ABSTRACT
Septic arthritis of the wrist can result in joint destruction, making timely diagnosis crucial for initiating empiric antibiotics and surgical intervention. Mycobacterium is a rare cause of this disorder. A 47-year-old man with bladder cancer was treated surgically and received BCG intravesical therapy. Eleven months later, this patient developed severe carpal BCGitis requiring total carpal resection. The first step was addition of a cement spacer and radiometacarpal stabilisation (Masquelet technique). Secondary infections occurred aggravating the prognosis. This case emphasises the importance of taking into account the patient's medical history. Tuberculosis of the wrist is a rare etiology for septic arthritis; delayed treatment leads to severe complications and functional sequelae.
Subject(s)
Arthritis, Infectious/microbiology , Arthritis, Infectious/therapy , BCG Vaccine/adverse effects , Tuberculosis, Osteoarticular/therapy , Wrist Joint/microbiology , Antibiotics, Antitubercular/therapeutic use , Carpal Bones/surgery , Ethambutol/therapeutic use , Humans , Isoniazid/therapeutic use , Male , Middle Aged , Mycobacterium bovis/isolation & purification , Rifampin/therapeutic use , Surgical Flaps , Synovectomy , Tuberculosis, Osteoarticular/etiology , Urinary Bladder Neoplasms/drug therapy , Wrist Joint/surgeryABSTRACT
An 18-year-old male with neurofibromatosis type I was treated for congenital pseudarthrosis of the tibia using the Masquelet induced-membrane technique with internal fixation by retrograde implantation of a transplantar intramedullary nail. Bone healing was obtained at the expense of malunion with external rotation and 5.5cm of lower limb shortening. A motorised intramedullary-lengthening nail (Fitbone®, Wittenstein, Igersheim, Germany) was implanted. This treatment was successful in correcting the rotational malalignment and limb length discrepancy. The motorised nail Fitbone® may be a valid option for treating complex cases of limb length discrepancy, including those combined with limb deformities.