Chondroblastic osteosarcoma of the distal tibia: a rare case report

Chondroblastic osteosarcoma, representing about 25% of osteosarcoma, is a fatal primary malignancy of the skeleton if not diagnosed and treated appropriately. It most commonly occurs in the long bones of the extremities near the metaphyseal growth plates. In this report, we describe the occurrence of chondroblastic osteosarcoma involving the left distal tibia in a 14-year-old male. The diagnosis was confirmed by the histological examination of a surgical biopsy. The patient was treated by both surgery and neoadjuvant chemotherapy. No recurrence was noted at 3 years of follow-up. To our knowledge, only two cases describing chondroblastic osteosarcoma of the distal tibia had been reported through English medical literature. Therefore, the aim of our article is to make the clinician aware of this rare clinical presentation and also to provide a comprehensive review of the literature related to this uncommon malignant tumour.Keywords: Osteosarcoma, chondroblastic, tibi

The place of the modified palmer technique for articular calcaneal fractures

Surgical treatment of displaced articular fractures of the calcaneus is currently recommended by most authors. Different surgical procedures are described in literature. The purpose of this study is to evaluate the functional and anatomic results of articular fractures of the calcaneus surgically treated with the modified Palmer method and precise the place, the conditions, and the advantages of this technique for articular fractures of the calcaneus. This is a retrospective study assessing the outcomes of surgical treatment of articular calcaneal fractures surgically treated using the modified Palmer technique. Twenty-two patients underwent this surgery for 6 years. All patients have diabetes and/or smoking history, and physical examination revealed a severe swelling within the hindfoot. Sanders classification Type II was found in 6 cases, whereas 18 cases fell below Type III. The mean preoperative Bohler angle was about 2.7°. An extended lateral approach was performed, and the void caused by elevating the intra-articular surface was filled by an iliac crest graft firmly impacted in all cases. Additional limited fixation was performed in 71 of patients. On follow-up, the functional and anatomic results were analyzed, respectively, by Kitaoka and Babin's quotations, and the radiological assessment was based on Bohler angle. No cutaneous or infectious complications were observed after surgery. The mean postoperative Bohler angle was 21.9°, and it was 19.8° at the last follow-up with a significant difference. At follow-up, the mean functional Kitaoka score was 75; it was considered as excellent in four cases, good in ten, fair in eight, and poor in two patients. The modified Palmer technique is a simple surgical procedure to treat intra-articular calcaneal fractures. It provides encouraging results. This method is recommended in the case of Sander's II and III calcaneal fracture for patients with a high risk of cutaneous complications to avoid infection and cutaneous complications

Reliability and Validity of a New Taekwondo-Specific Change-of-Direction Speed Test With Striking Techniques in Elite Taekwondo Athletes:A Pilot Study

International audienceThe purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 +/- 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 +/- 1.08 s for males and 11.74 +/- 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST's typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST's TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed (r = 0.71 to 0.85) and dynamic balance (r = -0.71 and -0.74), large correlations with COD speed (r = 0.57 to 0.60) and vertical jump performance (r = -0.50 to -0.65), and moderate correlations with horizontal jump performance (r = -0.34 to -0.45) and static balance (r = -0.39 to -0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed

An unusual Monteggia equivalent type 1 lesion: Diaphyseal ulna and radius fractures with a posterior elbow dislocation in a child

In this report, we describe an extremely unusual Monteggia equivalent type 1 lesion in a 10-year-old boy following a fall from a height of 1 m. On the plain radiographs, our patient had a particular Monteggia equivalent type 1 injury associating a posterior elbow dislocation with diaphyseal radius and ulna fractures. The patient was treated by closed reduction technique. At six months of follow-up, the fractures were consolidated and the elbow was stable. To our knowledge, only 8 adult cases and one paediatric observation with similar lesions had been reported through medical literature. Therefore, the aim of our case report is to remind this rare entity and also to provide a comprehensive review of the literature related to this uncommon lesion. Keywords: Monteggia equivalent, Children, Forearm fracture, Elbow dislocatio

Intra-articular knee arborescent lipoma: a case treated with arthroscopic synoviectomy

