[OLECRANON BURSITIS].

INTRODUCTION: The olecranon bursa is a pocket-like structure located at the posterior aspect of the elbow that is responsible for the smooth movement of the surrounding tissues. Frequently, it is the source of elbow pain due to an inflammation which may be caused by local injury or penetration of bacteria through the skin. This can lead to an initial acute and possibly a late chronic inflammation. Chronic inflammation may originate from systemic diseases such as gout and rheumatoid arthritis as well. The treatment of olecranon bursitis may be conservative (non-surgical) or surgical. Recently, there is more supporting evidence for the use of conservative management over surgical intervention in treating olecranon bursitis.

[RADIAL TUNNEL SYNDROME].

INTRODUCTION: The radial tunnel syndrome (RTS) is an entrapment of the radial nerve in the forearm. It is characterized by pain focused on the trapping area in the proximal forearm as well as pain radiated down the forearm. The syndrome is more common in men and in our estimation, there is a circumstantial connection to the continuous use of the computer keyboard. Radial tunnel syndrome is a consequence of nerve entrapment in the tunnel, which is formed from a covering consisting of the supinator muscle and the distal margins of this muscle. There is a clear association between radial tunnel syndrome and the occurrence of tennis elbow. The sensitivity in nearby locations along with the lack of familiarity of some of the clinicians with RTS lead to misdiagnosis and therefore, even to mistreatment in some cases. The physical examination is the most important means of making the correct diagnosis. The treatment of radial tunnel syndrome is divided into the conservative one in which emphasis is placed on physiotherapy and mobilizations of the nerve and the surgical one during which decompression of the radial canal is performed and in fact release of pressure at the exact anatomical location.

Trigger Finger Due to Anomaly of Lumbrical Insertion: A Case Report and Review of Literature.

CASE: Trigger finger (TF), or stenosing synovitis, is a common condition that can usually be diagnosed by physical examination. We recently operated on a patient with TF who did not respond to conservative treatment. At surgery, we found an anomalous insertion of the fourth lumbrical muscle to the A1 pulley. This insertion was observed to cause mechanical narrowing of the pulley due to a pulling effect by the muscle, which was relieved by resection. CONCLUSION: Although rare, the operating surgeon should be aware that local anatomical anomalies, such as insertion of a lumbrical into the A1 pulley, can be a cause of trigger finger.

[MEDIAN NERVE COMPRESSION BY LIPOMA CAN MIMIC CARPAL TUNNEL SYNDROME].

INTRODUCTION: Lipoma of the nerve is an uncommon tumor, and usually has the highest incidence in the upper limb, especially in the median nerve. When the lesion is large it can cause peripheral neuropathy such as carpal tunnel syndrome. Therefore, a physical examination is paramount for correct surgery and patient preparation. In this article we present a case that was mainly diagnosed by a complete physical examination, which led to the selection of appropriate surgery for the patient.

Combined approach for intrapelvic abscess drainage among adults.

Obturator internus muscle (OIM) and adductor brevis (AB) abscess occurs rarely in adults. This condition mainly affects children experiencing trauma. This paper presents and discusses a unique case of OIM and AB abscess in an adult male that was treated operatively with a combined surgical approach (modified Stoppa and Smith-Peterson) after multiple failed drainage procedures. CASE: A 23-year-old male underwent reduction and fixation of his right tibiae shaft fracture with an intramedullary nail. After several referrals to the emergency room due to recurrent symptoms of fever and groin pain, he was finally admitted and diagnosed with OIM and AB abscess and fulminant MRSA sepsis. The operative treatment was performed by addressing the abscess with an unusual combined surgical approach (Smith-Peterson and modified Stoppa) for abscess drainage. METHODS: Using PubMed, Google scholar and Hadassah Hebrew University search engines, we conducted a literature search using the following keywords: 'pyomyositis', 'obturator abscess', 'pelvic abscess', and 'pelvic osteomyelitis among children and adults'. Twenty case studies were found (14 children and 6 adults). No cases of combined OIM and AB abscess were found and only one OIM case was reported with methicillin-resistant Staphylococcus (MRSA).