ABSTRACT
Synovial chondromatosis is an uncommon lesion, which is characterized by cartilaginous and osseous metaplasia of the joint synovium. Synovial chondromatosis usually involves a large joint and rarely occurs in the hand. Intra-articular synovial chondromatosis during the hand should be considered in the differential diagnosis of swollen, stiff or painful joints. Other possible diagnoses include osteoarthritis, rheumatoid arthritis, gout, trauma and chronic infection. Moreover, if enchondral ossification of loose bodies is not seen a diagnosis of synovial chondromatosis can not be made preoperatively. Intra-articular synovial chondromatosis is a benign condition and surgical synovectomy remains the most effective treatment. The authors report a case of synovial chondromatosis of the fifth metacarpophalangeal joint.
Subject(s)
Arthritis, Rheumatoid , Chondromatosis , Chondromatosis, Synovial , Diagnosis, Differential , Gout , Hand , Joints , Metaplasia , Osteoarthritis , Synovial MembraneABSTRACT
PURPOSE: To evaluate the outcomes of distal tibial open fractures treated by two-staged delayed minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. MATERIALS AND METHODS: 25 cases of distal tibial open fractures were treated with temporary ring fixation and two-staged delayed MIPPO. A mean age was 46 years old, follow-up was 23 months. The type of fracture was evaluated using the AO/OTA classification. The type of open fracture was evaluated using the Gustilo-Anderson classification that revealed 6 cases of type I, 9 cases of type II, 8 cases of type IIIA and 2 cases of type IIIB. We analyzed the radiologic results and postoperative complications. The clinical and functional result were evaluated by using Teeny and Wiss scores. RESULTS: The average time of bone union was 18 weeks in 24 cases. There were three delayed union that achieved union twenty weeks after second operation, and 1 case underwent bone graft with additional plate fixation. 6 cases of skin necrosis were treated with skin graft, 2 cases were treated with flap. The clinical and functional assessment showed that 6 cases were excellent, 16 cases were good, 2 cases were fair, and 1 case were poor results. CONCLUSION: Two-staged MIPPO technique for distal tibia open fractures seems to be a good procedure to obtain bone union.
Subject(s)
Follow-Up Studies , Fractures, Open , Necrosis , Postoperative Complications , Skin , Tibia , TransplantsABSTRACT
PURPOSE: To evaluate the functional and radiologic results in the using of external fixation with bone cement (polymethylmethacrylate, PMMA) for unstable, osteoporotic distal radius fractures in elderly patients that have high morbidity and chronic medical problems. MATERIALS AND METHODS: We retrospectively analyzed 12 cases of 12 patients who were treated by external fixation and bone cement for unstable distal radius fractures in the aged persons with poor general condition from January 2003 to July 2004 and followed over one year. We analyzed the radiologic results, and measured the ranges of motion and grip strengths. Functional results were evaluated using the Modified Mayo Wrist Scoring System. RESULTS: Radiographically, mean volar tilt, mean radial inclination and mean radial length were 8.33o, 24.66 mm and 11.31o respectively on the last follow-up. The mean arc of range of motion was 74.4% of that the uninjured side, and the mean grip strength was 78.0% of that the contralateral side. The average Modified Mayo Wrist Score was 78.3. There were reflex sympathetic dystrophy in a case and pin tract infection in 3 cases as complications associated with external fixator. CONCLUSION: External fixation and bone cement is useful method for radial length maintenance, preventing reduction loss, restoring the articular surface, early exercise of the wrist joint without morbidity of donor site for unstable distal radius fractures requiring autogenous bone graft in the elderly patients.