Arborescent lipoma is an unusual intra-articular lesion that typically develops in the knee and has to be evoked before chronic effusion. It corresponds to hyperplasia of mature fatty tissue and hypertrophy of synovial villi, developing within a joint. The reference treatment is synovectomy by arthrotomy. The rare forms localized to the anterior compartment of the knee can benefit from an arthroscopic synovectomy. Theauthors report a case of arborescent knee lipoma in a 47-year-old patient who received arthroscopic synoviectomy. To our knowledge, only a few cases of arborescent lipoma treated by arthroscopic synoviectomy have been reported in the literature.Key words: Arborescent lipoma, knee, synoviectomy, arthroscopi

Place des gestes associés à l’ostéotomie de Scarf dans le traitement de l’hallux valgus

Devant la multiplicité des techniques proposées pour le traitement de l'hallux valgus, nous proposons d'évaluer l'ostéotomie Scarf associée ou non à une ostéotomie phalangienne et/ou une ostéotomie Weil. Il s'agit d'une étude rétrospective de 29 patients, dont un cas bilatéral, opérés entre 2011 et 2016 par une ostéotomie de Scarf du premier rayon avec un geste associé dans 80% des cas. Les résultats ont été analysés selon la satisfaction des patients, l'indice de Groulier et les mesures radiologiques. Le score global de Groulier donnait une bonne évaluation objective du résultat prenant en compte les données radiologiques et anatomiques qui influencent le résultat final en cas d'insuffisance de correction. Le recul moyen était de 3 ans et 5 mois. Une diminution significative du valgus phalangien (de 34,17% à 16,1%), du métatarsus varus (de 15,13% à 9,93%) et de l'angle articulaire distal métatarsien (de 17,63% à 12,73%) étaient retrouvés. Les patients sont satisfaits et très satisfaits dans 83% des cas. Les complications sont dominées par l'hypo-correction dans 13,3% des cas et nous n'avons noté aucun cas de pseudarthrose ou de nécrose de la tête de M1. Nos résultats sont comparables à ceux de la littérature. Nous insistons sur le caractère surtout fonctionnel de la chirurgie de l'hallux valgus qu'il convient d'intégrer dans une correction globale de l'avant-pied. L'ostéotomie de Scarf nécessite une technique rigoureuse, elle est fiable par ses résultats et présente comme limite les grosses déformations surtout de l'angle articulaire distal métatarsien

Burden and predictions of hospitalized injuries in a low-middle income country: results from a Tunisian university hospital

ABSTRACTInjuries are responsible for a high premature mortality and disability. They are poorly explored in low and middle income-countries. We aimed to estimate the burden of hospitalized injuries in the Monastir governorate (Tunisia) according to the nature of the injury, trends and projections of hospitalizations for injuries up until 2024, and to identify the distribution of this disease burden based on age and sex. We performed a descriptive study from 2002 to 2012 including all hospitalizations for injuries. Data were collected from morbidity and mortality register of the University Hospital of Monastir (Tunisia). We estimated the burden of injuries using the Disability Adjusted Life Years (DALYs). We described injuries (crude prevalence rate (CPR) and age standardized prevalence rate (ASR)), related mortality (lethality and standardized mortality ratio (SMR)), trends and prediction for 2024. A total of 18,632 hospitalizations for injuries representing 10% of all hospitalizations during study period were recorded. Per 1000 inhabitants per year, CPR was 3.36 and the ASR was 3.44. The lethality was of 17.5 deaths per 1000 injured inpatients per year and the SMR was of 2.95 (Confidence Interval of 95%: 2.64–3.29). Burden related to injuries was 2.36 DALYs per 1000 population per year, caused mainly by Years of Life Lost (83.4%), most frequent among men aged under 40 years. The predicted ASR for 2024 was 4.46 (3.81–5.23) per 1000 person-years. Injuries to the head was the most prevalent (20.7%) causing 67.7% of DALYs; and increasing by 226% through 2024. Injuries had a high prevalence and an important burden in a Tunisian university hospital. Prediction showed increased prevalence for 2024. Preventive measures and a trauma surveillance register should be implemented soon