Resection of the distal ulna for tumours and stabilisation of the stump. A case report and literature review.

The distal end of the ulna is an uncommon site for primary bone tumours. We report the case of a 23-year-old male, with a giant-cell tumour of the distal end of the ulna treated with en-bloc resection and stabilisation of the ulnar stump using one half of the extensor carpi ulnaris tendon. The amount of bone removed from the distal end of the ulna was 9.0 centimeters long. The functional and oncological results were excellent. Stabilisation of the ulnar stump, using one half of the extensor carpi ulnaris tendon, has been described by Goldner and Hayes in 1979, after resection of a relatively small segment of the distal ulna. This is the first report on this technique for stabilisation of the ulnar stump after resection of a large distal ulnar segment. A literature review of reported cases with a resection of the distal ulna for primary bone tumours is presented. The available data are inconclusive as to whether a simple excision is adequate or a reconstruction/stabilisation is required.

Atraumatic retrosternal dislocation of the clavicle.

Atraumatic retrosternal dislocation of the clavicle is an exceedingly rare event and three out of four previously reported cases lack any radiological evidence. We report the case of a 30-year-old male patient who presented an atraumatic retrosternal dislocation of the clavicle without a history of previous injury and underlying pathology. The diagnosis was delayed and established by a CT scan ten days after and initial presentation of the symptoms. A successful, stable, closed reduction under general anaesthesia was performed ten days after the initial presentation, having a cardiothoracic surgeon immediately available. There was no recurrence and the patient remains asymptomatic 18 months later.

Elemental mercury-induced subcutaneous granuloma. A case report and review of the literature.

The authors report a case of suicidal elemental mercury injection in the antecubital fossa, resulting in granuloma formation, which was treated with delayed resection. A 21-year-old man presented with a granuloma in the antecubital fossa after a suicide attempt by self-injection of elemental mercury. The patient was treated surgically with excision of the necrotic skin and granuloma under X-ray guidance, with good result. Despite the fact that human exposure to mercury has been ongoing for centuries, the deposition of metallic mercury into the skin and subcutaneous tissue, causing cutaneous granuloma formation is uncommon, with fewer than 100 reports presented in the dermatologic, toxicologic and general medical literature. On the contrary, there is a lack of reports of this soft-tissue injury in the orthopaedic literature.