Ewing's Sarcoma Disguised as Aneurysmal Bone Cyst Lesion: About a Case.

Aneurysmal bone cysts are defined as benign lesions. They expose the patients to a higher risk of pathological fractures. The typical clinical and radiological aspects of the tumor usually do not require a pathological confirmation before a definite treatment. However, in some cases, a malignant tumor will have the same clinical and radiological characteristics of a begin lesion. Our case highlights this fact. We present a case of a 13-year-old patient that presented to us with a pathological fracture. The X-ray and CT scan were in favor of ABC; however, the postoperative pathology revealed an Ewing sarcoma. A salvage treatment became mandatory after this finding but was refused by the parents, resulting in the death of the patient 6 months later. A biopsy must be mandatory each time we have a suspicious aneurysmal bone cyst even with typical clinical and radiological characteristics before starting a treatment plan.

Open reduction in treatment of neglected elbow dislocation in children.

Elbow dislocation in children is uncommon condition in children, it's occurred in 3 to 6% of all elbow injuries. Only case reports and small series reported in the literature. The aim of our study is to evaluate the outcomes of open reduction of neglected elbow dislocation (NED) in children. A retrospective review of 26 neglected elbow dislocation was treated by open reduction at our institution between January 2010 and December 2018 was performed. Age, mechanism of injury, associated fracture, manipulation by bone- setters, infectious complications, were recorded. The SOFCOT criteria was used to assess the stiffness of the elbow in preoperative and in postoperative. Besides, in postoperative we used DI SCHINO Criteria to assess useful ROM and subjective criteria to evaluate pain and performance of daily activity. A total of 26 patients with a mean age of 10 years ranging from 5 to 14 years, were identified and followed for a median of 4 years postoperatively. The median duration before presentation was 5 months ranges from 22 days to 5 years. All patients except one were manipulated by bonesetters with massage and manipulation. The dislocation was postero-lateral in 15 cases (58%). 17 patients (65%) have associated fracture. 17 patients went for internal approach, 5 posterior approach, and 4 with combined internal and external approach. Reduction of the ulnar humeral joint was assisted with a lengthening of the triceps with a Speed V-Y muscle plasty in 13 patients. According to SOFCOT criteria at the last follow-up we obtained 15(58%) of minim and moderate elbow stiffness, and according to DI- SCHINO criteria at the last follow-up, 7(27 %) has a very good result, 7(27%) has a good result. The open reduction and the early rehabilitation remain the key stone of treatment of NED in children regardless the chronicity of the injury. Prevention remains the best way to improve the prognosis of neglected elbow dislocations.

Psoas Hydatid Cyst in Children: A Rare Localization about a Case.

INTRODUCTION: The development of hydatid cysts in the muscle is rare, and it is even rarer in children. We report the case of a 9-year-old child treated in pediatric orthopedics department at the University Hospital of Marrakech for a hydatid cyst psoas muscle revealed by lameness. RESULT: The child was consulted for painless and afebrile lameness of the left hip evolving since 3 months. The clinical examination finds a mass of the left flank. Investigations based on the abdominal ultrasound in first intention showed a hydatid cyst depending on the left psoas muscle. Pelvic CT and abdominal MRI were able to confirm the diagnosis and allowed a better study of the cyst neighboring elements. The drainage of the cyst followed by pericystectomy after evacuation of the vesicles contained in the cyst was done as radical treatment. CONCLUSION: The hydatid cyst of the psoas is a rare entity in the child requiring a good radiological study of the cyst as well as its neighboring elements to propose the most adapted surgery.