Carcinoid tumor of the coccyx: case report and review of the literature.

STUDY DESIGN: Report of a patient with a carcinoid tumor of the coccyx. OBJECTIVES: To describe the clinical presentation, diagnosis, and treatment of a patient with a carcinoid tumor of the coccyx and to review the relevant medical literature in English. SUMMARY OF BACKGROUND DATA: No reports of a carcinoid tumor of the coccyx were found in the literature. Seven reports of carcinoid of the sacrum are described. METHODS: Clinical history, magnetic resonance imaging studies, and light and electronic microscope micrographs are reviewed. RESULTS: A coccygeal mass was detected during evaluation of coccygodynia in a 40-year-old woman. Four years after extended coccygectomy, there are no signs of local tumor recurrence. CONCLUSIONS: Carcinoid tumor of the coccyx is extremely rare. An extended coccygectomy may lead to a cure or at least to a prolonged disease-free interval.

Review of the current methods in the diagnosis and treatment of scaphoid fractures.

If neglected or misdiagnosed, non-union of a scaphoid fracture will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist with subsequent morbidity and lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wrist. The diagnosis and treatment are not simple. Familiarity with different imaging methods and treatment options is required. The treatment in most cases is conservative and will lead to uneventful union, but an operation may be needed in certain cases primarily and in the treatment of non-union. The current literature on the diagnosis and treatment of scaphoid fractures is reviewed, and the authors try to make a clear and concise picture of this complex and sometimes controversial field.

Could irrigation, debridement and antibiotic therapy cure an infection of a total hip arthroplasty?

Seven patients suffering from an acute (less than two weeks) infection of a total hip arthroplasty were treated by irrigation and debridement, with appropriate antibiotic therapy and retention of the prosthesis. They were followed for an average of 30 months. Infection did not recur in five (71%) patients, but the other two required further surgery. We conclude that a cure can be obtained by this method, although the results are inferior to re-implantation. A minimal procedure spares a patient the morbidity and cost of a more extensive operation. Higher success rates might have been achieved by selecting patients infected with organisms of low virulence, but there are insufficient data to predict whether this treatment would decrease the success of subsequent re-implantation.

A simple and efficient surgical technique for subungual exostosis.

Subungual exostosis is a benign osteochondral tumor usually involving the distal phalanx of the great toe. The lesion most frequently occurs in the second and third decades of life and is rare before the age of 10 years. There are few reports of its occurrence in children, and most of them advocate partial or complete nail excision to treat this lesion successfully. We report our experience with six children and adolescents using a simple surgical technique that involves approaching the exostosis under the nail to preserve nail coverage. Rapid recovery and excellent cosmetic appearance were achieved immediately after the operation.

Ankle arthrodesis using the Ilizarov apparatus: good results in 6 patients.

We report our experience with the Ilizarov apparatus in performing ankle arthrodesis in 6 patients. The average age of the patients was 52 (42-60) years. 3 patients had posttraumatic arthrosis and active infection of the ankle or distal tibia and the other 3 had posttraumatic arthrosis of the ankle without infection. Solid and painless arthrodesis was achieved in all patients in 7-15 weeks, including those with an active infection or failed multiple previous operations. While the method is useful for primary treatment of ankle arthrosis, we think it is better for treatment of certain complicated cases.

Talcum powder in revision surgery for olecranon bursitis. Good outcome in 11 patients.

We adapted the use of talcum powder in chest surgery to create a reactive pleuritis for treating recurrent olecranon bursitis. The 11 patients who underwent this procedure all had favorable outcomes.