Freiberg’s Disease of Bilateral and Adjacent Metatarsals

Callum John Donaldson; Ziad Harb; Laila Hussain; Roland Walker; Ali Abbasian

doi:10.1159/000506761

Freiberg’s Disease of Bilateral and Adjacent Metatarsals

Case Reports in Orthopedic Research ◽

10.1159/000506761 ◽

2020 ◽

Vol 3 (1) ◽

pp. 25-33

Author(s):

Callum John Donaldson ◽

Ziad Harb ◽

Laila Hussain ◽

Roland Walker ◽

Ali Abbasian

Keyword(s):

Avascular Necrosis ◽

Rare Condition ◽

Forefoot Pain ◽

One Year ◽

Freiberg’S Disease

Freiberg’s disease is a rare condition characterized by avascular necrosis of the lesser metatarsal heads. The incidence is highest in females, and the disease is usually unilateral, affecting just a single metatarsal. In this report, we describe the first male case of Freiberg’s disease involving the second and third metatarsals in both feet, with the aim of highlighting the condition as a potential cause of such forefoot pain. One year of follow-up is provided.

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Talus reconstruction using fresh structural allograft after nontraumatic avascular necrosis: case report

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1541 ◽

2021 ◽

Vol 15 (2) ◽

pp. 161-166

Author(s):

Andres Fuentealba Pooley ◽

Hugo Henriquez Sazo ◽

Leonardo Lagos Sepulveda ◽

Christian Bastias Soto ◽

Fernando Vargas Gallardo ◽

...

Keyword(s):

Avascular Necrosis ◽

Rare Condition ◽

Considerable Decrease ◽

Level Of Evidence ◽

Structural Allograft ◽

Patient Reported ◽

Advanced Stages ◽

One Year ◽

Therapeutic Alternatives

Avascular necrosis of the talus is a rare condition that can lead to important functional sequelae. There are few therapeutic alternatives for more advanced stages of this disease, the majority of which sacrifice the ankle joint. We report the case of a 50-year-old patient with nontraumatic avascular necrosis that compromised a large part of the talar surface. After non-structural autograft failed, it was reconstructed using fresh structural talar allograft. At one year of follow-up, the patient reported a considerable decrease in pain. To our knowledge, this is the first reported case in which fresh structural allograft was used in the treatment of nontraumatic avascular necrosis of the talus. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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AVASCULAR NECROSIS OF THE TRIQUETRUM: A CASE REPORT

Hand Surgery ◽

10.1142/s0218810405002504 ◽

2005 ◽

Vol 10 (01) ◽

pp. 91-94 ◽

Cited By ~ 5

Author(s):

Y. C. POR ◽

W. Y. CHEW ◽

I. Y. Y. TSOU

Keyword(s):

Case Report ◽

Avascular Necrosis ◽

Total Ischemia ◽

One Year ◽

The Right

A case of total ischemia of the triquetrum after a crushing injury to the right wrist by a dumbbell is reported. He was treated conservatively with splinting and analgesia. There was complete clinical and radiological recovery after a follow-up of one year.

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Vascularized fibular epiphyseal transfer for proximal humeral reconstruction in children with a primary sarcoma of bone

The Bone & Joint Journal ◽

10.1302/0301-620x.100b4.bjj-2017-0830.r1 ◽

2018 ◽

Vol 100-B (4) ◽

pp. 535-541 ◽

Cited By ~ 11

Author(s):

J. D. Stevenson ◽

R. Doxey ◽

A. Abudu ◽

M. Parry ◽

S. Evans ◽

...

