1/21. Peroneus longus tendon rupture as a cause of chronic lateral ankle pain.rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is presented. The authors review their clinical, radiographic, and operative treatment of this patient and review the literature of this unusual injury.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/21. Gross vertebral collapse associated with long-term disodium etidronate treatment for pelvic Paget's disease.Inhibition of skeletal mineralisation is a well-recognized complication of disodium etidronate therapy that was identified in the earliest studies of its use in osteoporosis and Paget's disease. The effect is seen at lower doses in Paget's disease than in osteoporosis. Several cases of spontaneous fractures occurring in unaffected bones of Paget's patients have been reported. However, we believe the case described here is the most severe example of etidronate-induced osteomalacia published in the literature, featuring widespread vertebral collapse occurring as a consequence of nearly 10 years of uninterrupted etidronate treatment for isolated hemipelvic Paget's disease.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
3/21. "Silent" transverse patellar fracture following anterior cruciate ligament reconstruction.Patellar fracture is a rare but specific complication of anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft. When this complication occurs, early internal fixation is recommended and need not compromise the outcome. We report 2 cases of displaced transverse patellar fracture occurring after reconstruction but which were not diagnosed and presented with late sequelae.- - - - - - - - - - ranking = 3keywords = fracture (Clic here for more details about this article) |
4/21. Vertical-split fracture of mandibular condyle and its sequelae.A case of vertical-split fracture of the right mandibular condyle and its sequelae is presented. The patient was a 16-year-old female being assessed for orthodontic treatment. Orthopantomograph and plain joint view radiographs showed a remodelled condyle which had suffered trauma 10 years previously. This type of fracture is unusual in nature but has not led to any secondary lack of growth, restriction of movement or facial asymmetry.- - - - - - - - - - ranking = 3keywords = fracture (Clic here for more details about this article) |
5/21. Evaluation of donor site intrinsic healing response in autologous osteochondral grafting of the knee.We report the case of a 45-year-old male patient who underwent autologous osteochondral autografting in the knee for osteochondritis dissecans. The patient required revision surgery 1 year postoperatively, which allowed histologic and mechanical characterization of the intrinsic healing response of the initial graft donor sites. Histologic examination showed heterogeneous areas of dense fibrous tissue, bone, and discrete areas of cartilage. Mechanical testing using a confined compression testing technique determined the equilibrium stiffness as 0.97 MPa. The majority of dense fibrous tissue and areas of bone are likely responsible for the observed increased stiffness. When performing osteochondral autografting, consideration must be given to the benefit afforded to improving the areas of cartilage injury with the potential morbidity associated with graft harvest at the donor sites.- - - - - - - - - - ranking = 0.0046938402700132keywords = compression (Clic here for more details about this article) |
6/21. Bilateral symmetric polyarthralgia revealing Fanconi's syndrome.We report the case of a 45-year-old woman who presented with a six-year history of diffuse polyarthralgia responsible for major disability. She reported bilateral symmetric arthralgia in nearly every joint, as well as back pain. Muscle wasting predominating in the roots of the limbs was found. Laboratory tests showed hypocalcemia, severe hypophosphatemia, hypokalemia, alkaline phosphatase elevation, aminoaciduria, and hyperphosphaturia, with no glycosuria. Radiographs disclosed osteolysis of the pubic symphysis, multiple pelvic fractures, vertebral compression fractures, and diffuse demineralization. A bone scan visualized symmetric foci of hyperactivity in nearly all joints and fracture sites. Dramatic improvements in clinical and radiographic abnormalities were noted after six months of treatment with phosphate and calcitriol. This is a case of incomplete fanconi syndrome, with no glycosuria. The clinical presentation of fanconi syndrome can be misleading. fanconi syndrome should be borne in mind as a possible cause of polyarthralgia to avoid diagnostic delay, which in our patient led to a picture of pseudomyopathy with multiple fractures.- - - - - - - - - - ranking = 2.00469384027keywords = fracture, compression (Clic here for more details about this article) |
