Maisonneuve injury with no fibula fracture:A case report

BACKGROUND Ankle syndesmosis injury is difficult to diagnose accurately at the initial visit.Missed diagnosis or improper treatment can lead to chronic complications.Complete syndesmosis injury with a concomitant rupture of the interosseous membrane(IOM)is more unstable and severe.The relationship between this type of injury and Maisonneuve injury,in which the syndesmosis is also injured,has not been discussed in the literature previously.CASE SUMMARY A 16-year-old patient sustained left medial malleolar fracture,and the associated inferior tibiofibular syndesmotic instability was overlooked.After open reduction and internal fixation of the medial malleolar fracture,inferior tibiofibular syndesmosis diastasis with IOM rupture was detected by auxiliary imaging.Secondary surgical intervention was performed to reduce anatomically and fix with two trans-syndesmosis screws.Twelve weeks later,the screws were removed.At the 6-mo follow-up,the patient gained full range of motion of the ankle.CONCLUSION Complete syndesmosis injury with IOM rupture should be considered Maisonneuve-type injury.Open reduction and internal fixation could obtain good outcomes.

Delayed complications of intradural cement leakage after percutaneous vertebroplasty:A case report

BACKGROUND Intradural cement leakage following percutaneous vertebroplasty is a rare but acute and devastating complication that usually requires emergent treatment.Here,we report a delayed complication of intradural leakage after percutaneous vertebroplasty.CASE SUMMARY A 71-year-old female patient with an L1 osteoporotic compression fracture underwent percutaneous vertebroplasty in 2014.She was referred to our hospital 5 years later due to complaints of progressive weakness and numbness in both legs combined with urinary incontinence and constipation.Initially,she was suspected to have a spinal meningioma at the level of L1 according to imaging examinations.Postoperative pathological tests confirmed that cement had leaked into the dura during the first percutaneous vertebroplasty.CONCLUSION Guideline adherence is essential to prevent cement from leaking into the spinal canal or even the dura.Once leakage occurs,urgent evaluation and decompression surgery are necessary to prevent further neurological damage.

Closed reduction of hip dislocation associated with ipsilateral lower extremity fractures:A case report and review of the literature

BACKGROUND Traumatic hip dislocation usually occurs following high-velocity trauma.It is imperative that the dislocation be reduced in a timely manner,especially in a closed manner,as an orthopedic emergency.However,closed reduction can hardly be achieved in patients who also have ipsilateral lower extremity fractures.Herein,we focus on hip dislocation associated with ipsilateral lower extremity fractures,excluding intracapsular fractures(femoral head and neck fractures),present an early closed hip joint reduction method for this injury pattern,and review the literature to discuss the appropriate closed reduction technique for this rare injury pattern.CASE SUMMARY We report a case of a 37-year-old male who sustained a left acetabular posterior wall fracture,an ipsilateral comminuted subtrochanteric fracture and dislocation of the hip.The hip dislocation was reduced urgently in a closed manner using the joy-stick technique with a T-shaped Schanz screw.The fractures were reduced and fixed as a 2nd-stage surgery procedure.At the 17-month postoperative follow-up,the patient had full range of motion of the affected hip.CONCLUSION Closed reduction of a hip dislocation associated with ipsilateral lower extremity fractures is rarely achieved by regular maneuvers.Attempts at closed reduction,by means of indirectly controlling the proximal fracture fragment or reconstructing the femoral leverage rapidly with the aid of various external reduction apparatuses,were shown to be effective in some scenarios.Mandatory open reduction is indicated in cases of failed closed reduction,particularly in irreducible dislocations.

USP11通过去泛素化p53调控p53稳定性(英文)

研究目的:深入研究p53的泛素化及稳定性的调控。创新要点:发现一个新的调控p53去泛素化的酶USP11,它可以通过与p53的结合去泛素化并稳定p53,从而揭示了一个新的p53去泛素化调控的机制。研究方法:通过免疫共沉淀发现p53可以与USP11结合(图1a),通过泛素化检测试验发现USP11可以去泛素化p53(图3a和3b),最后通过逆转录-聚合酶链式反应(RT-PCR)试验发现在DNA损伤后,USP11对p53转录活性的提高是非常重要的。重要结论:USP11可通过去泛素化p53来调控p53稳定性。