RESUMO
La localización del osteocondroma en la tibia distal es poco frecuente y su crecimiento con compromiso y deformidad del peroné distal es aún más raro, haciéndolo una condición más sintomática que en otras ubicaciones. Factores como la severidad de los síntomas, deformidad progresiva del tobillo, complicaciones sindesmóticas, riesgo de fractura patológica o transformación maligna, junto con nuevas y mejores técnicas quirúrgicas, han llevado a que el manejo expectante de esas lesiones sea excepcional y escasamente reportado. Presentamos el caso de un joven de 17 años con osteocondroma solitario interóseo tibio distal sintomático y compromiso fibular, que fue exitosamente manejado en forma expectante. A los 5 años de seguimiento clínico-radiológico no presenta complicaciones y la lesión se mantiene estable.
Osteochondromas located in the distal tibia are a rare condition, and the involvement of the distal fibula with deformity is even more uncommon. Factors such as the severity of symptoms, progressive deformity of the ankle, syndesmotic complications, the risk of pathological fracture or malignant transformation, together with new and safer surgical techniques, have led to scarce reports of non-surgical management. We present a case report of a 17-year-old male with a symptomatic interosseous solitary osteochondroma in the distal tibia with fibular involvement, which was successfully managed non surgically. After 5 years of clinical and radiological follow-up, he has no complications, and the lesion remains stable.
Assuntos
Humanos , Masculino , Adolescente , Tíbia , Neoplasias Ósseas/terapia , Osteocondroma/terapiaRESUMO
The purpose of the study reported in this article was to determine whether dream analysis can provide insight into the emotional problems of female adolescents. A number of classical and contemporary theories on dreams and dream analysis were used to design guidelines for dream analysis. This was followed by a qualitative study of five pur- posefully selected adolescent girls with emotional problems. Data gathering included the following: recorded dreams; interviews; diaries; a personality test; (the Emotions Profile Index); a projection medium (Three Wishes) and the above-mentioned guidelines for dream analysis. Findings indicated that insights may be gained into adolescent emotional problems by means of dream analysis; revealing the intrapsychic world of the individual. Emotional problems that were revealed by the dream analysis; include(d) anxiety; aggression; negative self-concepts; feelings of social isolation and depression. These were revealed by means of manifest dream content such as being chased; falling; biting; fighting and stabbing. The emotional problems were often caused by fear; conflict; lack of confidence or trauma. Compensatory and regulatory functions were revealed by the investigation