Traumatic rupture of the extensor hallucis longus (EHL) is an uncommon finding in an outpatient setting. Surgical repair is typically necessary, particularly in chronic conditions that have persisted for six weeks or more. While several studies have reported EHL repair using autograft tendons, rehabilitation regimes vary, and standardized protocols have not yet been established. This case report presents with an inability to extend her left great toe. She underwent tendon reconstruction with an autograft semitendinosus tendon. At an 8-week follow-up, the patient reported greatly improved outcomes on the American Orthopaedic Foot and Ankle Society, Foot and Ankle Ability Measure, Foot and Ankle Disability Index questionnaire. Full recovery was achieved 12 weeks after surgery. The use of autograft semitendinosus tendon repair for chronic EHL tendon rupture, in conjunction with rehabilitation program, can be expected to yield favorable results.
Improvements in microsurgical and neuroanesthesiological have resulted in an increasing number of operation for aneurysm clipping in elderly patients. It is the purpose of this article to evaluate surgical outcome of elderly patients(stand point of three groups), considering neurologic grade on admission, amount of subarachnoid hemorrhage(SAH) on computerized tomography(CT) findings and timing of surgery.
The subjects of the present study are 34 patients who were admitted to department of neurosurgery and treated surgically between 1991 and 1997 in Mok-Dong and Tongdaemun hospital. All the patients in this study were verified as having aneurysmal SAH on CT scanning followed b cerebral argiography. The patients were classified by age into three groups : 65 to 70 years(24 cases), 76 years(7 cases) and 76 years or older(3 cases). On admission, the clinical condition of patients was graded according to the scals of Hunt and Hess and the amounts of SAH was graded according to grading system of Fisher. The day 7 SAH was defined as Day O. the timing of operation was divided into three. 1-3 days ; 3-7 days; 8-days.
The surgical mortality according to the different age groups, Hunt-hess grade, grading system of Fisher and timing of operation was analised.
Overall, 11 of the 34 patients died, for a mortality rate 32%. The mortality rate by age groups was 21% for 65 to 70 years, 57% for 71 to 75 years and 20% for 76 years of older. The mortality rate by Hunt-Hess grade was 35%, in I-II, 33% in III and 20% in IV-V, and the mortality rate as related to grading system of Fisher was 0% in 1, 36% in 2, 36% in 3 and 25% in IV. The mortality rate according to timing of operation was 31% in 1-3 days, 25% in 3-7 days and 25% in over days.
In recent years, with improvement in surgical technique and neuroanesthesia, the number of operation for ruptured aneurysm have increased in elderly patient. A more aggressive treatment in elderly patients is justified.
Spontaneous renal rupture with subcapsular renal hematoma is a rare disease entity. Hereby, we report a 60-year-old female who presented with abrupt right flank pain and was diagnosed as spontaneous renal rupture with subcapsular hematoma related to urinary tract infection and review related literatures.