[Treatment of recurrent giant cell tumor of the tibia with en bloc resections, bone transport and arthrodesis using an AO type external fixations system. A case report]. / Resección en bloque, transporte óseo y artrodesis con fijador tubular AO del tumor de células gigantes recurrente de tibia. Reporte de un caso.

INTRODUCTION: The primary treatment for the giant cell tumor (GCT) at the knee level, both distal femur and proximal tibia remains curettage and application of methyl methacrylate. In the cases where recurrence occurs, controversy exists in the decision making algorithm whether to preserve the joint, or to perform en bloc resection. CASE REPORT: We report a case of GCT that relapsed at proximal tibia in a stage III of Enneking, in a 26 year old patient, that was handled with en bloc resection, transportation and bone arthrodesis using an AO type tubular external fixator (Synthes). After two years of evolution there was no evidence of tumor relapse, the limb was preserved and we obtained a solid arthrodesis, and an acceptable gait. DISCUSSION: We believe this procedure is a feasible option and an alternative to tumoral prosthesis and amputation. However, despite the success obtained with this procedure, we strongly recommend to assess the functional reconstruction procedures on an individual basis and according to the need of each patient.

[Fracture due to bilateral avulsion of the tuberosity of the shin bone (tibia). A case report]. / Fractura por avulsión bilateral de la tuberosidad de la tibia. Reporte de un caso.

INTRODUCTION: The avultion-fracture of the tibial tuberosity is a rare injury, one which appears in adolescents, predominantly male and happens in a zone in which the conditions of bone immaturity are favorable, so that an abrupt traction of the patellar tendon generates the injury. The reports of simultaneous fractures in both knees are rare. CLINICAL CASE: A 14-year-old masculine patient, who had suffered indirect trauma in both knees while playing soccer. The injuries correspond to a 3-A and one 3-B of Ogden's classification for the right and left knee respectively. Both injuries were treated in the same surgical act using screws and wire. The recovery of the patient was satisfactory. CONCLUSION: The avultion-fracture of the tibial tuberosity is a rare injury. The bilateral presentation in simultaneous form is even rarer. Generally they are injuries of type 3 that require surgical handling. Preexisting conditions such as Osgood-Schlatter disease and the type of athletic training must be considered.

[Treatment of traumatic clavicular pseudoarthrosis with the Hunec Colchero nail]. / Tratamiento de la seudoartrosis traumáitica de clavícula con clavo Colchero Hunec.

INTRODUCTION: Post-traumatic clavicular pseudoarthrosis occurs as a complication of mid third fractures, particularly of those with an important displacement that leads to failure of conservative treatment. Most reports on the management of this complication use various plates and grafts. We used the Hunec nail as an implant and an iliac crest graft. MATERIAL AND METHODS: We report the results obtained in 17 patients with a diagnosis of clavicular pseudoarthrosis treated with the Hunec nail and an iliac crest graft. Patients were 9 males and 8 females; mean age was 38 years. Ten pseudoarthrosis were located on the right side and seven on the left side. Eleven were classified as atrophic and six as hypertrophic. Only one case had undergone previous surgery. Regardless of the type of pseudoarthrosis, an iliac crest graft placed as "barrel ribs" was used. RESULTS: In all cases bone healing occurred in a period of approximately 12 weeks; there was complete recovery of the ranges of motion. Only one case had nail migration, but this happened after bone healing and no other complications occurred. The nail was removed from 10 patients one year after surgery. We conclude that the Colchero Hunec nail provides enough stability to achieve healing of the traumatic clavicular pseudoarthrosis.