RESUMEN
Fibrous or desmoid tumors are grouped under the term fibromatosis; there are several groups; the pediatric aggressive form is rare, especially the pelvis and/or hip presentation. This causes a variable degree of destruction of the surrounding tissues. It is a diagnosis by exclusion and histopathologic testing; treatment is always surgical and conservative treatment is indicated only for special locations and/or patient conditions. This article reports a case of aggressive pediatric hip fibromatosis with severe joint destruction, as well as the work-up and management protocol followed at the National Pediatrics Institute Pediatric Orthopedics Service to approach bone tumors. No cases similar to this one have been reported.
Asunto(s)
Neoplasias Óseas/diagnóstico , Fibromatosis Agresiva/diagnóstico , Articulación de la Cadera , Niño , Femenino , Humanos , Invasividad Neoplásica , Índice de Severidad de la EnfermedadRESUMEN
The defects of the spinal cord enclose diverse malformations that go from spina bifida to myelomeningocele but there is also a rare variant that is the intercalary bone. The incidence of this phenomenon may vary in 1 to 1,000 to 5,000. At our knowledge, there are no cases reported where it can be an association of intercalary bone and a bifid spine in different levels. In this article we report the case of one patient that coincide with an intercalary cervical bone, bifid spine in lumbar column and bifid spine in sacral column. The objective of this article is also to comment how the clinical symptoms are unspecific, the chronic pain is the frequent symptom, and how the physiotherapy and anti-inflammatory drugs can provide excellent results in a short and medium term.
Asunto(s)
Anomalías Múltiples , Vértebras Cervicales/anomalías , Espina Bífida Oculta , Anomalías Múltiples/diagnóstico , Adulto , Femenino , Humanos , Región Lumbosacra , Espina Bífida Oculta/diagnósticoRESUMEN
INTRODUCTION: Our institution implemented a minimally-invasive surgery program that included a thorough preoperative assessment and planning to provide the patient with an appropriate correction of the radiographic parameters as well as esthetic satisfaction, together with a shorter hospital stay and less analgesic use. MATERIAL AND METHODS: Retrospective, comparative, longitudinal and observational clinical trial. The study period was from January 2002 to December 2007; 40 patients with hallux valgus underwent minimally invasive surgery, 12 of them underwent bilateral surgery, for a total of 52 feet with hallux valgus; 100% of them were females. Patients with mild hallux valgus were 59.6% (31 patients) and those with moderate hallux valgus represented 40.4% (21 patients). Radiographic measurements were assessed in the pre- and postoperative periods; the AOFAS test was performed in the pre- and postoperative periods and 6 months later. Central trend and scatter measurements and Student's t-Test were performed. RESULTS: A significant difference was found in both the pre- and postoperative measurements. In both groups the postoperative results were within the normal ranges and there was no significant difference between them in the 6-month postoperative assessment. DISCUSSION: Any failed correction of some of the intrinsic and extrinsic components may cause a recurrent deformity. Certain parameters cannot be corrected with this method and therefore the orthopedic surgeon should be familiar with more than one corrective surgical method to decipher the deformative biomechanics of each patient.
Asunto(s)
Hallux Valgus/cirugía , Adolescente , Femenino , Humanos , Estudios Longitudinales , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Procedimientos Ortopédicos/métodos , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
Osteoarticular tuberculosis is a chronic inflammatory disease caused by Mycobacterium tuberculosis that affects joints. It reaches skeleton and joints by hematogenous spread. The clinical presentation includes localized pain associated with fever and weight loss. A cold abscess (swelling without inflammation) is strongly suggestive of musculoskeletal tuberculosis. Diagnosis requires a high degree of clinical suspicion, supported with radiological and laboratory techniques. Treatment requires thorough debridement of the joint and antitubercular medical treatment (isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin). We report a case of hip tuberculosis treated with resection arthroplasty, presenting as caseating abscess and severe destruction of the hip joint.
Asunto(s)
Articulación de la Cadera , Tuberculosis Osteoarticular , Femenino , Humanos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Tuberculosis Osteoarticular/diagnóstico , Tuberculosis Osteoarticular/cirugíaRESUMEN
Fibrous dysplasia affects principally bone, but it might comprise extraskeletal anomalies; bone is replaced by dysplastic fibrous tissue. It is classified accordingly to the number of affected bones, and its association to endocrine alterations in: monostotic, polyostotic and Albright's disease. A congenital etiology is suggested. Pathologic fractures are the most frequently associated complications. We present a case with a subtrochanteric fracture caused by fibrous dysplasia, and a comprehensive review of diagnosis and treatment decision making. Differential diagnosis with multiple myeloma among others, and best treatment decision was made.