Keyword(s):

Limb Salvage ◽

Avascular Necrosis ◽

Proximal Humerus ◽

Bone Tumour ◽

Limb Salvage Surgery ◽

Primary Sarcoma ◽

Toronto Extremity Salvage Score ◽

The Mean ◽

One Year

Aims Preserving growth following limb-salvage surgery of the upper limb in children remains a challenge. Vascularized autografts may provide rapid biological incorporation with the potential for growth and longevity. In this study, we aimed to describe the outcomes following proximal humeral reconstruction with a vascularized fibular epiphyseal transfer in children with a primary sarcoma of bone. We also aimed to quantify the hypertrophy of the graft and the annual growth, and to determine the functional outcomes of the neoglenofibular joint. Patients and Methods We retrospectively analyzed 11 patients who underwent this procedure for a primary bone tumour of the proximal humerus between 2004 and 2015. Six had Ewing’s sarcoma and five had osteosarcoma. Their mean age at the time of surgery was five years (two to eight). The mean follow-up was 5.2 years (1 to 12.2). Results The overall survival at five and ten years was 91% (confidence interval (CI) 95% 75% to 100%). At the time of the final review, ten patients were alive. One with local recurrence and metastasis died one-year post-operatively. Complications included seven fractures, four transient nerve palsies, and two patients developed avascular necrosis of the graft. All the fractures presented within the first postoperative year and united with conservative management. One patient had two further operations for a slipped fibular epiphysis of the autograft, and a hemi-epiphysiodesis for lateral tibial physeal arrest. Hypertrophy and axial growth were evident in nine patients who did not have avascular necrosis of the graft. The mean hypertrophy index was 65% (55% to 82%), and the mean growth was 4.6 mm per annum (2.4 to 7.6) in these nine grafts. At final follow-up, the mean modified functional Musculoskeletal Tumour Society score was 77% (63% to 83%) and the mean Toronto Extremity Salvage Score (TESS) was 84% (65% to 94%). Conclusion Vascularized fibular epiphyseal transfer preserves function and growth in young children following excision of the proximal humerus for a malignant bone tumour. Function compares favourably to other limb-salvage procedures in children. Longer term analysis is required to determine if this technique proves to be durable into adulthood. Cite this article: Bone Joint J 2018;100-B:535–41.

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Multiple Congenital Bilateral Trigger Digits in a 2-Year-Old Child: Case Report

The Open Orthopaedics Journal ◽

10.2174/1874325001307010075 ◽

2013 ◽

Vol 7 (1) ◽

pp. 75-77 ◽

Cited By ~ 3

Author(s):

V De Luna ◽

V Potenza ◽

L Garro ◽

P Farsetti ◽

R Caterini

Keyword(s):

Bacterial Infections ◽

Rare Condition ◽

Trigger Finger ◽

Left Hand ◽

Right Hand ◽

History Of ◽

One Year ◽

The One ◽

The Right

Trigger finger is a rare condition in children. In this paper, we report on a 2-year-old boy with multiple congenital bilateral trigger digits. The patient had no history of perinatal trauma, viral or bacterial infections, or metabolic disorders. The patient was treated with physiotherapy for one year. At the one-year follow-up, the boy presented with six trigger fingers (3 on the right hand, 3 on the left hand). Neither thumb was involved. The six trigger fingers were treated surgically: first, the right-hand trigger fingers and, six months later, those of the left hand. After each operation, a 4-week brace in extension was applied to the operated hand. The symptoms were completely resolved after surgical treatment. Many authors have recommended surgical release for the treatment of trigger finger in children; empirical treatment with physiotherapy may be an option when symptoms present or appear at an older age.

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Idiopathic gingival enlargement: A case report

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v11i1.13319 ◽

2015 ◽

Vol 11 (1) ◽

pp. 26-28

Author(s):

Rajesh Shah ◽

Shivalal Sharma

Keyword(s):

Case Report ◽

Oral Hygiene ◽

Rare Condition ◽

Psychological Disturbances ◽

Gingival Enlargement ◽

Gingival Fibromatosis ◽

One Year ◽

Maxillary Region

Idiopathic gingival fibromatosis is a relatively rare condition characterized by the proliferation of the gingival tissues resulting in masticatory, esthetics, phonetics and psychological disturbances. We present a case with generalized diffuse gingival enlargement involving the maxillary and mandibular arches extending on buccal and lingual/palatal surfaces and covering incisal/occlusal third of the tooth in the left maxillary region. Gingivectomy was carried out in all four quadrants. Periodic recalls showed maintenance of good oral hygiene and one year follow-up revealed no recurrence.JCMS Nepal. 2015;11(1): 26-28

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Secondary ablation of saphenous veins: The reasons and the ratios

