ABSTRACT
INTRODUCTION AND IMPORTANCE: The ulnar's nerve compression at the Guyon's canal is not a frequent entity add to it that vascular lesions are rarely involved as a causative agent of this syndrome. CASE PRESENTATION: We report a case of a young male patient admitted in our department for a Guyon's canal syndrome due to an aneurysm of the ulnar artery and underwent a surgical decompression. Post-operative course was uneventful and the patient was satisfied with the result. CLINICAL DISCUSSION: Many etiologies are involved in the Guyon's canal syndrome and these etiologies can be arranged into groups. Previous treatment attempts, the duration and severity of the symptoms and the underlying etiology dictate the treatment options. Adjacent vascular enlargement is not a usual cause of Guyon's canal compression and a few case reports were reported in the literature. Surgical treatment by opening and releasing the roof of Guyon's canal and removing the aneurysm helped to achieve good outcome in most reports. CONCLUSION: Guyon's canal syndrome is less frequent than both cubital tunnel syndrome or carpal tunnel syndrome and many causative agents have been described. Vascular lesions are not the usual cause of compressing the ulnar nerve at the wrist and through this case we spotlighted this entity as another possible etiology requiring an adequate treatment for a better outcome.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Bilateral combined fractures of the greater tuberosity with anterior internal shoulder dislocation are extremely rare, presenting challenges in treatment due to their uncommon occurrence and lack of standardized management protocols. CASE PRESENTATION: We report the case of a 22-year-old patient who experienced bilateral anterior shoulder dislocations with associated fractures of the greater tuberosities following a seizure-induced fall. Clinical Discussion: The unique aspect of our case is the unusual mechanism of injury. Unlike typical convulsive seizures, which often result in bilateral posterior dislocations, our patient suffered bilateral anterior dislocations and fractures of the greater tuberosities. Therapeutic management of greater tuberosity fractures lacks a standardized approach, but surgical intervention is warranted if displacement exceeds 0.5 cm. Treatment options include open reduction and internal fixation (ORIF), percutaneous screw fixation, arthroscopic procedures with suture anchors for double-row repair, or a combination of arthroscopic techniques and screw fixation. ORIF with plate osteosynthesis may be recommended for comminuted fractures with large fragments. To assess functional outcomes, commonly used scoring systems include the UCLA Shoulder Score, ASES Score, and Constant-Murley Score. CONCLUSION: Bilateral anterior shoulder dislocation associated with combined fractures of the greater tuberosity is an extremely rare occurrence. Given its anatomopathological significance and impact on functional recovery, careful and individualized management of greater tuberosity fractures is crucial, considering its role as a point of insertion for the rotator cuff tendons.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Bone hydatidosis is a rare parasitic infection caused by Echinococcus granulosus, with a frequency of 1-2 %, it has a high morbidity and mortality rate due to its long clinical latency and lack of symptomatic specificity. This often leads to delayed diagnosis and discovery, usually at the stage of complications. CASE PRESENTATION: We present a case of sacral hydatidosis in a 71-year-old patient with no prior medical history. The symptomatology was a pelvic pain that had been ongoing for 5 months with constipation and difficulty with defecation. The clinical and radiological findings initially suggested a primary or metastatic malignant tumour. The biopsy revealed a multivesicular cystic lesion, indicating a hydatid cyst of the sacrum, confirmed later by anatomopathological examination. The lesion was almost completely removed, drainage was performed and the patient was put on anti-parasitic treatment. CLINICAL DISCUSSION: The clinical presentation of bone hydatidosis is poor and its course is insidious, which often leads to a delay in diagnosis. Medical imaging can provide a precise assessment of the lesion, allowing for extensive surgical resection to be planned. However, therapeutic methods and health education in endemic countries are still the best measures for limiting the considerable damage caused by this parasite. CONCLUSION: Hydatid osteopathy is a slow and progressive disease that can be difficult to diagnose early, which can compromise the quality of treatment. Therefore, it is important to focus on preventive measures to eradicate this parasitic infection.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Slipped capital femoral epiphysis (SCFE) is a common phenomenon of the proximal femur in adolescents with an unclear etiology. It is more common in boys than girls and there does seem to be some predilection to race, weight, and age (Lehmann et al., 2006 [7]). CASE PRESENTATION: We reported a 13-year-old boy who presented with unilateral SCFE following subtrochanteric left femur fracture, which was fixed by blade plate 6 monthes before the SCFE. The SCFE fixed by two cannulated screw. We aim to discuss the possible link between the surgical technique used for proximal femur fractures and the delayed onset of SCFE. CLINICAL DISCUSSION: Slipped capital femoral epiphysis (SCFE) after treatment of subtrochanteric fracture can be caused by inadequate treatment of the fracture. Orthopedic surgeons should be aware of this complication so that they can promptly recognize this complication and treat it urgently (Chinoy et al., 2020). CONCLUSION: Slipped capital femoral epiphysis (SCFE) after treatment of subtrochanteric fracture is a very rare condition, that it can be prevented by proper reduction and fixation of the fracture using appropriate osteosynthesis material.