7/21. Regional migratory osteoporosis: a pathogenetic hypothesis based on three cases and a review of the literature.Regional migratory osteoporosis (RMO) is a migrating arthralgia of the weight-bearing joints of the lower limb which mainly affects middle-aged males. Its aetiology is unknown. The association of RMO with generalised osteoporosis has recently been reported. A concurrent systemic osteoporosis was also reported in some cases of transient osteoporosis of the hip (TOH), a disorder closely related to RMO. In its turn, TOH is considered a reversible stage of avascular necrosis of the hip (AVN), and the aetiopathogenesis of both of them remains strongly debated. We report three cases of RMO associated with generalised severe idiopathic osteoporosis. Three men, in the fourth and fifth decades of life, complained of at least four episodes of arthralgia in the lower limbs, with a migratory pattern, radiographic focal osteoporosis and final clinical resolution. The most striking common feature of these patients was the presence of a severe systemic osteoporosis with a prevailing trabecular involvement. We suggest that a prolonged or exaggerated activation of regional acceleratory phenomena (RAP) is the cause of transient osteoporosis. Bone tissue microdamage due to osteoporosis may be the most frequent noxious stimulus that turns RAP on, and, bone tissue microfracture is the most prevalent consequence. When this pathogenetic pathway is activated, the progression from focal osteoporosis and bone marrow oedema to avascular necrosis is associated with the amount of structural damage.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
8/21. The diagnostic and therapeutic challenge of femoral head osteoid osteoma presenting as thigh pain: a case report.Osteoid osteoma, an infrequent but important cause of musculoskeletal pain, is often difficult to diagnose. We present a case of a 31-year-old man who, for 2 years, had left groin pain radiating to the thigh. Symptoms began 1 month after a motorcycle crash in which he sustained only shin abrasions. Initial spine and hip radiographs were negative. Treatment with naproxen provided significant relief, but the symptoms gradually worsened over 6 months. An electromyogram and lumbar magnetic resonance imaging (MRI) of the left lower leg were unremarkable. hip MRI revealed edema without fracture. Prophylactic femoral pinning for impending stress fracture provided no relief. Rheumatologic evaluation revealed normal serologies and synovial fluid. Cyclobenzaprine and sulfasalazine were started and provided mild relief. At presentation to our institution, he was in significant discomfort, but could ride a bicycle for exercise and was completing a home exercise program. He had antalgic gait and globally restricted hip motion with end-range pain. A neurologic examination showed no abnormalities. hip and pelvis computed tomography scan revealed increased sclerosis of the femoral head, with a central lucency suggestive of osteoid osteoma. This was confirmed by biopsy. Radiofrequency ablation provided significant symptom relief.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
9/21. hip pain in a case of hypophosphatemic osteomalacia.Hypophosphatemic rickets, a rare metabolic bone disease, presents mainly in children but has also been reported in several adults. In this report, we describe the case of a man presenting with hip pain and weakness, both of several months' duration, and tested for hypophosphatemic rickets. The patient was eventually referred to a tertiary-care center, where he was diagnosed with bilateral subtrochanteric femoral stress fractures and severe osteopenia secondary to hypophosphatemic osteomalacia. The patient was treated with closed reduction and internal fixation and vitamin d and phosphorus. Outcomes were good at 7-month follow-up.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
10/21. hip pain related to femoral neck stress fracture in a 12-year-old boy performing intensive soccer playing activities--a case report.We describe the rare case of a 12-year-old boy complaining of repetitive severe pain in the left thigh, during physical activity related to a femoral neck stress fracture. Even though stress fractures are common in the adult athletic population, they occur rarely in children, with the epiphyseal growth plates still open. Diagnosis is delayed as only unspecific changes are found when conventional radiography is performed. For adequate treatment, early diagnosis by MRT or bone scintigraphy is essential. Conservative treatment will be effective through prevention of overuse.- - - - - - - - - - ranking = 3keywords = fracture (Clic here for more details about this article) |
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