[Chondrosarcoma secondary to an exostosis of the distal femur [Report of a case with review of literature]]

The solitary osteochondroma or exostosis, is the most benign frequent tumor of the skeleton. It is the privilege of the young. It can be solitary or multiple in the framework of a multiple hereditary osteochondromata. The surgical indication is retained only when the tumour becomes symptomatic. The degeneration occurs in 1 to 25%, this rate increase when the great size tumors and the old patient. We report the case of a 25 years old patient, presenting a solitary osteochondroma of the left lower femoral metaphysis, with signs of malignancy in low grad secondary chondrosarcoma, suspected on elements of imagery and confirmed by the biopsy, this patient has underwent a monobloc large resection of the tumor, the bone and the adjacent muscle, with a favourable outcome after four years. This case illustrates the great limits ambiguity between the benign and the malign in the cartilaginous neoplastic pathology of the bone and the importance of the respect of algorithms of the skeleton tumors surgery in suspicious cases, because even if the histological examination of the operative model has not found the clear malignancy aspect, that does not eliminate the diagnosis of a chondrosarcoma, indeed, the histological distinction between an osteochondroma and a chondrosarcoma of low rank is very subtle

[Serious sprains of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb]

The sever strain of the thumb's metacarpophalangeal joint interest specially the ulnar collateral ligament [UCL]. The authors reported their experience about managing the acute rupture of the UCL. Authors reported 26 cases of severe strain of the UCL of the thumb's metacarpophalangeal joint. There were 22 mans and 4 women. The mean age was 27 years [17-50 years]. The sports accident caused 77% of all injuries. The diagnosis was allowed by physical exam, standard and stress radiographies. There were 8 patients with avulsion fractures of the UCL [2 undisplaced], 7 with corporeal rupture and 11 with distal desinsetion of the UCL. Two patients [with undisplaced fracture avulsion] had an orthpaedic treatment and 24 were operated. With a mean follow-up of 3, 5 years 22 patients [85%] had a very good or good results, 2 patients [8%] had average result and 2 authors [8%] had poor result. The severe strain of UCL of the thumb's metacar-pophangeal joint may have a good result if diagnosed and treated correctly in the acute phases. Excepted undisplaced fracture avulsion, all these injuries must be treated surgically, immobilised in plaster for 4 weeks and reeducated adequately