CONTEXT Primary patellar dislocation continues to be a common problem facing clinicians today. These injuries are associated with significant morbidity and a substantial recurrence rate. Myriad operative and nonoperative options have been described to treat these injuries, although the evidence-based literature is sparse. EVIDENCE ACQUISITION PubMed was searched from 1970-2010 to identify pub...

Factor X deficiency (also known as Stuart-Prower factor deficiency) is an extremely rare hereditary hematologic disorder, affecting 1 person in 2 million. The gene causing this condition is autosomal recessive; thus, only those inheriting from both parents exhibit clinical symptoms, such as moderate bleeding, easy bruising and subcutaneous bleeding from mucous membranes. Patients with marked de...

Patella sleeve fracture is a rare fracture that only occurs in children. Diagnosis is difficult both clinically and radiologically. A high-riding patella and hemarthrosis are important signs when diagnosing this fracture. We report a case of an 11-year-old boy who suffered from patella sleeve fracture without visible bony fragments on a lateral radiograph. Open reduction with transosseous tunne...

A 47-year-old African American woman was evaluated for a prolonged prothrombin time (PT) result obtained before she underwent right total hip arthroplasty. The patient had no history of gastrointestinal or intracranial bleeding, epistaxis, or hemarthrosis. However, she reported a tendency toward easy limb bruising and menorrhagia, which required iron supplementation. She had a negative family h...

www.aafp.org/afp AMERICAN FAMILY PHYSICIAN 419 vessel wall and, in response to the exposed subendothelial collagen, release adenosine diphosphate (ADP) and thromboxane A2. The released ADP and thromboxane A2 cause further platelet aggregation and the formation of a platelet plug that is responsible for primary hemostasis. Secondary hemostatic mechanisms consist of a series of sequential enzymat...

Background: Inhibitory antibody to exogenous Factor VIII (FVIII) is a major complication of hemophilia treatment. This study was conducted to determine the prevalence of inhibitor antibody directed against FVIII.Methods: From May 2010 to May 2011, 52 patients with severe hemophilia A admitted in Amirkola Children’s Hospital were evaluated. Those who had abnormal mixing study, antibody against F...

Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain syndrome, whereas teenage boys and young men are more likely to have knee extensor...