ABSTRACT
<p><b>PURPOSE</b>Distal finger amputations pose a therapeutic problem with the distal fragment quality. Reimplantation remains the reference treatment for functional and aesthetic recovery of the hand. The interest of this study is to propose the reposition flap as an alternative to different hedging techniques in the proximal stump, in many situations where revascularization is impossible. It consists in osteosynthesis of the bone fragment and its coverage by a pedicled local flap.</p><p><b>METHODS</b>The technique of reposition flap was evaluated retrospectively between 2003 and 2016 through a study of 13 patients compiled in Nabeul orthopedic department. For each patient, the sensitivity, the pulp trophicity, the interphalangeal mobility, the digital length, the appearance of the nail and radiological consolidation were evaluated.</p><p><b>RESULTS</b>The reposition flap keeps more than 80% of the length of p3. This procedure improves nail aesthetics in comparison with the regularizations. There is no significant difference in sensitivity of the pulp or of the mobility of the distal inter-phalangeal (DIP) joint as a function of the technique studied. However there is a significant difference in average test of the Quick Dash (350 against 500 for regularizations).</p><p><b>CONCLUSION</b>The reposition flap seems to be a good alternative to regularization in the context of trans-p3 fingers amputations, in which the distal fragment is not revascularizable. It allows better aesthetic and functional results.</p>
ABSTRACT
Tuberculosis is a major public health problem in developing countries. Hand and wrist is a rare localization for extra-pulmonary tuberculosis, a pseudotumoral form of soft tissue tuberculosis of the wrist is exceptional. We report the case of a 45-year-old male presenting with a painful swelling of the dorsal aspect of the right wrist evolving for six months. Clinical study was evoking a ganglion cyst of the wrist. Intraoperatively a pseudotumoral mass with rice bodies was found, suggesting tuberculous tenosynovitis. The histopathological study revealed caseating giant cell granulomas with epithelioid cells. Cultures on Lowenstein-Jensen medium detected Mycobacterium tuberculosis. Synovectomy with removal of all the rice bodies followed by anti-tuberculous chemotherapy provided uneventful recovery
Subject(s)
Humans , Male , Middle Aged , Wrist , Mycobacterium tuberculosisABSTRACT
Osteoarticular tuberculosis is a rare type of tuberculosis. The spine is the most frequent location, while peripheral locations in the limbs are rare. We report a case of tuberculous osteoarthritis of the metatarsophalangeal joint of the first ray of the foot in a 48-year-old woman
The patient presented with painful swelling of the dorsum of the big toe, insidiously evolving for 6 months. Diagnosis was obtained with histological study after surgical biopsy. Antitubercular chemotherapy for 12 months promoted healing
Through this clinical case the authors describe the epidemiological, diagnostic features, and treatment of osteoarticular tuberculosis and discuss the causes of delayed diagnosis often encountered in these exceptional locations and differential diagnoses, gout in particular, for this particular case
ABSTRACT
Intraosseous ganglion cyst of the carpal bones represents a rare cause of wrist pain. We report a case of a 42 year-old, right-handed female, who presented with pain of the right wrist following a fall on the palm of the hand. Clinical study revealed a moderate swelling over the mid-section of the palmar face and pain through extreme ranges of motion of the wrist. Plain radiographs and CT-scan of the wrist have revealed an intraosseous ganglion cyst of the lunate bone. Curetting-filling by Kuhlman's vascularized radial bone graft allowed a good functional recovery. The clinical, radiological and therapeutic aspects are discussed.
