PMC7201552_01
Anteroposterior radiograph of the both hip joints.
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A radiograph of the hip joint showed right subluxated osteoarthritis classified as Crowe's group 3 (Figure 1).
Anteroposterior (a) and lateral (b) radiograph of lumbar spine in standing. Anteroposterior radiograph of bilateral whole lower limbs in standing (c).
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Scoliosis with the convex to the right topped the L1 vertebrae, and a Cobb angle of 22 degrees was measured via standing lumbar anteroposterior radiograph (Figure 2(a)). Flexion contracture of the hip joint caused an increase in lumbar lordosis, and the pelvis was anteverted in the lateral lumbar to pelvic radiograph (Figure 2(b)). The femorotibial angle (FTA) was used to determine the standing bilateral lower limb alignment; the right and left legs measured 178 and 173 degrees, respectively (Figure 2(c)).
Anteroposterior radiograph immediately after total hip arthroplasty. A bulk bone was grafted by bioabsorbable screws.
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High Offset type: Zimmer Biomet, TN, USA) (Figure 3). The center of the femoral head moved inferiorly and medially (21 and 45 mm, respectively) postoperation. The leg length discrepancy was resolved in radiographic measurement. Full weight bearing was allowed immediately after surgery as postoperative therapy. Her postoperative process was successful; she could ambulate without a cane three months after the surgery.
Bilateral radiograph of the right ankle joint immediately after presence of symptoms (a, b) and three weeks after that (c, d). Transverse liner fracture was obvious in (c) (arrow), but not in (a).
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A few days later, she visited a different hospital for her symptoms and a radiograph of the right ankle joint was obtained, which did not reveal an obvious fracture (Figures 4(a) and 4(b)). A radiograph of the right ankle joint revealed a transverse fracture 5 cm proximal to the lateral malleolus tip (Figures 4(c) and 4(d)).
Anteroposterior radiograph of bilateral whole lower limbs in standing (a) and right hip joint (b) six months after surgery.
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Right and left standing lower limb alignments measured 168 and 176 degrees, respectively, via FTA (Figure 5(a)). A loosening of the implant was not obvious and the grafted bulk bone appeared to union in the radiograph of the hip joint (Figure 5(b)).
MRI showed an isolated fibular fracture, bone marrow edema, and surrounding soft tissue edema without any pathological lesion: (a) PDW coronal, (b) STIR coronal. Bone union was confirmed in anteroposterior radiograph (c) three months after identifying fracture.
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There were no findings of fracture and edema in the tibia (Figure 6(a) and 6(b)). Bone union was confirmed on a follow-up radiograph three months after splinting (Figure 6(c)).