Cases reported "Exostoses"

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11/60. subclavian vein thrombosis caused by an unusual congenital clavicular anomaly in an atypical anatomic position.

    The optimal surgical management of subclavian vein effort thrombosis remains a dilemma because outcomes after different treatment strategies are only on the basis of small retrospective series. SVT treatment should be on the basis of the cause of thrombosis. Primary effort thrombosis or Paget-Schroetter syndrome frequently necessitates a surgical approach. The type of surgery has to be individualized after careful diagnostic evaluation. We report a congenital clavicular exostosis that had not been identified with chest radiograph and computed tomographic scan that caused SVT in a young woman. This unusual cause of Paget-Schroetter syndrome was treated with a unique approach.
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12/60. Hard palate mucosal grafts for defects of the nail bed.

    The authors present 2 children in whom a hard palate mucosal graft was used for a defect of the nail bed after resecting subungual exostosis. After the tumor was resected with the overriding nail bed, hard palate mucosa without periosteum was grafted to the nail bed defect. In both patients the graft took completely, and within 2 weeks after the operation the patients were able to enjoy activities of daily life, including athletic movement, without any symptoms. Nail growth was uneventful and was complete in 4 or 5 months after the operation without any complications. The authors think that a hard palate mucosal graft is a valid choice for a defect of the nail bed, and the mucosa does not need to be harvested with periosteum. The grafting of hard palate mucosa without periosteum to a defect of the nail bed contributes to a shorter healing time, resulting in a reduction in the period of restriction of movement in activities of daily life, and this is a great advantage in children.
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13/60. Pericardial hemorrhage caused by costal exostosis.

    This report describes a 21-year-old man who presented with pericardial hemorrhage due to a puncture wound of the pericardium by an inward-facing exostosis of the left fifth rib.
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14/60. Exostosis following a subepithelial connective tissue graft.

    This case report describes the formation of an unusual unaesthetic gingival enlargement during a five year post operative period subsequent to a subepithelial connective tissue graft placed facial to teeth #4 and #6. Histological assessment of the enlarged tissue indicated that it consisted of viable bone and marrow. The exostosis was reduced with rotary instruments and acceptable soft tissue aesthetics were created using a carbon dioxide laser for gingivoplasty. Possible causes for this unusual enlargement are discussed.
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15/60. An unusual cause of hiccup: costal exostosis. Treatment by video-assisted thoracic surgery.

    The described case is of a 15-year-old boy who presented with a persistent hiccup and repeated episodes of left-sided chest pain. At computed tomography scan an exostosis originating from the costo-chondral junction of the left 4th rib was seen. The tip of the exostosis reached the external surface of the pericardium. Removal of a 2 cm rib segment including the implantation basis of the exostosis was achieved by video-assisted thoracic surgery. Symptoms disappeared after surgery. This report shows an exceptional symptom of costal exostosis.
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16/60. Deviation of a finger at the proximal interphalangeal joint caused by juxta-articular exostosis.

    An exostosis around the interphalangeal joint can cause deformity of a finger. We present two children with deviated fingers as a result of exostoses that developed near the proximal interphalangeal joints and were successfully treated by resection and closed wedge osteotomy.
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17/60. Subungual exostosis of the thumb.

    A 19-year-old girl presented with painful raised skin lesions over the right thumb for the past one year that had ulcerated over the last one month. On examination, a lobulated nodule of bony-hard consistency, measuring around 2 cm was present over the lateral aspect of the tip of the right thumb. The lesion was tender and the overlying skin showed superficial erosions. Roentgenogram of the hand showed mature bone projecting from the distal end of the terminal phalanx of the right thumb forming a "Y"-like bifurcation. histology from a bit of excised tissue from the lesion (thumb) showed evidence of mature trabecular bone with a fibrocartilaginous cap in the deep dermis. There was no evidence of malignant change on histology. Local excision of the entire lesion was done and there has been no recurrence till date.
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ranking = 4
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18/60. Subungual exostosis following toe nail removal--case report.

    Removal of toe nail is a minor procedure that can be under ring block with no significant complications. We report the case of a young lady who developed a rapidly growing subungual exostosis on her right great toe following nail removal. Inadvertent iatrogenic injury to the nail bed and underlying phalangeal periosteum during nail removal might have triggered off rapid bone growth resulting in the large exostosis. To our knowledge, this aetiology for subungual exostosis formation has not been reported before.
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ranking = 7
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19/60. Subungual exostosis: a review of 16 cases focusing on postoperative deformity of the nail.

    We reviewed the clinical features of 16 patients who underwent surgery for subungual exostosis, focusing on postoperative deformity of the nail. In 7 patients, the lesion did not destroy the nail bed and was excised with a fish-mouth-type incision. In 9 patients, the lesion destroyed the nail bed and was excised with a direct approach. In 5 of the 9 patients, artificial skin was applied after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by a fish-mouth-type incision when the tumor did not destroy the nail bed, although 2 patients had local recurrence. onycholysis occurred postoperatively when the tumor destroyed the nail bed and the defect of the nail bed was large after excision of the tumor. Secondary nail bed reconstruction may be indicated in such cases with postoperative deformity of the nail.
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ranking = 5
keywords = exostosis
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20/60. Report of an unusual case of trigger finger secondary to phalangeal exostosis.

    Trigger finger is commonly secondary to stenosing tenosynovitis. Space occupying lesions in the tendon bed, although uncommon, may prevent smooth tendon gliding. These include lipoma, anomalous muscle insertions, tumours of the tendon sheath and haemangiomas. We describe a patient who had triggering of the left middle finger at the proximal interphalangeal joint due to an exostosis blocking the flexor tendons gliding. Removal of the exostosis relieved the problem. The clinician must be aware that there are other causes for triggering. These may be identified with pertinent findings in the history and physical examination.
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ranking = 6
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