Chondromyxoid Fibroma of the Lateral Malleolus: A Case Report

Chondromyxoid fibromas account for <1% of primary bone neoplasms. We report one such case occurring in the distal fibula of a 27-year-old woman. The patient underwent curettage, followed by phenolisation, insertion of a Steinmann pin, and cementation. This treatment reduced morbidity, restored stability, and enabled rapid functional recovery. There was no recurrence after 2 years

A distal-lock electromagnetic targeting device for intramedullary nailing: Suggestions and clinical experience

Purpose: To describe our clinical experience with a system named SureShot™ Distal Targeting (Smith & Nephew, Memphis, USA) based on magnetic field presence and discuss our suggestions on this technique. Methods: We analysed prospectively 47 patients affected by humeral, tibial or femoral fractures, treated in our institution during a 3-year period of time (August 2010 to September 2013). We considered the following parameters: the time to set up, the time to position a single screw, the effectiveness of the system (drilling ad screwing), the irradiation exposure time during distal locking procedure and surgical complications. Results: A total number of 96 screws were inserted. The mean preparation time of the device was 5.1 min ± 2 min (range 3–10 min). The mean time for single screw targeting was 5.8 min ± 2.3 min (range 4–18 min). No major complications occurred. Only a few locking procedures were needed to be practiced in order to obtain the required expertise with this targeting device. Conclusion: According to our results, this device is reliable and valid whenever the correct technique is followed. It is also user friendly, exposes to lower radiation and needs less surgical time compared to relative data from the literature. However, the surgeon should always be aware of how to use the free hand technique in case of malfunctioning of the system

Management of post-traumatic elbow instability after failed radial head excision: A case report

Radial head excision has always been a safe commonly used surgical procedure with a satisfactory clinical outcome for isolated comminuted radial head fractures. However, diagnosis of elbow instability is still very challenging and often underestimated in routine orthopaedic evaluation. We present the case of a 21-years old female treated with excision after radial head fracture, resulting in elbow instability. The patient underwent revision surgery after four weeks. We believe that ligament reconstruction without radial head substitution is a safe alternative choice for Mason III radial head fractures accompanied by complex ligament lesions

A two-choice strategy through a medial tibial approach for the treatment of pilon fractures with posterior or anterior fragmentation

【Abstract】Objective: The anterolateral approach to the tibia has been popularized for the management of tibial pilon fractures. For complex fracture patterns a combined anterolateral/anteromedial approach is suitable buta high rate of complicat ion has been reported. In our retrospective study a two-choice strategy adopting a medial tibial approach was proposed for the treatment of pilon fractures with anterior or posterior fragmentation. Methods: Based on an anatomic study of tibial pilon fractures, we retrospectively analyzed the fractures with primary posterior, posterior-lateral or anterior, anterior-lateral (Tillaux-Chaput) involvement of the distal tibia. This retrospective study consisted of 18 patients with a closed tibial plafond fracture. The inclusion criteria were: (1) presence of an anterior/anterolateral type fragment or a posterior (Volkmann) type fragment involving &gt;25% of the articular surface, (2) a minimum follow-upof 12 months, (3) a fibula f racture associated with a medial column fracture of the distaltibia, and (4) soft tissue conditions at the time of operation that did not compromise the choice of surgical access (Tscher ne classi fication for closed fr actures: grade 0 and grade 1). Tibial plafond fractures were classified into two groups: one presenting anterior and the other with posterior rim (Volkmann) fragments. Resul ts: Most patients achieved a good clinical recovery in terms of range of motion and Olerud-Molander scale scores. Only three patient s presented a grade 2 osteoarthritis at the 12 month follow-up. Conclusion: Our two-choice strategy highlights concepts which have been previously debated and described in the literature. But a new extended protocol for surgical approach to the distal tibia, including more fracture patterns and their association should be further investigated. Key words: Tibial fractures; Fracture fixation; Surgical procedures, operative; Intraoperative complication

Chondromyxoid Fibroma of the Lateral Malleolus: A Case Report

Chondromyxoid fibromas account for <1% of primary bone neoplasms. We report one such case occurring in the distal fibula of a 27-year-old woman. The patient underwent curettage, followed by phenolisation, insertion of a Steinmann pin, and cementation. This treatment reduced morbidity, restored stability, and enabled rapid functional recovery. There was no recurrence after 2 years

Missed posterior shoulder dislocation and McLaughlin lesion after an electrocution accident

【Abstract】Posterior shoulder dislocation is a rare event that may occur after a direct trauma, an epileptic seizure, electric shock or electroconvulsive therapy. In more than 50% of the cases, posterior dislocations are missed on initial evaluation and often misdiagnosed as frozen shoul-ders with unfortunate consequences. We present the case of a missed posterior subluxation and reverse Hill Sachs lesion (McLaughlin lesion) in a 40-year-old woman caused by anelectric shock of 240 V. The patient underwent sur-gery in our institute two weeks after the injury. The humeral head was reduced and the reverse Hill Sachs lesion was filled by demineralized bone matrix allograft with osteoinductive factors. Tendons were repaired and a temporaneous artrodesis was performed. At the final follow up of 12 months, we obtained a Costant Score of 93 and the patient returned to her previous daily activities. Key words: Shoulder dislocation; Electric injuries; Bone matri

Surface-based haemangioma of the tibia: a case report.

We present in this paper a case of surface-based haemangioma of the tibia in a 34-year-old patient which had been misdiagnosed as periostitis. X-ray examination demonstrated a periosteal reaction, confirmed by a MRI showing a soft tissue mass adjacent to bone. We performed an incisional biopsy and made a diagnosis of haemangioma only after examining the histological results. An angiographic study was performed in order to have embolisation of the vessels, but this was not possible because of the excessive number and calibre of afferent arteries. No further symptoms arose after biopsy and therefore an en bloc or radical excision was not performed. Indications for making a correct diagnosis and performing a suitable treatment are presented below