Desmoplastic Fibroblastoma of the Ankle: A Case Report of a Rare Localization and a Literature Review.

Introduction: Desmoplastic fibroblastoma is a rare, slow-growing benign soft tissue tumor. It has a wide anatomical distribution and mainly affects adult males. Fourteen percent of cases occur in the ankle or foot. Case Report: In this study, we report a rare location of desmoplastic fibroblastoma on the ankle of a 76-year-old female, discovered as a slowly growing mass. Discussion: Desmoplastic fibroblastoma is an anatomical and clinical entity. It appears macroscopically as a pseudocartilaginous structure and histologically as a stellate or spindle-shaped fibroblastic proliferation in a collagenous stroma. Conclusion: Desmoplastic fibroblastoma has anatomical specificities and should still be clearly distinguished from certain malignant tumors.

CORIN KneeTec DeepDishTM: Functional outcomes after a follow-up of 12 months and comparison with the STRYKER Triathlon PS.

Several competing concepts of anteroposterior stabilization have been developed for total knee arthroplasty (TKA), with an overall great success despite some differences in terms of clinical or radiological outcomes. The CORIN KneeTec DeepDish TM is a novel mobile-bearing implant, stabilized with an ultra-congruent deep-dish poly- ethylene insert. The aim of the present study was to report clinical and radiological outcomes of a series of patients who received the KneeTec DeepDish TM after a follow-up of 12 months, and to compare them to those of a comparable series of patients who received the STRYKER Triathlon ® posterior- stabilized. This was a retrospective comparative cohort study (level of evidence III). Demographic data, radiographic data and range of motion (ROM), as well the International Knee Society score and Oxford Knee Score were collected pre-operatively, and after a follow-up of 12 months. 106 KneeTec DeepDish TM and 80 Triathlon ® PS were evaluated at follow-up. Patients who received the KneeTec DeepDish TM had significant improvement in ROM, radiographic and clinical outcomes. There were no significant differences between the cohorts in terms of ROM, radiographic and clinical outcomes, as well as antero-posterior stability. This study is the first to report the 12-month outcomes of the CORIN KneeTec DeepDish TM. The novel KneeTec DeepDish TM achieved comparable ROM, radiographic and clinical outcomes to the Triathlon ® PS after 12 months. Further studies will be necessary to evaluate the mid- to long-term outcomes of the KneeTec DeepDish TM .

Brachymetatarsia: Surgical Management, Case Report, and Literature Review.

Background: Brachymetatarsia is defined by an abnormal shortening of the metatarsal bone. This rare condition is mostly primary and congenital. Consequences of this malformation are both esthetic and functional, due to pain and mechanical problems in the forefoot. Surgical management is an important part of patient care. There are two main options: gradual lengthening by progressive callotosis distraction using an external fixator and one stage lengthening using bone graft and osteotomy of the bone. This review presents two cases using the one stage lengthening surgical management method. We also discuss some reports in the literature with the aim to compare the advantages and disadvantages of the two surgical methods. Literature concerning the surgical management of brachymetatarsia was identified using the PubMed and Google Scholar databases. Patient Presentation. We describe two female patients aged 20 and 26 years who underwent one stage lengthening surgery of the fourth toe with isolated brachymetatarsia using an iliac bone graft and internal fixator plate. The two patients had a lengthening of around 10 mm after postoperative evaluation. No skin complications were noted, but one of the patients reported flexor stiffness after surgery. Concerning the functional and cosmetic aspects, the two patients are satisfied with the management. Conclusions: In the literature, one stage lengthening seems to be the most favorable option for the care of brachymetatarsia. Studies show a short healing time and fewer complications like infection, stiffness, malalignment, and malunion. Some reviews note the utility of the gradual lengthening of severe brachymetatarsia when a longer lengthening is necessary. There is no definite consensus concerning the management of brachymetatarsia.

A Fatal Case of Massive Incarcerated Genital Prolapse.

Genital prolapse is usually seen as a benign condition warranting treatment only when bothersome. We report the case of a 77-year-old woman who presented with massive incarcerated pelvic organ prolapse, which led to bladder necrosis, cystectomy with bilateral cutaneous ureterostomy, and death from medical complications 5 weeks after the initial presentation. This first case report of death from bladder necrosis after incarcerated genital prolapse could warrant treatment of massive prolapse even when apparently well tolerated.

Safety and Feasibility of Laparoscopic Nephrectomy for Big Tumors (≥ 10 cm): A Retrospective Multicentric Study.

OBJECTIVE: Evaluate the feasibility of laparoscopic nephrectomy for big tumors. MATERIAL AND METHODS: Data from 116 patients were retrospectively collected from 16 tertiary centres. Clinical and operative parameters, tumor characteristics, pre- and postoperative parameters, and renal function before and after surgery were analyzed. RESULTS: Mean age and body mass index were 61 years and 27.8 kg/m(2), respectively. Males represented 63.8% of patients, and 54.4% presented symptoms at diagnosis. Median tumor size was 11 cm, and 75% of the cases were performed by expert surgeons. Median operative time and blood loss were 180 minutes and 200 mL respectively. Conversion to open surgery was necessary in 20.7% of cases. Intraoperative complications related to massive hemorrhage occurred in 16.4% of patients, resulting in open conversion in 62.5%. Major postoperative complications occurred in only 10 patients (8.6%). In univariate analysis, intraoperative complications, age, and blood loss were predictive factors of conversion to open surgery. Positive surgical margins occurred in 6 patients (5.2%). None of them presented a local recurrence. Predictive factors of recurrence or progression were lymph node invasion, metastases, and Furhman grade. CONCLUSION: Laparoscopic nephrectomy for tumors > 10 cm can be performed safely. Complication rate and positive surgical margins are similar to open surgery. In experienced hands, the benefit of a mini invasive surgery remains evident.