ABSTRACT
Adamantinoma is a rare primary low-grade malignant tumor composed of cells with epithelial and fibrous characteristics. It represents 0.4% of all primitive malignant bone tumours. It is predominantly located in the mid-shaft of tibia. We report an adamantinoma of the clavicle, occurring in a 19-year-old female patient. The lateral half of the clavicle was excised. After a period of 3 years, she is still remaining free of local recurrence and metastatic disease.
Subject(s)
Adamantinoma/surgery , Bone Neoplasms/surgery , Clavicle/surgery , Adamantinoma/pathology , Adult , Bone Neoplasms/pathology , Clavicle/pathology , Female , Follow-Up Studies , Humans , Rare Diseases , Treatment OutcomeSubject(s)
Carcinoma, Verrucous/diagnosis , Foot Diseases/diagnosis , Skin Neoplasms/diagnosis , Toes , Aged , Amputation, Surgical , Biopsy , Carcinoma, Verrucous/pathology , Carcinoma, Verrucous/surgery , Cell Transformation, Neoplastic/pathology , Foot Diseases/pathology , Foot Diseases/surgery , Humans , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Magnetic Resonance Imaging , Male , Neoplasm Invasiveness , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Skin/pathology , Skin Neoplasms/pathology , Skin Neoplasms/surgerySubject(s)
Neurilemmoma/complications , Peripheral Nervous System Neoplasms/complications , Sciatic Neuropathy/complications , Sciatica/diagnosis , Sciatica/etiology , Adult , Humans , Magnetic Resonance Imaging , Male , Neurilemmoma/diagnosis , Neurilemmoma/diagnostic imaging , Peripheral Nervous System Neoplasms/diagnosis , Peripheral Nervous System Neoplasms/diagnostic imaging , Radionuclide Imaging , Sciatic Nerve/diagnostic imaging , Sciatic Nerve/pathology , Sciatic Neuropathy/diagnosis , Sciatic Neuropathy/diagnostic imaging , Sciatica/diagnostic imagingABSTRACT
Osteoid osteomas are small-sized benign painful bony tumors. The authors report the case of an osteoid osteoma located in the distal third of the tibia, treated by the surgical excision of the nidus using the intraoperatively isotopic marking which allows reducing the incision size and the bony resection.
ABSTRACT
Bilateral anterior dislocation of the shoulders with fractures of both greater tuberosities is very rare. A 76-year-old woman sustained a bilateral anterior dislocation of her shoulders with fractures of the greater tuberosity on both sides after a fall on stairs. Her arms were abducted and externally rotated. Radiological examination revealed the bilateral anterior dislocation and also the bilateral fractures of the greater tuberosity. Prompt closed reduction followed by a 3 weeks immobilization and subsequent rehabilitation allows a good outcome. Results at one-year follow-up were satisfactory with normal range of motion and no redislocations occurring. To our knowledge, this is the first reported case of bilateral anterior shoulder dislocation associated with fractures of both greater tuberosities in elderly woman.
ABSTRACT
Multifocal long bones tuberculosis without articular involvement is very rare. Pain and swelling are the common presenting symptoms. Difficulties in diagnosis often lead to delayed treatment, sometimes with devastating consequences for patients. Radiographs may mimic other diseases. Histopathological study is necessary to establish the diagnosis. The antibacillary chemotherapy produces excellent results. We report a case of a 60-year-old woman afflicted with multifocal tibial tuberculosis.
Subject(s)
Tuberculosis, Osteoarticular/diagnostic imaging , Female , Humans , Middle Aged , Radiography , Tuberculosis, Osteoarticular/pathologyABSTRACT
Tibiotalar dislocation without associated fracture is a rare injury. We report a case of an unusual open medial ankle dislocation without any associated bony injury. After reduction and debridement under general anaesthesia, capsule suture and ligaments repair were performed. An external fixator was applied for ankle immobilization. After 3 years follow-up, functional results were excellent without signs of instability or degenerative arthritis.
Subject(s)
Joint Dislocations , Adult , Ankle Injuries/etiology , Ankle Injuries/therapy , Female , Humans , Joint Dislocations/etiology , Joint Dislocations/therapyABSTRACT
Tuberculosis of the hand and wrist is a rare entity. We report 30 cases of tuberculosis of the hand and wrist, including ten cases of wrist osteoarthritis, ten cases of tenosynovitis, four cases of metacarpophalangeal and interphalangeal osteoarthritis and six cases of metacarpal and phalangeal osteitis. The histological study after surgical biopsy revealed caseating giant cell granulomas with epitheloid cells confirming the diagnosis. Antibacillary chemotherapy promoted healing and good outcome in our patients. The aim of our work is to analyze the epidemiological, diagnostic, therapeutic and evolutionary aspects of this disease through a series of 30 cases.
