The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study.

BACKGROUND AND STUDY AIMS: The success of conversion total hip arthroplasty (THA) among primary THA and revision THA remains unclear. We hypothesized that most conversion THA's can be performed using primary implants and will have an uncomplicated post-operative course. MATERIALS AND METHODS: Thirty-six patients (23 females, mean age 68,0y) who underwent conversion THA for failed interventions for proximal femur fractures in the period 2008-2018 were matched sequentially against patients of the same sex and age who underwent primary THA or revision THA. Data were collected on implants used, major complications, and mortality. PROMs used included the Western Ontario and McMaster Osteoarthritis Index, Harris Hip Score, Visual Analogue Scale and the EQ-5D Health Questionnaire. RESULTS: Seventy-two percent of patients who underwent conversion THA were treated with primary implants and never suffered from a major complication. PROMs were excellent for this group of patients. The distinction primary/conversion/revision THA could not explain differences in outcomes; however, the necessity of using revision implants and the development of major complications could. CONCLUSIONS: The majority of conversion total hip arthroplasties can be considered a primary replacement. Predicting outcomes for THA should focus on patient frailty and technical difficulties dealing with infection, stability and loss of bone stock and should discard the conversion versus revision terminology.

Giant squamous cell carcinomas of the shoulder.

Giant squamous cell carcinomas (SCC) larger than 5 cm in diameter are uncommon; there is no guideline on the size of an SCC that is considered giant. Treatment may be difficult with the need for large tissue resections and complex surgical reconstruction. We report a rare case of giant squamous cell carcinoma of the shoulder attached to deep anatomic planes. The entire mass was removed, resulting in a large defect that was repaired with myocutaneous flap rotation of the latissimus dorsi. Three courses of radiotherapy were performed after surgery. Fifteen months after the operation, the patient is well and working without any local recurrence and metastasis.

Sclerosing epithelioid fibrosarcoma: rare and serious.

Sclerosing Epithelioid Fibrosarcoma (SEF) is a rare form of soft tissue sarcoma. It is characterized by a slow evolution, with local recurrences and late metastases that are mainly pulmonary and pleural in about 50% of cases. The treatment is based on the surgery which must be as wide as possible. The efficacy of adjuvant therapy in the control of SEF is not yet demonstrated. Chemotherapy is used in recurrences, some have also proposed radiotherapy. Long-term follow-up of patients with SEF is therefore essential.

Carpal antelunar dislocation and Fenton syndrome: Extremely rare association.

Carpal antelunar dislocations are much rarer than posterior dislocations. Their frequencies are between 3 and 6% of carpal perilunar dislocations. Out of 23 cases of carpal antelunar dislocations listed in the literature, there are only 11trans-scapho antelunar dislocations. Carpal antelunar dislocation and Fenton syndrome are two exceptional entities in the literature. In the case of Fenton syndrome, the head of the capitatum is described with a rotation of 90° to 180°. The association of these two entities remains anecdotal (3 cases described). The anterior approach of carpal antelunar fracture-dislocation was recently honored. This approach offers the benefit of better control of associated intracarpal fractures. In our case, the fracture of the capitatum forced us to a dorsal approach. This approach allowed the reduction and osteosynthesis of the scaphoid satisfactorily. At 3 months, the patient has very good clinical and radiological results.

Extra bone chondroma of the shoulder: a case study and literature review.

Extra-osseous chondroma is a benign and rare tumor. It usually sits at the extremities, we report an exceptional case of a chondroma of the soft parts of the shoulder in a 28 year old woman who manifested by a painless swelling of the left shoulder. The histology confirmed the diagnosis on the excision piece. Clinical and radiological follow-up after a 24-month follow-up did not show a sign of recurrence.

[Gauthier's osteotomy and fixation using osteosuture in the treatment of Freiberg's disease]. / Ostéotomie de Gauthier et fixation par ostéo-sutures dans le traitement de la maladie de Freiberg.

Freiberg's disease is an osteochondrosis of the metatarsal heads mainly affecting the second metatarsal head. This study was conducted over a 3 year period. It reports 6 cases of patients, whose average age was 19.8 years, who had undergone Gauthier's dorsal subtraction osteotomy with fixation using osteosutures. The outcome of this technique was satisfactory. Indeed, the majority of patients had no pain and recovered normal daily activity. This study highlights that fixation using osteosutures is a reliable and inexpensive method.

[Simultaneous bilateral rupture in both cruciate knee ligaments (about a case)]. / Rupture bilatérale simultanée des deux ligaments croisés du genou: à propos d'un cas.

Bilateral cruciate ligament rupture is rare while simultaneous rupture in both anterior cruciate ligaments (ACL) is exceptional; that's why post-traumatic simultaneous bilateral cruciate ligament rupture has never been described in the literature making this case study based on patient's observation, follow-up and therapeutic discussion very interesting. The procedure was performed in two surgical steps spaced in time and results were very satisfactory for both us and patient.