Giant cell tumour of the femoral neck: Failure of curettage-cavity filling cementation with screw fixation, a case report.

BACKGROUND: Giant cell tumours are common primary long bone tumours with femoral neck locations infrequent and notorious for pathological fractures. Treatment with simple curettage often results in local recurrence. Aggressive treatment that combines tumour resection with cement filling and internal fixation aims at preserving native joint function. CASE REPORT: The authors intend to illustrate the short falls of such conservative approach through a case report of a femoral neck giant cell tumour in a 37 year old patient. Patient had undergone curettage-cavity filling with screw fixation for a pathological femoral neck fracture. Total hip arthroplasty was undertaken following implant failure and severe hip impairment 3 years after initial surgery. CONCLUSION: Intralesional curettage and cavity cementation with internal fixation of giant cell tumour of the proximal femur allows joint preservation. Mechanical failure, local recurrence and degenerative changes hinder long term outcomes especially in the setting of pathological fractures. Further studies are required to delineate the benefits of joint sparing techniques vis-a-vis total hip replacement for giant cell bone tumours of the femoral neck.

Surgical management of intramuscular hemangioma of the foot: a case report.

BACKGROUND: Hemangiomas are benign tumors usually found in the lower extremity yet their surgical management on the location in the foot is rarely documented. CASE PRESENTATION: We report a case of a plantar intramuscular hemangioma in 25-year-old patient with a history of percutaneous therapy. Patient had undergone intralesional sclerotherapy 3 years prior to his admission with persistent pain on weight bearing activities.MRI demonstrated a multi lobulated lesion of the 1st IMS with a peripheral enhancement on gadolinium injection. The patient underwent elective surgery with complete excision and no functional impairment at the last follow-up 3 years after surgery. CONCLUSION: Intramuscular hemangiomas are rare occurrences. Steroid injection and sclerotherapy are effective non-operative methods. Complete excision of isolated hemangioma lesions allows definite diagnosis with no recurrence.

Surgical treatment by percutaneous anterior screw fixation of scaphoid fractures.

The aim of this study was to evaluate the results of percutaneous screw fixation of scaphoid waist fractures in our surgery unit by comparing them with recent data from the literature. This was a retrospective, descriptive study conducted between January 2010 and September 2016. Patients operated due to a recent scaphoid fracture and treated by percutaneous anterograde screw fixation with a Herbert screw were included in this study. Our cohort was a sub-set from a scaphoid fracture group; other fracture sites, other treatment techniques and fractures associated with scapholunate ligament lesions were excluded. The time to union and union rate were recorded. The Youm and McMurtry indices, scaphoid and scapholunate angles were measured on radiographs. A total of 21 patients were included. The mean age was 30 years (18-44) and the sex ratio (male/female) was 9.5. The union rate was 95% with an average follow-up of 24 months. Four patients had a mobility deficit in the sagittal plane of about 9°. No malunion was found, and no major complications were observed. Based on this study, percutaneous fixation of the scaphoid with Herbert's screw is a reliable technique that leads to union in most cases with limited postoperative immobilization.

Musculoskeletal Echinococcus infection as a rare first presentation of hydatid disease: case report.

BACKGROUND: Hydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown. CASE PRESENTATION: We deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow. Meticulous examination and preoperative imaging did not reveal other localizations. Patient was admitted for surgery where total excision of cyst was done without intraoperative spillage and a cutaneous skin flap was subsequently required to make up for soft tissue loss. CONCLUSION: Primary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications.

[An unusual location of juxtaosseous ossified lipoma. A case report]. / Une localisation inhabituelle d'un lipome ossifié juxtaosseux. À propos d'un cas.

We report a case of juxtaosseous ossified lipoma. Clinical and radiological features make it an exceptional case, because of its location at the hand and presence of cortical erosion of the subjacent bone. However, the histological study of this rare benign tumor showed neither cytonuclear atypia nor increasing number of mitosis. It made easy its surgical treatment, without any functional sequelae. The patient reported no local recurrence in the follow-up; the risk is low, given its histological character.

[Anterior dislocation of the elbow joint without peri-articular fracture in an adult]. / Une luxation antérieure du coude sans fracture péri-articulaire chez un adulte.

In view of the comparative frequency of posterior dislocations of the elbow, it is rather remarkable that anterior dislocations of that joint should be among the rarest of injuries [1]. Our case is one of the first cases of anterior dislocation of the elbow without any periarticular fracture or pre-existing deformities around the elbow [2].

[The intermetacarpal double pinning in the surgical treatment of Bennett fracture (report of 24 cases)]. / Le double embrochage intermétacarpien dans le traitement chirurgical de la fracture de Bennett (à propos de 24 cas).

OBJECTIVES: The interest of this work is to show the benefits of surgical treatment of Bennett fractures by intermetacarpal double pinning. PATIENTS AND METHODS: It is a retrospective study of 24 cases of Bennett fracture treated by intermetacarpal double pinning, between January 2005 and December 2009. The treatment was surgical for all patients. The intermetacarpal double pinning using the technique of Iselin has been reserved for fractures with small fragment found in the series in 18 cases (72% of operated patients), and by Tubiana in six cases (24%). RESULTS: After a mean of 36 months, we could follow only 21 patients, the evaluation of results was based on clinical criteria relevant to pain, mobility and the pinch grip, and on criteria after radiological analysis of radiographs specific trapezo-metacarpal. All fractures were consolidated. Two cases of moderate osteoarthritis were observed. Overall, the results were excellent in 15 patients (71%), good in four patients (19%) and poor in two patients (10%). CONCLUSION: Intermetacarpal double pinning is a technique of choice in surgical treatment of Bennett fracture. It ensures a good closed reduction and a satisfactory functional result.

[A giant tumor of the thumb revealing bronchic adenocarcinoma (a case report)]. / Tumeur géante du pouce révélant un adénocarcinome pulmonaire (à propos d'un cas).

Bone metastases in the hand are rare. The authors report a case of a 46-year-old woman diagnosed with a giant hand tumor, revealing a lung adenocarcinoma. An amputation of the thumb was performed. Histology confirmed a metastasis from the lung adenocarcinoma.

Humerus pathological fracture revealing biliary carcinoma.

Tumors of the biliary tract are rare, and their survival prognosis is short since diagnosis is often made at advanced stages of the disease. Diagnosis remains difficult because symptoms are often unspecific. Bone metastasis from biliary carcinoma are rare. We report a case of a humeral metastasis revealing a biliary carcinoma.

[Isolated echinococcosis of the flexor digitorum profondus: a case report]. / Echinococcose isolée du muscle flexor digitorum profondus : à propos d'un cas.

Echinococcosis is a widespread zoonosis which is endemic in most sheep-raising countries. Primary isolated muscular localisation is uncommon even in these endemic areas. The authors report a rare case of primary hydatid cyst localized in the myotendinous junction of the flexor digitorum profundus. According to our review of the medical literature, there are no reports of a similar case, making ours the first such report.