Rukshan Sooriyarachchi - Academia.edu (original) (raw)

Uploads

Papers by Rukshan Sooriyarachchi

International Journal of Surgery Case Reports, Sep 1, 2021

Introduction and importance The ideal treatment of proximal humerus fracture remains a controvers... more Introduction and importance The ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome. Case presentation A 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion. Clinical discussion The ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar. Conclusion Although this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.

International Journal of Surgery Case Reports, May 1, 2022

INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint th... more INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint that occurs in infancy and has considerable morbidity. Reports on surgical management of severe hip dysplasia in adulthood secondary to TSA are extremely limited. We describe a patient who successfully underwent a bilateral total hip arthroplasty for the severely damaged hip joints secondary to TSA with satisfactory functional outcomes. CASE PRESENTATION A 25-year-old female was unable to walk for more than 10 ft due to pain in both hips and knees predominantly on the left side. She developed pyogenic septic arthritis with sepsis at 6 weeks of age and underwent multiple surgical procedures to drain the infection and for reconstruction. She had limited range of motion and was severely disabled. She underwent an uneventful left total hip arthroplasty and two years later, a right total hip arthroplasty using S-ROM modular hip systems. The pre and post-operative Harris Hips scores were 53.4 (left), 46 (right) and 95.7 (left), 89.65 (right), respectively. CLINICAL DISCUSSION Detailed preoperative evaluation of the anatomy was paramount. Assessment of the limb-length discrepancy by means of scanogram, templating the anatomy with computed tomography and planning the anatomical location of the centre of the relocated hip were mandatory. CONCLUSION Bilateral total hip arthroplasty is a feasible option to manage the rare occurrence of severely damaged bilateral hip joints caused by TSA presenting in adulthood. Reconstructive options for late sequelae should be individualized based on the degree of involvement, hip stability, and patient expectations.

International Journal of Surgery Case Reports

International Journal of Surgery Case Reports, 2021

Introduction and importance The ideal treatment of proximal humerus fracture remains a controvers... more Introduction and importance The ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome. Case presentation A 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion. Clinical discussion The ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar. Conclusion Although this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.

Ceylon Medical Journal, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

BMC Infectious Diseases, 2020

Background Melioidosis-associated peri-prosthetic infection is extremely rare. To date, melioidos... more Background Melioidosis-associated peri-prosthetic infection is extremely rare. To date, melioidosis associated septic arthritis of the ankle joint following a medial malleolar internal fixation has not been reported. Case presentation We describe a 49-year-old male with a history of long standing diabetes who presented with fever, constitutional symptoms and right ankle pain for 1 week. Ten years ago, he underwent a medial malleolar screw fixation following a traumatic closed fracture. His initial right ankle radiographs showed no evidence of osteomyelitis. He underwent a wound debridement and washout of the right ankle joint. The peripheral blood and pus from the ankle joint was culture positive for Burkholderia pseudomallei with very high antibody titres. His subsequent radiographs showed features of chronic osteomyelitis. He was treated with a prolonged course of antibiotics and repeated wound debridement. At follow up after 6 months, he had no clinical features of recurrent infe...

International Journal of Surgery Case Reports

INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint th... more INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint that occurs in infancy and has considerable morbidity. Reports on surgical management of severe hip dysplasia in adulthood secondary to TSA are extremely limited. We describe a patient who successfully underwent a bilateral total hip arthroplasty for the severely damaged hip joints secondary to TSA with satisfactory functional outcomes. CASE PRESENTATION A 25-year-old female was unable to walk for more than 10 ft due to pain in both hips and knees predominantly on the left side. She developed pyogenic septic arthritis with sepsis at 6 weeks of age and underwent multiple surgical procedures to drain the infection and for reconstruction. She had limited range of motion and was severely disabled. She underwent an uneventful left total hip arthroplasty and two years later, a right total hip arthroplasty using S-ROM modular hip systems. The pre and post-operative Harris Hips scores were 53.4 (left), 46 (right) and 95.7 (left), 89.65 (right), respectively. CLINICAL DISCUSSION Detailed preoperative evaluation of the anatomy was paramount. Assessment of the limb-length discrepancy by means of scanogram, templating the anatomy with computed tomography and planning the anatomical location of the centre of the relocated hip were mandatory. CONCLUSION Bilateral total hip arthroplasty is a feasible option to manage the rare occurrence of severely damaged bilateral hip joints caused by TSA presenting in adulthood. Reconstructive options for late sequelae should be individualized based on the degree of involvement, hip stability, and patient expectations.

Journal of Gerontology and Geriatrics, 2020

How to cite this article: Jayarajah U, Palkumbura C, Arulanantham A, et al. Unusual presentation ... more How to cite this article: Jayarajah U, Palkumbura C, Arulanantham A, et al. Unusual presentation of bilateral inferior shoulder dislocation following a trivial fall in an elderly female: a case report.

