsgren, B.O. LjungImmunohistochemical analysis of wrist ligament innervation in relation to their structural composition
10. J Hand Surg, 32 (2007), pp. 30-36
11. Moody, Lisa, and Andrew Y. Zhang. “Treatment of an Unusual Trans-Scaphoid Perilunate Avulsion Fracture Dislocation: A Case Report.” Hand, vol. 10, no. 2, Mar. 2014, pp. 328–332., doi:10.1007/s11552-014-9634-x.
12. Sotereanos DG, Mitsionis GJ, Giannakopoulos PN, et al.Perilunate dislocation and fracture-dislocation: a critical analysis of the volar-dorsal approach. J Hand Surg Am. 1997;22:49–56.
13. Yao, Yu-Cheng, et al. “Lunocapitate Fusion with Scaphoid Excision for the Treatment of Scaphoid Nonunion Advanced Collapse or Scapho-Lunate Advanced Collapse Wrist.” Journal of the Chinese Medical Association, vol. 80, no. 2, 2017, pp. 117–120., doi:10.1016/j.jcma.2016.10.001

How to Cite this article: Bukalsaria DV, Kale S, Samant PD, Vatkar A, Dhar S, Chaudhari P | Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture-Dislocation with Extensor Tendon Injury | Trauma International | January-June 2021; 7(1): 15-18.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of the Literature

Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture- Dislocation with Extensor Tendon Injury

Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of the Literature

Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture- Dislocation with Extensor Tendon Injury

Full Sized Blog Element (Big Preview Pic)

Chronic Tibial Tunnel Infection Following ACL Reconstruction: A Case Report and Review of the Literature

Author: Bishnu Pokharel [1], Rosan Prasad Shah Kalawar [1], Ashish Kumar Goyal

Abstract

References

(Article Text HTML) (Download PDF)

Acute Scaphoidectomy and Lunocapitate Fusion for the Surgical Treatment of Compound Trans Styloid, Trans-Scaphoid, Peri-Lunate Fracture- Dislocation with Extensor Tendon Injury

Author: Divyesh V. Bukalsaria [1], Sachin Kale [1], Prakash D. Samant [1], Arvind Vatkar [1], Sanjay Dhar [1], Prasad Chaudhari [1]

Abstract

References

(Article Text HTML) (Download PDF)

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