Subject(s)
Hand Bones/microbiology , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Osteoarticular/therapy , Wrist/microbiology , Adolescent , Adult , Aged , Female , Granuloma, Giant Cell/pathology , Humans , Male , Middle Aged , Osteitis/etiology , Osteitis/therapy , Osteoarthritis/etiology , Osteoarthritis/therapy , Tenosynovitis/etiology , Tenosynovitis/therapy , Young AdultABSTRACT
Este estudio retrospectivo tiene como objetivo mostrar el papel de la escapulectomía en el tratamiento de tumores escapulares analizando los resultados en 6 pacientes tratados en el Servicio de Cirugía Ortopédica del Hospital IBN SINA en Rabat por distintos tumores en la escápula entre los años 1996 y 2009. La evaluación de estos pacientes mediante el sistema de Enneking mostró en el plano funcional, excelentes resultados para 4 pacientes y buenos en los otros dos casos. En el aspecto oncológico, sólo un caso requirió la ampliación de la escapulectomía por recidiva tumoral, teniendo este paciente una buena evolución posterior. Ya que la escapulectomía ampliada es una intervención que lleva a un déficit funcional importante, actualmente el tratamiento de los tumores malignos de la escápula se realiza con una cirugía conservadora de miembro, realizándose una escapulectomía simple. Ésta debe llevarse a cabo tras una buena estadificación del paciente, para lo que es necesario un estudio de imagen completo y buen conocimiento de la anatomía para una correcta indicación quirúrgica (AU)
This retrospective study aims to demonstrate the role of scapulectomy in the treatment of scapular tumours by assessing the results of 6 patients treated for various scapular tumours in the Orthopaedic Department of IBN SINA hospital in Rabat between 1996 and 2009. The evaluation of these patients by the Enneking system showed, on a functional scale, an excellent score for 4 patients and good one for 2 patients; on the oncology scale, a single case required a total scapulectomy after recurrence with a good evolution. Since an enlarged scapulectomy leads to functional deficit, the majority of malignant tumours of the shoulder are currently treated conservatively, by performing a simple scapulectomy. Patient selection must be made after appropriate staging, a complete imaging study and a good knowledge of anatomy for a correct surgical indication (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Scapula/pathology , Scapula/surgery , Scapula , Chondrosarcoma/complications , Chondrosarcoma/diagnosis , Osteolysis/complications , Osteolysis , Retrospective Studies , Neoplasm Staging/methods , Neoplasm Staging/trends , Shoulder/pathology , Shoulder/surgery , Shoulder , ChondrosarcomaABSTRACT
Pure tibiotalar dislocations without associated fracture are rare. The authors report a case of an unusual closed tibiotalar dislocation without fracture involving proximal ascension of the talus. Immediate closed reduction was performed. Repair of the disrupted medial ligament was performed and one syndesmosis screw inserted, followed by 6 weeks of immobilization. After 1 year of follow-up, functional results were excellent.
Subject(s)
Joint Dislocations/diagnostic imaging , Tarsal Joints/diagnostic imaging , Tarsal Joints/injuries , Accidents, Traffic , Adult , Bone Screws , Casts, Surgical , Humans , Joint Dislocations/surgery , Male , Radiography , Tarsal Joints/surgeryABSTRACT
Congenital epulis or congenital gingival cell tumour is a rare tumour in the neonate. It arises from the gingival mucosa. This benign condition can be life threatening when obstructive. In this report, a case of a male neonate, with features of obstructive congenital epulis arising from both maxillary and mandibular alveolar ridge, interfering with breast-feeding is described. Diagnosis was suspected clinically and confirmed by histology. Outcome was good after prompt surgery.
Subject(s)
Gingival Neoplasms/pathology , Granular Cell Tumor/pathology , Airway Obstruction/etiology , Airway Obstruction/surgery , Gingival Neoplasms/surgery , Granular Cell Tumor/surgery , Humans , Infant, Newborn , MaleABSTRACT
Enchondroma is a common bone tumor of hand. It is rarely localized in scaphoid. We report a new case of this tumor revealed by fracture. The diagnosis was suggested by standard radiography and confirmed then by anatomic pathology examination. Enucleation and bone graft with osteosynthesis yielded good result.
Subject(s)
Bone Neoplasms/diagnosis , Chondroma/diagnosis , Fractures, Bone/complications , Scaphoid Bone/surgery , Adult , Bone Neoplasms/surgery , Chondroma/surgery , Fractures, Bone/surgery , Humans , Male , Scaphoid Bone/injuriesABSTRACT
Post-traumatic aneurysms are extremely rare in the infant population. We report a case of delayed abdominal aortic aneurysm that appeared in a 5-year-old female, admitted 5 months previously with contusions to the abdomen.
Subject(s)
Abdominal Injuries/complications , Aortic Aneurysm, Abdominal/etiology , Contusions/complications , Aorta, Abdominal/surgery , Aortic Aneurysm, Abdominal/diagnosis , Aortic Aneurysm, Abdominal/surgery , Child, Preschool , Female , Humans , Polytetrafluoroethylene , Time FactorsABSTRACT
We observed a pathological fracture of the femur in a 21-year-old woman with a venous malformation. Physical examination and plain x-rays disclosed a pathological bone. Biopsy revealed the venous malformation. The extent of the lesion that involved the entire quadriceps muscle was detailed with duplex-Doppler, computed tomography and arteriography. The patient was treated with an intramedullary nail. Intra-operative bleeding necessitated transfusion (packed cells and frozen plasma). Outcome was favorable. Bone healing was achieved at seven months.
