Bulent Kilic

A case of schwannoma of the common peroneal nerve in the knee

Schwannomas are benign neurogenic tumors of peripheral nerves that originate from neural sheath. The aim of this case report is to bring to mind the schwannoma in the patient with knee pain. A 39-year-old woman presented with a complaint of knee pain of three months history. After surgical intervention, the patient’s complaints completely disappeared in the post-operative period. This should come to mind in the differential diagnosis of knee pain.

Deep peroneal nerve palsy due to osteochondroma arising from fibular head and proximal lateral tibia

Highlights • Osteochondroma are the most common benign tumors.• Disease affecting knee joint in 94% of all cases.• Clinicians should be aware of the possible tumoral lesions in drop foot etiology.

Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections: a report of two cases.

Intermittent negative pressure wound therapy with instillation (NPWTi) is starting to be used successfully to treat early periprosthetic infections of endoprostheses. However, few articles have reported the outcome of treatment with intermittent NPWTi for late persistent periprosthetic infections of the hip. In this study, we report two cases who underwent several rounds of radical wound debridement for the treatment of a late persistent periprosthetic infection of the hip. Intermittent NPWTi was used in both cases. Patients were treated successfully and there was no recurrence after 3 and 1 years of follow-up, respectively.

Comparison between two anatomic landmarks using ultrasonography in spinal anesthesia: a randomized controlled trial.

Abstract Background and objective: Tuffier’s line is the most used anatomic landmark in clinical practice. We aimed to compare the accuracy of Tuffier’s line with a landmark that joins the two lowest points of the tenth rib on the flanks with the help of ultrasound. Methods: A prospective, randomized, controlled, double-blinded trial was performed with 200 patients aged between 18 and 50. Patients taller than 180 cm or shorter than 150 cm, or with body mass index >30 kg/m2 were excluded. The first anesthesiologist examined Group T according to Tuffier’s line and Group R according to the tenth rib line and marked L4–5. Only one anesthesiologist evaluated the marked level with ultrasound for accuracy of the anesthesiologist’s examination. Results: There was no difference between groups for demographic and surgical data (p > 0.05). However, we observed a significant difference between the two techniques for success rate (60% in group T vs. 74% in group R) at estimation of correct level (p < 0.05). There was no correlation between success of estimation and patients’ demographic data. Conclusion: We conclude that the tenth rib line is better than Tuffier’s line for accuracy with palpation. However, it must be confirmed by further studies including more than one examiner for palpation and also include different patient populations.

Effects of Local Application of Nano-silver on Osteomyelitis and Soft Tissue Infections: An Experimental Study in Rats

Purpose: Bone and soft tissue infections are among the least desired complications after orthopaedic surgery. This study analysed the in vivo effects of the local application of nano-silver particles (AgNPs) [1nm = 1 billionth of a meter] in soft tissue infections. Materials-Method: An experimental osteomyelitis model was formed by inoculating both tibias of 24 rats with methicillin-resistant Staphylococcus aureus. The rats were followed without treatment for 21 days. Blood samples and tibial x-rays at day 21 confirmed the development of infection. Then, the rats were divided randomly into two groups. One group (12 rats) underwent surgical debridement and received 21 days of teicoplanin therapy. The second group had the same treatment, with the addition of local nano-silver. All of the rats were sacrificed at day 42. Blood and wound swab samples were taken and the culture results were analysed. Results: No differences were observed between the groups in healing values at pathological examination, or in changes in the number of colonies at days 21 and 42. No differences in white blood cell count (WBC) were observed between the groups before and after the treatment. Conclusion: Although in vitro studies suggest the effectiveness of AgNPs on pathogens, we found that the application of nano-silver did not make any difference when used in addition to the classical osteomyelitis treatment with antibiotics and local surgical debridement. We believe that additional in vivo studies using repeated nano-silver application could be beneficial.

An Unusual Orthopaedic Disease: Sarcoidosis—A Case Report

Sarcoidosis is an idiopathic, noncaseating granulomatous disorder with wide systemic involvement. It is encountered widely around the world and it affects both sexes, all the races in all age groups. Lungs, eyes, and skin are the organs most commonly affected. Constitutional features such as weight loss, fatigue, and myalgia are the most common symptoms. Bone involvement, which is very rare, was reported as present in 3 to 13% of effected cases, and it is most commonly seen in hands and feet, compared with long bone involvement, which is extremely rare. We hereby present a case with a diagnosis of sarcoidosis and multiple bone involvement emphasizing the importance of differential diagnosis.

A rare case of a medullary, multifocal lesion in the distal radius

In multifocal findings, the possibility of multifocal osteoid osteomas should be considered and this case helps us to be attentive for the unusual radiographical presentation of osteoid osteoma.

Endometrial adenocarcinoma recurrence presenting with tibial metastasis: Report of a case

Highlights • Endometrial adenocarcinoma recurrence in tibia after 2 years of total abdominal hysterectomy and bilateral salpingo-oophorectomy.• Endometrial adenocarcinoma metastasis to skeletal system is extremely rare and mostly have been reported to be in axial skeleton.• Fresh frozen femoral allograft was used after wide resection for the metastatic adenocancer area of the tibia and provided the bone union.• Wide resection and reconstruction with an allograft might be an option to increase survival and possible cure of the patient as seen in our case.

Preiser's disease in a five-fingered hand.

Abstract Preiser’s disease, also known as idiopathic avascular necrosis of the scaphoid, and five-fingered hand are rare hand conditions. In this report, we present a case of a 25 year old female patient who had avascular necrosis of the scaphoid and five-fingered hand.