Acral post-traumatic tumoral calcinosis in pregnancy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Tumoral calcinosis is an uncommon disorder characterized by the development of calcified masses within the peri-articular soft tissues of large joints, but rarely occurs within the hand.</p> <p>Case presentation</p> <p>We present the case of a 31-year-old pregnant Indian woman with a three-month history of painful swelling within the tip of her right middle finger following a superficial laceration. She was otherwise well and had normal serum calcium and phosphate levels. Plain radiography demonstrated a dense, lobulated cluster of calcified nodules within the soft tissues of the volar pulp space, consistent with a diagnosis of tumoral calcinosis. This diagnosis was confirmed on the basis of the histopathological examination following surgical excision.</p> <p>Conclusion</p> <p>To the best of our knowledge, we present the only reported case of acral tumoral calcinosis within the finger, and the first description of its occurrence during pregnancy. We review the etiology, pathogenesis and treatment of tumoral calcinosis.</p

Dor como sintoma de soltura de acetábulo rosqueado Pain as symptom of threaded acetabular cup loosening

Foram avaliadas clínica e radiograficamente 37 artroplastias totais de quadril não cimentadas tipo CO-10, com seguimento mínimo de 60 meses, onde observamos componentes radiograficamente fixos em 23 e o componente acetabular com sinais de soltura em 14. A análise dos resultados mostrou que 65% dos pacientes com o componente acetabular evidentemente solto não queixavam de dor (29%) ou a apresentavam de forma discreta (36%), enquanto que 26% dos pacientes com o acetábulo fixo apresentavam dor discreta. Desta forma, concluímos que a dor não é sintoma que deva ser esperado na maioria dos pacientes com soltura do componente acetabular tipo CO-10 e que uma parcela significativa dos pacientes com o acetábulo fixo pode apresentar dor.<br>37 cementless CO-10 total hip replacements were clinically and radiographically evaluated, with a minimum follow-up of 60 months. 23 cups were found to be fixed and 14 presented signs of loosening. Nine patients (26%) with an obviously fixed cup presented some degree of pain, a symptom also referred by ten patients (36%) with signs of cup loosening, but in this latter group pain varied from mild (5/10) to moderate (3/10) and severe (2/10). Interestingly, four patients with a loose cup had no pain at all. The authors concluded that pain is not a symptom present in the majority of the patients with a loose threaded CO-10 cup and that a significant number of patients with fixed cups can present pain

Management of trochanteric fractures of the femur with external fixation in high-risk patients

The aim of this prospective study was to assess the outcome of trochanteric fractures of the femur after external fixation in a group of elderly patients with high surgical risk. The study population consisted of 50 patients with trochanteric fractures of the femur and a mean age of 87 years who were classified by an anaesthetist as ASA 3 or 4 and considered not suitable for conventional fractures fixation. The fracture was fixed with an external fixator under spinal anaesthesia. The final follow-up was at 12 months. All fractures healed within 12 weeks. Superficial pin tract infection occurred in 30 patients, and fracture united with a shortening of 14 mm (5–20) in 12 patients. No implant failures or limitation of knee movements were recorded. Five patients died within 1 year. External fixation is a valuable treatment alternative for trochanteric fracture of the femur in elderly patients