A pathological fracture of the scaphoid revealing an intraosseous ganglion cyst

Intraosseous ganglion cyst is a benign bone lesion with histological similarities to the soft tissue ganglion cyst. Its location on the short bones, including the carpal bones has rarely been reported. The radiolucent carpal lesions are usually symptom-free found incidentally on radiographs of the wrist performed for other reasons. Detecting a pathological fracture of the scaphoid revealing an intraosseous ganglion cyst is exceptional. We report the case of a 21-year-old, right-handed male, presented with a one year history of progressive right-wrist pain, worsened since a month without a history of previous trauma. Plain radiographs and CT-scan revealed a cystic lesion of the scaphoid with a pathological fracture. He was successfully treated with curettage and packing with a Zaidemberg's vascularized radial graft without recurrence at two years postoperatively.Pan African Medical Journal 2016; 2

Tuberculous flexor tenosynovitis of the hand

AbstractTuberculosis is a major public health problem in developing countries. Flexor tenosynovitis of the fingers constitutes an exceptional tuberculosis localization (Gabl et al., 1997; Senda et al., 2011) [1,2]. Unusual presentations, such as tuberculous tenosynovitis, often go undetected and are associated with a diagnostic and therapeutic delay, especially when bacteriological research proves to be negative. Here, we report a case of tuberculous flexor tenosynovitis of the hand

Teeth syndrome: diagnosis, complications and management

Teeth syndrome or fight bite is a specific entity in hand surgery that is little known. It includes infectious complications of the hand following a fist against the teeth. Neglected or misdiagnosed this injury  frequently leads to serious complications that could compromise the function of the hand. A retrospective study was performed on 20 patients treated for teeth syndrome at our department, during a period of 12  years (January 2003 to April 2015). All young adults with a mean age of 28 years and a significant male  predominance. The dominant side was involved in 15 patients. Lesions were divided into 4 cases of simple dorsal wounds facing the MP joint, 8 cases of dorsal hand cellulitis, and 8 cases of arthritis and osteoarthritis of the  metacarpophalangeal (MP) joint of the long fingers. The index was the most affected finger. Treatment  consisted in debridement of necrotic tissues, stabilization with external fixation for arthritis, skin  reconstruction was performed secondarily. Result was assessed as good in 60% of cases. Clenched fist  injuries to the mouth (teeth syndrome or fight bite) are known as being the worst human bites. Usually  treated as minor injuries, without realizing a breach of the joint capsule, a lesion of the extensor tendon, or a contamination by oral flora. Any patient with a wound near the joint of the hand and was involved in a fight, need an appropriate evaluation and a specialized treatment to avoid serious complications.Key words: Human bite, cellulitis, arthritis, finger, Hand surger

Kuhlmann vascularized bone grafting for treatment of Kienböck’s disease: a case report

Treatment of Kienböck's disease has historically been determined by staging, ulnar variance, and presence or absence of arthritic changes. With the advent of newer techniques of vascularized bone grafting, the status of the cartilage shell of the lunate has become another factor that can influence the procedure performed. The purpose of this article is to describe the technique of Kuhlmann vascularized bone graft for Kienböck's disease. In addition, the indications, contraindications, and outcomes are described.Pan African Medical Journal 2016; 2

Carpal tunnel syndrome caused by lipoma: a case report

Lipoma is a relatively frequent, benign soft-tissue tumor rarely located in the hand. A lipoma of the hand causing a carpal tunnel syndrome by compression of the median nerve is exceptional. We report the case of a 70-year-old female presenting with a carpal tunnel syndrome. A compression of the median nerve by a lipoma was discovered during surgery. Transverse carpal ligament release with lipoma excision and neurolysis of the median nerve were performed. Histopathological study of the resected mass was consistent with a lipoma. Two-month postoperatively, the patient recovered full hand function with entire disappearance of  acroparesthesia. Carpal tunnel syndrome caused by space occupying lesions is rare. Diagnosis is difficult, usually based on the clinical study, electrophysiology and magnetic resonance imaging (MRI). Transverse carpal ligament release and excision of lipoma provides excellent functional recovery.Key words: Lipoma, carpal tunnel syndrome, median nerve, nerve compressio

Glomus tumor of the leg: a case report

Glomus tumors are uncommon benign tumors developing from the neuro-myo-arterial glomus body. They are typically located in the fingers. The extra-digital involvement is unusual and makes diagnosis difficult. Only few cases have been reported in literature. We report an exceptional case of a glomus tumor of the lower leg in a 65-year-old male. The diagnosis was clinically suspected and confirmed by a biopsy. Surgical excision gave immediate pain relief. The aim of this report is to make the surgical community more aware of this entity based on the analysis of our own experience and a review of the literature

Pseudotumoral form of soft-tissue tuberculosis of the wrist

Tuberculosis is a major public health problem in developing countries. Hand and wrist is a rare localization for extra-pulmonary tuberculosis, a pseudotumoral form of soft tissue tuberculosis of the wrist is exceptional. We report the case of a 45-year-old male presenting with a painful swelling of the dorsal aspect of the right wrist evolving for six months. Clinical study was evoking a ganglion cyst of the wrist. Intraoperatively a pseudotumoral mass with rice bodies was found, suggesting tuberculous tenosynovitis. The histopathological study revealed caseating giant cell granulomas with epithelioid cells. Cultures on Löwenstein–Jensen medium detected Mycobacterium tuberculosis. Synovectomy with removal of all the rice bodies followed by anti-tuberculous chemotherapy provided uneventful recovery

Osteoarticular tuberculosis dactylitis: Four cases

Tuberculosis dactylitis is exceptional. We report 4 cases of osteoarticular tuberculous dactylitis in 3 women and 1 man. The diagnosis was suspected on chronic and insidious clinical presentation, and confirmed by histology. Patients were treated by anti-tubercular drugs with good functional and radiological outcome in all cases. Clinical and therapeutic issues are discussed by the authors in the context of an endemic country

Transformation of dermatofibrosarcoma protuberans into a fibrosarcoma

Dermatofibrosarcoma protuberans is a rare cutaneous mesenchymal tumor characterized by a low potential of malignancy with a very low rate of metastasis but an important rate of local recurrence. Its transformation into a fibrosarcoma is exceptional, responsible for a higher metastatic potential. This transformation implies a closer surveillance. Through a case report and literature review, we will try to expose epidemiological, clinical, histological, therapeutic, and outcome particularities of this entity

A rare localization of tuberculosis of the wrist: The scapholunate joint

The tuberculosis of the hand and the wrist is a rare entity. Affecting the scapholunate joint is exceptional. It is usually diagnosed at an advanced stage of carpal destruction, due to slowly development of the symptoms. We report the case of a 58-year-old female, presenting as wrist pain for 3 months. Clinical study showed a local swelling in the left wrist, the mobility of the wrist was normal but painful at the end of motion. The diagnosis of osteoarticular tuberculosis was suspected after radiological and biological study then confirmed after histological study. Antibacillary chemotherapy during 12 months promoted healing and good outcome