Subject(s)
Adult , Female , Humans , Ganglion Cysts , Diagnostic Imaging , Pathology , General Surgery , Lunate Bone , Diagnostic Imaging , Pathology , General Surgery , Wrist , Diagnostic ImagingABSTRACT
Tuberculosis dactylitis is exceptional. We report 4 cases of osteoarticular tuberculous dactylitis in 3 women and 1 man. The diagnosis was suspected on chronic and insidious clinical presentation, and confirmed by histology. Patients were treated by anti-tubercular drugs with good functional and radiological outcome in all cases. Clinical and therapeutic issues are discussed by the authors in the context of an endemic country
ABSTRACT
Tuberculosis is a major public health problem in developing countries. Flexor tenosynovitis of the fingers constitutes an exceptional tuberculosis localization [Gabl et al., 1997; Senda et al., 2011] [1,2]. Unusual presentations, such as tuberculous tenosynovitis, often go undetected and are associated with a diagnostic and therapeutic delay, especially when bacteriological research proves to be negative. Here, we report a case of tuberculous flexor tenosynovitis of the hand
Subject(s)
Humans , Female , Adult , Tuberculosis , Fingers , Hand , Mycobacterium tuberculosisABSTRACT
The tuberculosis of the hand and the wrist is a rare entity. Affecting the scapholunate joint is exceptional. It is usually diagnosed at an advanced stage of carpal destruction, due to slowly development of the symptoms. We report the case of a 58-year-old female, presenting as wrist pain for 3 months. Clinical study showed a local swelling in the left wrist, the mobility of the wrist was normal but painful at the end of motion. The diagnosis of osteoarticular tuberculosis was suspected after radiological and biological study then confirmed after histological study. Antibacillary chemotherapy during 12 months promoted healing and good outcome
ABSTRACT
Pseudotumoral pigmented villonodular synovitis is rare and diagnosis is difficult. Report of new case. We report an original observation of a pseudotumoral pigmented villonodular synovitis occurred in a 28 years old patient with no recurrence after surgical treatment. A review of the literature was made in order to precise the epidemiological, diagnostic and therapeutic characteristics
ABSTRACT
Soft-tissue chondroma is a rare and benign cartilaginous tumour often localized in the extremities. The thumb is very rarely affected. We report a new case typical for this lesion with review of literature. 43 year-old man presented with soft tissue tumour of the left thumb for about 4 years without any symptoms. Radiographs of the thumb showed a calcification out of the bone. Surgery resection of the tumour was complete and easy. Histological examination confirmed the diagnosis of soft-tissue chondroma. There was not tumoral recurrence at three years follow-up. Soft tissue chondroma is not a diagnosis evoked when we have a soft tissue tumor of the hand. Diagnosis is confirmed by pathology which should eliminate a low grade chondrosarcoma. Complete surgical resection will avoid recurrence
ABSTRACT
Squamous cell carcinoma [SCC] of the lateral nail fold is rare, it has been suggested that trauma, roentgen radiation, arsenic exposition, dyskeratosis and infections [HPV] are risk factors for the development of these carcinoma.This tumour is mostly a slow growing and low grade malignancy which rarely metastasis.Early diagnosis by biopsy, especially in patients with predisposing factors, may lead to treatment and prevent the tumour from metastasizing. Report of new case. We report one case of [SCC] of the lateral nail fold of the thumb in a 66 year old man, treated with local excision; function and cosmetic results are more acceptable. A review of the literature was made in order to precise the epidemiological, diagnostic and therapeutic characteristics
Subject(s)
Humans , Male , Skin Neoplasms/diagnosis , Carcinoma, Squamous Cell , Nails , Thumb , Nail Diseases/surgeryABSTRACT
The tumor of buschke lowenstein or giant condyloma acuminata is a pseudo-epitheliomatous profileration bilonging to verrucous carcinoma group due to their aggressive local evolution.A malignant change as mic invasive carcinoma or epidermoiz keratinizing carcinoma well-differentiated was reported.Diagnosis and surgical treatment represents an efficient alternative at the moment that must be precocius and large due to the frequencies of local recurrences and malignant change. We present in this stady an observation of an unusual localization of buschke Lowenstein tumor with review of literature 50 year-old men presented with bilateral tumours it the battock area whose diagnosis of buschke Lowenstein tumour h been clinically suspected and confirmed by biopsy and histopathologic study .The cover has been achieved by VY fasciocutaneous flaps of the muscle gluteus maximus