Osteochondroma of the scapula associated with a subclavian artery pseudoaneurysm: Case report.

Osteochondromas rarely induce vascular complications by mechanical compression. We present the case of a subclavian artery pseudoaneursym caused by an osteochondroma of the scapula in a 67-year-old male. The diagnosis was based on a previous history of multiple exostoses, computed tomography and magnetic resonance imaging, as well as the local vascular clinical status of the lesion. Surgical treatment consisted of vascular and orthopaedic intervention. First, the vascular surgeon implanted a bypass of the subclavian artery from the ventral aspect, enabling the orthopaedic surgeon to resect the osteochondroma from the dorsal aspect. The patient recovered with full function. Vascular pseundoaneurysms should be taken into consideration in patients with osteochondromas, especially with a known history of multiple hereditary exostoses.

Hand function and recurrence after limited fasciectomy for Dupuytren's contracture: Long-term follow-up.

PURPOSE: The aim of this study was to analyze long-term results after limited fasciectomy for Dupuytren's contracture. METHODS: The study included 34 patients (52 rays), with an average follow-up of 9.5 years (range: 7-13 years). Range of motion, functional status, recurrence, and complications were recorded. RESULTS: Preoperative metacarpophalangeal joint (MCPJ) contracture (median: 35°, range: 0-90°) improved postoperatively to full extension in all but one patient, with no recurrence at the most recent follow-up. Preoperative proximal interphalangeal joint (PIPJ) contractures (median: 52°, range: 5-100°) were initially corrected, but recurred with time (median: 25°, range 0°-80°). Hand function was assessed using the Disabilities of the Arm, Shoulder and Hand questionnaire. Postoperative hand function improved (median: 0, range: 0-27), compared to preoperative function (median: 20, range: 0-51). Hand function worsened with time (at most recent follow-up: median: 3, range: 0-40), mainly due to PIPJ contracture recurrence, but function remained better than before surgery. CONCLUSION: Limited fasciectomy is an effective treatment method for MCPJ, with full correction achievable in both the short and long term. Regarding the PIPJ, treatment outcomes seem to be multifactorial. Further clarification is required to distinguish between local recurrence and remaining contracture of the PIPJ.

Current knowledge in orthopaedic surgery on recommending sport activities after total hip and knee replacement.

The increasing number of younger patients with total hip arthroplasty and total knee arthroplasty sets higher demands on the postoperative quality of life. When it comes to athletic activity, recommendations and guidelines for sports remain unclear. We have reviewed published literature to determine the extent to which patients resume their athletic activities postoperatively, and what would be the best choice. Golf and double tennis remain the most recommended activities. No-impact, low power sports like swimming and bicycling are generally allowed. Jogging is not considered as a factor for short-term implant failure, but a long-term analysis is needed. Contact and high-impact sports like football or basketball are not recommended. There are no recommendations regarding alpinism and field hockey.