Subject(s)
Calcinosis/complications , Femoral Fractures/etiology , Fractures, Spontaneous/etiology , Leg/blood supply , Vascular Diseases/complications , Veins/abnormalities , Adult , Female , HumansABSTRACT
PURPOSE OF THE STUDY: We present our experience with a rare localization of tuberculosis, the wrist, focusing on symptoms and outcome after treatment. MATERIAL AND METHODS: Our series included eleven patients, eight men and three women, mean age 42 Years, who presented tuberculosis of the wrist. Tuberculosis was known in four patients who were being treated and a context of tuberculosis was recognized in three others. One patient on long-term corticosteroid therapy was immunodepressed. Mean time from symptom onset to consultation was fifteen months indicating a slow and progressive disease process. An inflammatory syndrome was noted in nine patients. Based on the standard x-rays, the David-Chausse classification was: stage I n=1; stage II n=1; stage III n=3; stage IV n=4. The AP view of the wrist was normal in two patients. Diagnosis of tuberculosis was confirmed on the surgical biopsy specimen which revealed epithelio-gigantocellulary granuloma with caseous necrosis. In only five patients Koch bacilli developed in culture on Lowenstein-Jensen. Patients were given anti-tuberculous antibiotics and the wrist was immobilized in a plaster splint. RESULTS: Mean follow-up was two years. The disease course was blunted by the antituberculosis treatment. Surgical drainage was only required to clear abscesses. Wrist stiffness was frequent and had a significant functional impact. DISCUSSION: These eleven cases of a rare localization of tuberculosis illustrate the slow progressive course of clinical symptoms and radiological signs of tuberculosis, emphasizing the difficulties encountered in establishing early diagnosis of such isolated non-abscessed localizations. Anti-tuberculous treatment is effective but the functional outcome depends on early diagnosis before the development of radiological evidence of joint destruction.
Subject(s)
Carpal Bones , Tuberculoma/diagnosis , Tuberculoma/therapy , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Osteoarticular/therapy , Wrist Joint , Abscess/classification , Abscess/diagnosis , Abscess/etiology , Abscess/therapy , Adult , Antitubercular Agents/therapeutic use , Biopsy , Combined Modality Therapy , Diagnosis, Differential , Disease Progression , Drainage , Female , Follow-Up Studies , Hand Strength , Humans , Magnetic Resonance Imaging , Male , Range of Motion, Articular , Severity of Illness Index , Splints , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Tuberculoma/classification , Tuberculoma/etiology , Tuberculosis, Osteoarticular/classification , Tuberculosis, Osteoarticular/etiologyABSTRACT
The Authors report a retrospective series of eight cases of posterior radiocarpal fracture-dislocation. Average age of patients was 32 years (23/54), with a male predominance (7 men and a woman). Injury was often due to a fall on the hand in extension from an elevated place (5/8). The wrist in back of fork is the characteristic deformity. Diagnosis was confirmed by AP and lateral views of the wrist. Radial styloïd fracture, posterior dislocation of the carpus and posterior rim avulsion were constant. Ulnar styloïd fracture was present in half of the cases and distal radio-ulnar dislocation in two cases. Four patients were treated conservatively and four surgically. Whatever the treatment choice, results are satisfactory at a short follow-up. The two patients presenting a distal radio-ulnar dislocation resulted in a bad result.
Subject(s)
Fracture Fixation/methods , Joint Dislocations/pathology , Radius Fractures/pathology , Wrist Injuries/pathology , Adult , Carpal Bones/injuries , Carpal Bones/surgery , Female , Humans , Internal Fixators , Joint Dislocations/surgery , Male , Middle Aged , Radius Fractures/surgery , Retrospective Studies , Sex Factors , Wrist Injuries/surgeryABSTRACT
We report a case of false iatrogenic aneurism of the femoral artery observed after external fixation for septic malunion of the femur subsequent to emergency plate fixation. This false aneurysm ruptured, requiring femoropopliteal arterial repair. In the septic context, the vascular sutures failed making it necessary to ligature the femoral artery. Vascularization was maintained by satisfactory collateral circulation.
Subject(s)
Aneurysm, False/etiology , Femoral Artery/injuries , Femoral Fractures/surgery , Fracture Fixation/adverse effects , Iatrogenic Disease , Adult , Aneurysm, False/surgery , Collateral Circulation , External Fixators/adverse effects , Humans , Ligation , Male , Surgical Wound Infection/complicationsABSTRACT
This article is based on the retrospective study of 4 cases of necrotic fasciitis of the upper extremity, in adult patients with a mean age of 57 years (range: 36 to 78 years) and with a male predominance (3 M/1 F). Presenting signs were variable: pain, febrile and inflammatory oedema, ecchymoses with inflammatory masses containing clear or haemorrhagic fluid. Treatment with antibiotics and anti-inflammatory drugs did not prevent progression to painless, necrotic ulcers. Rapid medical and surgical treatment constitutes an element essential of the prognosis and must include wide large debridement, antibiotics and intensive care.