RESUMO
BACKGROUND: Chronic irritation is a known cause of malignant change in humans. It is believed that at least a minimum of five years is needed for the evolution of the illness. OBJECTIVE: To present cases of consecutive squamous cell malignant change in patients with various irritations, and to highlight that these cases are not too uncommon in our environment. METHODS: Case reports of patients with definitive treatments offered. Patients had amputation done after incisional biopsies were done to determine the mitotic status of the lesions. RESULTS: The three patients presented late. All had lower limb affectation. Conservatism was difficult, all of them ending up with amputation of the affected limbs. One of them had inguinal lymph node metastasis after the amputation, signifying advanced disease, but unfortunately had to leave hospital because she could not cope with the financial demands of treatment. CONCLUSION: Malignant change from chronic irritations can occur under five years. Education might help early presentation and improved outcome. Our hospitals should provide for the treatment of these group of patients despite their financial status.
Assuntos
Neoplasias de Células Escamosas/patologia , Fraturas da Tíbia/complicações , Úlcera/complicações , Adolescente , Adulto , Amputação Cirúrgica , Biópsia , Transformação Celular Neoplásica , Doença Crônica , Feminino , Seguimentos , Antepé Humano , Humanos , Inflamação , Joelho , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Neoplasias de Células Escamosas/etiologia , Neoplasias de Células Escamosas/cirurgia , Fraturas da Tíbia/patologia , Fraturas da Tíbia/cirurgia , Resultado do Tratamento , Úlcera/patologia , Úlcera/cirurgia , CicatrizaçãoRESUMO
BACKGROUND: External fixators have been noted to have a place in the orthopaedic management of problems involving the ankle and foot. We here report a case of ankle and foot contracture managed by soft tissue release and slow, gradual external fixator distraction. METHOD: A case report of a patient with acquired ankle and foot contracture and discussion of relevant literature. RESULTS: A 9-year old female presented to our out-patient clinic with features of right ankle and foot contracture following treatment by traditional bone setters 6 years earlier. The contracture was fixed at 30 degrees. She had soft tissue release and slow, gradual external fixator distraction which corrected the foot to a plantigrade position. Subsequently she had skin grafting for the skin defect. After removal of the external fixator she was placed on a below knee cast and commenced weight bearing. The cast was removed after three weeks and the patient has continued to bear weight on a plantigrade foot. CONCLUSION: External fixators have a definite place in contracture release and should be widely utilized.