International Journal of Surgery Case Reports, Sep 1, 2021

Introduction and importance The ideal treatment of proximal humerus fracture remains a controvers... more Introduction and importance The ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome. Case presentation A 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion. Clinical discussion The ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar. Conclusion Although this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.

International Journal of Surgery Case Reports, May 1, 2022

INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint th... more INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint that occurs in infancy and has considerable morbidity. Reports on surgical management of severe hip dysplasia in adulthood secondary to TSA are extremely limited. We describe a patient who successfully underwent a bilateral total hip arthroplasty for the severely damaged hip joints secondary to TSA with satisfactory functional outcomes. CASE PRESENTATION A 25-year-old female was unable to walk for more than 10 ft due to pain in both hips and knees predominantly on the left side. She developed pyogenic septic arthritis with sepsis at 6 weeks of age and underwent multiple surgical procedures to drain the infection and for reconstruction. She had limited range of motion and was severely disabled. She underwent an uneventful left total hip arthroplasty and two years later, a right total hip arthroplasty using S-ROM modular hip systems. The pre and post-operative Harris Hips scores were 53.4 (left), 46 (right) and 95.7 (left), 89.65 (right), respectively. CLINICAL DISCUSSION Detailed preoperative evaluation of the anatomy was paramount. Assessment of the limb-length discrepancy by means of scanogram, templating the anatomy with computed tomography and planning the anatomical location of the centre of the relocated hip were mandatory. CONCLUSION Bilateral total hip arthroplasty is a feasible option to manage the rare occurrence of severely damaged bilateral hip joints caused by TSA presenting in adulthood. Reconstructive options for late sequelae should be individualized based on the degree of involvement, hip stability, and patient expectations.

International Journal of Surgery Case Reports

International Journal of Surgery Case Reports, 2021

Introduction and importance The ideal treatment of proximal humerus fracture remains a controvers... more Introduction and importance The ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome. Case presentation A 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion. Clinical discussion The ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar. Conclusion Although this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.

Ceylon Medical Journal, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

BMC Infectious Diseases, 2020

Background Melioidosis-associated peri-prosthetic infection is extremely rare. To date, melioidos... more Background Melioidosis-associated peri-prosthetic infection is extremely rare. To date, melioidosis associated septic arthritis of the ankle joint following a medial malleolar internal fixation has not been reported. Case presentation We describe a 49-year-old male with a history of long standing diabetes who presented with fever, constitutional symptoms and right ankle pain for 1 week. Ten years ago, he underwent a medial malleolar screw fixation following a traumatic closed fracture. His initial right ankle radiographs showed no evidence of osteomyelitis. He underwent a wound debridement and washout of the right ankle joint. The peripheral blood and pus from the ankle joint was culture positive for Burkholderia pseudomallei with very high antibody titres. His subsequent radiographs showed features of chronic osteomyelitis. He was treated with a prolonged course of antibiotics and repeated wound debridement. At follow up after 6 months, he had no clinical features of recurrent infe...

International Journal of Surgery Case Reports

INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint th... more INTRODUCTION AND IMPORTANCE Tom Smith arthritis (TSA) is a pyogenic arthritis of the hip joint that occurs in infancy and has considerable morbidity. Reports on surgical management of severe hip dysplasia in adulthood secondary to TSA are extremely limited. We describe a patient who successfully underwent a bilateral total hip arthroplasty for the severely damaged hip joints secondary to TSA with satisfactory functional outcomes. CASE PRESENTATION A 25-year-old female was unable to walk for more than 10 ft due to pain in both hips and knees predominantly on the left side. She developed pyogenic septic arthritis with sepsis at 6 weeks of age and underwent multiple surgical procedures to drain the infection and for reconstruction. She had limited range of motion and was severely disabled. She underwent an uneventful left total hip arthroplasty and two years later, a right total hip arthroplasty using S-ROM modular hip systems. The pre and post-operative Harris Hips scores were 53.4 (left), 46 (right) and 95.7 (left), 89.65 (right), respectively. CLINICAL DISCUSSION Detailed preoperative evaluation of the anatomy was paramount. Assessment of the limb-length discrepancy by means of scanogram, templating the anatomy with computed tomography and planning the anatomical location of the centre of the relocated hip were mandatory. CONCLUSION Bilateral total hip arthroplasty is a feasible option to manage the rare occurrence of severely damaged bilateral hip joints caused by TSA presenting in adulthood. Reconstructive options for late sequelae should be individualized based on the degree of involvement, hip stability, and patient expectations.

Journal of Gerontology and Geriatrics, 2020

How to cite this article: Jayarajah U, Palkumbura C, Arulanantham A, et al. Unusual presentation ... more How to cite this article: Jayarajah U, Palkumbura C, Arulanantham A, et al. Unusual presentation of bilateral inferior shoulder dislocation following a trivial fall in an elderly female: a case report.