ABSTRACT
Osteoblastoma is an infrequent primary osseous tumour. Its presentation in the upper extremities and more specifically in the carpal bones is unusual. We present a case of osteoblastoma localized in the hamate bone and review the treatment realized in this infrequent localization. A young male patient with pain and swelling in the back of his hand of one year's evolution, resistant to medical treatment. Complementary tests showed lytic tumefaction in the hamate bone with non-aggressive characteristics. It was treated by curettage and filling the iliac crest with autologous graft. The pathological anatomical study diagnosed that it was a case of osteoblastoma. The result was satisfactory, with total disappearance of the pain and a radiological image of complete restitution of the osseous defect, with no signs of recurrence after 4 years. The treatment should be curettage plus autologous graft. Conversely, resection of the affected bone can be considered in cases with aggressive data.
Subject(s)
Bone Neoplasms , Hamate Bone , Osteoblastoma , Adult , Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Humans , Male , Osteoblastoma/diagnosis , Osteoblastoma/surgeryABSTRACT
BACKGROUND: Humeral nonunion that persists through various unsuccessful attempts at management, presents a real challenge. When combined with severe osteoporosis in elderly patients, the problems only increase. This study aims to investigate the best option for treating this combination of factors. MATERIALS AND METHOD: This study analyses the outcomes of five patients with the following inclusion criteria: nonunion of the humeral diaphysis, after at least two unsuccessful interventions and/or after a period of 18 months or more, associated with severe osteoporosis in patients aged over 65. All cases were treated by debridement of the site of nonunion and stabilisation with locking plates and bone graft. RESULTS: All cases consolidated after a mean follow-up period of 19 months (8-36 months). CONCLUSIONS: In cases of humeral nonunion in elderly patients with osteoporotic bones, locking plates have been proven to provide consistent, long-term stability, with better results than traditional compression plates. The authors consider that locking plates should be considered as a valid option in cases of extreme bone and biological instability, as is the case in recalcitrant humeral nonunion.
Subject(s)
Humeral Fractures/surgery , Pseudarthrosis/surgery , Aged , Female , Humans , Humeral Fractures/complications , Osteoporosis/complications , Pseudarthrosis/complicationsABSTRACT
Objetivo. Estudio de dos casos de fractura-avulsión aislada del troquín del húmero tratados quirúrgicamente mediante la reinserción anatómica del mismo utilizando anclajes óseos.Material y método. Se describen dos casos de esta infrecuente lesión y los estudios de imagen realizados para su diagnóstico preciso. Se trata de una fractura-avulsión, que puede pasar desapercibida en las radiografías iniciales, siendo diagnosticada de forma tardía ante la persistencia de una disfunción dolorosa del hombro afecto y la realización de pruebas de imagen complementarias. Resultados. En ambos casos los pacientes lograron una recuperación funcional completa del hombro. Conclusiones. El tratamiento quirúrgico es preferible en los casos diagnosticados precozmente, y debe incluir la exploración de posibles lesiones asociadas de la porción larga del bíceps y del manguito de los rotadores, así como su reparación anatómica
Purpose. A study of two cases of isolated avulsion fracture of the lesser tuberosity of the humerus treated surgically by anatomical reattachment using bony anchors is reported. Material and methods. Two cases of this rare lesion are described as well as the images obtained for its precise diagnosis. The condition is an avulsion fracture, which is apt to be overlooked in initial X-rays, and only diagnosed when the persistence of a painful dysfunction of the affected shoulder leads to further imaging. Results. In both cases reported the patients achieved a complete functional recovery of their shoulders. Conclusions. In cases that are diagnosed early the treatment of choice is surgery. It must include the examination of the long portion of the biceps and the rotator cuff, to determine the presence of possible lesions and carry out their anatomical repair
