Case: A 25-year-old man presented with cauda equina syndrome after a fall from height. Imaging revealed an isolated transverse sacral fracture with contiguous S1 to S4 fracture lines, creating a distinctive “stepladder” morphology without significant canal compromise. The fracture was managed conservatively. Neurological status improved from ASIA Grade C to D, with recovery of perianal sensation and bladder function. At 12 months, the patient demonstrated clinical recovery, with improved functional outcome. Conclusion: This unique “stepladder pattern” transverse sacral fracture demonstrated excellent neurological recovery with conservative management in selected patients without progressive deficits.
Case: Fractures involving the physeal plate can lead to physeal bar formation and growth disturbance. Rotational deformities due to growth arrest is not widely reported in literature. We present a rare case of proximal humerus growth arrest leading to humerus varus, shortening, and a 360 external rotation deformity of the humerus which was surgically treated and had a reasonable clinical outcome. Conclusion: We report an extremely rare case of 360° rotational deformity of humerus along with varus and shortening caused by growth arrest. This case reiterates the potential use of growth modulation for correcting rotational deformities.
Case: A 20-year-old immunocompetent man developed spondylodiscitis 2 months after near-drowning with vehicular submersion. Scedosporium species identified in sputum during admission was initially considered colonization. Diagnosis was eventually confirmed through biopsy. Treatment with voriconazole was discontinued prematurely at 6 weeks due to an allergic reaction, but clinical recovery was favorable at 1-year follow-up. Conclusion: Approximately 15 cases of Scedosporium apiospermum spondylodiscitis have been reported, with a minority occurring in immunocompetent patients following near-drowning. This case highlights that pathogens identified after submersion should not be dismissed as colonization, as delayed invasive infection may occur even in immunocompetent individuals.
CASE:A seventy-six-year-old woman with a prior total hip arthroplasty (THA) presented with instability requiring component revision. Seated imaging was used to understand functional component orientation in a position of high risk for posterior dislocation. Successful acetabular revision was performed using a polar axis angle (PAA)-driven approach to optimize postoperative stability. THA stability was maintained at 1-year and 2-year follow-up by imaging and clinical examination. CONCLUSION:This case report applies the novel concept of the PAA, a method for assessing the mechanical stability of hip prostheses, in preoperative planning for a revision THA secondary to instability. This report highlights the utility of the PAA to guide acetabular revision, reduce dislocation risk, and achieve favorable short-term clinical outcomes.
CASE:A 55-year-old man underwent total knee arthroplasty (TKA) for advanced osteoarthritis. A small preoperative Baker's cyst enlarged postoperatively, causing progressive posterior knee swelling and restricted flexion. Conservative treatment, including aspiration and corticosteroid injection, failed. Posteromedial arthroscopic decompression was performed. At 14-month follow-up, the patient was pain-free with full range of motion and no clinical evidence of recurrence. CONCLUSION:Posteromedial arthroscopy is an effective minimally invasive option for persistent symptomatic Baker's cysts following TKA.
