Late onset hyperplastic callus formation in osteogenesis imperfecta type V simulating osteosarcoma-A case report.

INTRODUCTION: We report a case of late onset hyperplastic callus formation (HPC) in the right femur in type V osteogenesis imperfecta (OI) mimicking the occurrence of a malignant osteosarcoma. PRESENTATION OF CASE: A 27-year-old female patient consulted us due to swelling in her right femur over 2-3 months without trauma. X-rays looked like an osteosarcoma, blood tests showed increased bone metabolism. A CT scan, a MRI and biopsy were performed, showing late onset HPC due to osteogenesis imperfecta type V. DISCUSSION: OI shows a heterogeneous disease pattern due to a variety of clinical and radiographic findings. HPC is a rare complication of OI type V. Differential diagnosis range from cortical or periosteal osteosarcoma, periostitis, myositis ossificans, subperiosteal hematoma secondary to trauma or osteomyelitis. CONCLUSION: Recognition of HPC as a form of this particular type of OI is important to avoid misdiagnosis like malignant transformation to osteosarcoma. A biopsy and advanced imaging modalities like CT, MRI and scintigraphy are recommended.

Regular, in-situ, team-based training in trauma resuscitation with video debriefing enhances confidence and clinical efficiency.

BACKGROUND: To assess the clinical impact of a regular, multidisciplinary, video debriefed training intervention for trauma team members on real trauma resuscitations. In addition, attending personnel evaluated the training program via questionnaire. METHODS: The training intervention is a regular (monthly), video debriefed, team-based trauma simulation. Training takes place in the fully functional resuscitation bay (in-situ) of the Department of Traumatology at the Klinikum Oldenburg (Level 1, primary teaching hospital for the Carl von Ossietzky University Oldenburg) involving a complete trauma team. Laerdal® Resusci Anne® dummy serves as the patient simulator. A special feature is a structured video debriefing of each participating team to analyse team performance. Data before and after implementation of training was retrospectively analysed. RESULTS: We found a significant decrease in the time from arrival of the patient to computer tomography (CT, Spearman rank coefficient r = - 0.236, p = 0.001). Evaluation of the questionnaire by team members described a significant increase in self-confidence (p < 0.05). CONCLUSION: Monthly video assisted team based in situ training with video debriefing significantly reduces resuscitation time in the emergency bay.