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515581742 ◽

2015 ◽

Vol 31 (2) ◽

pp. 141-144 ◽

Cited By ~ 1

Author(s):

Aykut Recep Aktas ◽

Ugur Ozkan

Keyword(s):

Laser Energy ◽

Rare Condition ◽

Foam Sclerotherapy ◽

Endovenous Laser Ablation ◽

Alcohol Ablation ◽

Saphenous Veins ◽

Before And After ◽

The Mean ◽

One Year

Objective To assess recurrence of saphenous veins and their tributaries following endovenous laser ablation (EVLA) and define primary or secondary ablation ratios as a result of misinterpretation, new incompetency formation, and re-canalization. Methods The EVLA procedure was applied for vein insufficiency to 50 symptomatic patients (range, 22–78 years; mean age 45 ± 14 years; gender, 18 [36%] men, and 32 [64%] women). Before and after the procedure, a total of 80 legs were prospectively evaluated for recanalization of the great and small saphenous vein, anterolateral, posteromedial, intersaphenous thigh, and the calf veins by Doppler ultrasonography. EVLA was performed on the saphenous veins along with their tributaries, and was defined as the primary ablation. EVLA and alcohol ablation after the first procedure was defined as the secondary ablation. We evaluated the veins according to re-canalization and secondary ablation, and also measured the primary and secondary ablation ratios. Results Seventy-three (97.0%) VSM and 39 (95.0%) VSP were treated with primary ablation and 2(3.0%) VSM and 2 (5.0%) VSP were treated with secondary ablation because of newly developed incompetency. In addition, 15 (71.0%) saphenous tributaries were treated with primary and 6 (29.0%) with secondary ablation. After primary or secondary ablation, 9 (12.0%) misinterpretation or new incompetency formation was found during a one-year follow-up. Seven (9.0%) VSM were re-canalized at the mean length of 46 ± 15 cm (range 32–65 cm) in one year. The laser energy in the re-canalized VSM was 78 ± 25 joules/cm (range 61–83) and all were retreated with laser or foam sclerotherapy. Conclusions VSM re-canalization and new vessel incompetency formation are reasons for secondary ablation, which is not a rare condition. Follow-up examinations and anatomical mapping are crucial for detecting new vessel formation or miss-interpretation after sclerotherapy or EVLA treatment.

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Tuberculosis of breast: a rare case report

International Surgery Journal ◽

10.18203/2349-2902.isj20175420 ◽

2017 ◽

Vol 4 (12) ◽

pp. 4099

Author(s):

Shubhi Bhatnagar ◽

Shahaji Chavan ◽

Mayank Chakraborty ◽

Rahul Banik ◽

Sree Ganesh Balasubramanian ◽

...

Keyword(s):

Elderly Women ◽

Histopathological Examination ◽

Rare Condition ◽

Antituberculous Therapy ◽

Breast Tuberculosis ◽

Multiparous Women ◽

Rare Case Report ◽

Diagnostic Difficulties ◽

One Year

Tuberculosis of the breast is an extremely rare extra pulmonary presentation of tuberculosis accounting for less than 1% of all diseases of the breast. It usually affects young lactating multiparous women, although it may also be reported in prepubescent males, or in elderly women. This rare condition can pose diagnostic difficulties and can mimic carcinoma breast or abscess. We report a case of a 42-year-old female patient with breast tuberculosis. We have reviewed this case in terms of clinical presentation, investigations, surgical treatment and antituberculous therapy and have shortly described our experience. Ultrasonography of breast, mammography and magnetic resonance imaging of breast supported the diagnosis of tuberculosis of breast. Wide local excision of the breast lump was done, and the excised specimen was sent for histopathological examination which confirmed the diagnosis of tuberculosis of breast. Antituberculous therapy was started post operatively. Post-operative period was uneventful. No active breast or pulmonary disease was present one year after surgery in chest computerized tomography scan. Possibility of this condition should be kept in mind in cases of breast carcinoma or abscess. Diagnosis is made by assessing a combination of clinical, radiological and pathological features. Treatment is mainly antituberculous therapy. Surgery is rarely required. A regular follow up is recommended to rule out recurrence of tuberculosis.

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