Arthroscopic-Assisted Bone Graft Harvest From the Proximal Humerus for Distal Third Clavicle Fracture Nonunion.

Clavicle fracture nonunion can lead to persistent pain and loss of shoulder function. Distal clavicle fractures have the greatest risk of nonunion and are often treated surgically. Bone grafting plays a vital role in the treatment of distal clavicle nonunion. Although multiple options for bone graft exist, the iliac crest has long been considered the gold standard for harvest. Despite its extensive use, multiple complications have been associated with iliac crest bone graft harvest. We advocate a surgical technique for arthroscopic bone graft harvest from the proximal humerus with open reduction and internal fixation of an ipsilateral distal clavicle nonunion.

Bilateral Tibial Fibrous Dysplasia in a Pediatric Patient treated with Intramedullary Nailing.

Fibrous dysplasia is a benign developmental disorder of bone in which fibrous connective tissue containing abnormal bone with irregular trabeculae replaces normal cancellous bone. It may affect 1 (monostotic) or multiple bones (polyostotic). Polyostotic disease is the less common of the 2, occurring in only 20 to 25% of fibrous dysplasia patients and tending to affect those who are younger than 10 years of age; patients having this form tend to experience bone enlargement beyond normal skeletal maturation, which can cause pain, progressive damage, and increased risk of pathological fracture. There are limited reports of bilateral involvement in fibrous dysplasia, with said involvement presenting most frequently in early childhood. We describe the rare case of an adolescent presenting with bilateral fibrous dysplasia in the tibial diaphysis (in the exact same location) that was successfully treated with bilateral intramedullary nailing of both tibias.

Bilateral Tibia Fibrous Dysplasia in a Pediatric Patient Treated with Intramedullary Nailing: A Case Report.

Fibrous dysplasia is benign developmental disorders of bone where normal lamellar cancellous bone is replaced with immature fibro-osseus tissue resulting in poorly formed trabeculae of immature woven bone. It may affect one (monostotic) or multiple bones (polyostotic). Polyostotic disease is less common, 20-25% of patients, mostly in children below 10 years old and tends to enlarge beyond bone maturation ration which can cause pain, progressive damage and higher tendency of pathological fractures.(1) We report a case of polyostotic fibrous dysplasia present on bilateral tibia diaphysis. Patient presented with bilateral leg pain on examination and imaging showed bilateral tibia lytic lesion. Management consisted of reaming and intramedullary nailing on bilateral tibia after which patient presented without pain and radiographs showing no evidence of lesion. Tibia x-rays demonstrated exuberant cortical intramedullary bone formation with disappearance of the scalloped osteolytic lesions on the inner wall of tibial cortex. Clinically the patient's symptoms disappeared giving the opportunity to return to contact sports without limitation.

An Isolated Gluteus Minimus Tendon Tear with Stress Fracture of the Iliac Wing in a Marathon Runner: A case report.

Stress fractures and muscle strains are common in marathon runners. Most stress fractures occur in lower extremities and tibia stress fractures comprise almost half. Iliac wing stress fractures are not commonly found in runners and are usually related to osteoporosis. There have been 4 previous reports of iliac stress fractures in marathon runners none reported an associated isolated gluteus minimus tendon tears. We will report a case of a female marathon runner with iliac wing stress fracture with associated isolated gluteus minimus tendon tear.

Isolated Rectus Femoris Muscle Tear in a Non-Athletic Patient: A Case Report.

Quadriceps muscle injuries are common in athletes and middle age patients. Strains and tears of the distal portion of the muscle is the most common presentation of these injuries. Isolated rectus femoris tears are rare and few reports are published that evaluate outcomes in of nonsurgical treatment of these injuries. This article will described an unusual case of isolated distal rectus femoris tear in a patient with no associated risk factors, who initially presented with extensor mechanism weakness and limping, treated conservatively with range of motion therapy and strengthening.