Acrometastasis: A Rare Entity. A Proximal Radius Case

Bone metastases under de knee and elbow (acrometastasis) are rare. We present the case of a patient diagnosed with lung adenocarcinoma, with a lesion in the right proximal radius. Radiological imaging through CT and MR suggested metastatic lesion, which anatomopathological results confirmed. As the presence of these markers provides a poor outlook, radiotherapy was initially considered. However, given the clinical stability of the patient and the limited amelioration observed, surgical treatment was finally conducted.

Pediatric Proximal Radius Fracture and Reduction Techniques: An Educational Review

The article's abstract is not available.

Traumatic elbow dislocation in a patient with congenital radioulnar synostosis

This case report describes a traumatic elbow dislocation in a patient with congenital radioulnar synostosis. It discusses the difficulties and potential complications of managing this complicated injury. Congenital radioulnar synostosis (CRUS) is a rare elbow pathology that is characterised by the abnormal fusion of the proximal radius and ulna bones at the elbow. This case report describes a traumatic posterior elbow dislocation in a 30 year old patient with CRUS. Patients with CRUS are more susceptible to elbow dislocation due to laxity of stabilising ligaments and increased stiffness of the forearm leading to greater force transfer to the elbow. CRUS should be considered in patients with difficult to reduce elbow dislocations.

SYMPTOMATIC SOLITARY OSTEOCHONDROMA OF PROXIMAL RADIUS IN AN ELDERLY FEMALE: A CASE REPORT

Osteochondroma is a common benign tumor in adolescence but is unusual in elderly age group with atypical site of presentation as proximal radius. Osseous lesions at the level of proximal forearm have often lead to limitations in movements and impingement on surrounding soft tissue structures. Here, we describe a case of a 61 year old female who presented with gross restrictions of forearm rotations with progressively increasing swelling over the proximal forearm. Imaging studies hinted at an osseous lesion with a cartilaginous cap. Surgical excision was done due to rapidly growing mass with functional restrictions. Incidental adjoining bursitis was seen intra-operatively and histopathology conrmed the diagnosis. Patient regained full range of motion and was asymptomatic postoperatively at 8 weeks. Atypical presentations though rare, are a possibility and so surgeons should be aware for appropriate management of these tumors.

Fractures of the proximal radius in children: management and results of 100 consecutive cases

Introduction Pediatric radial neck and head fractures are rare, accounting for only 1% of all fractures in children. The aim of this study is to describe the management and results of the respective fracture types and different injury characteristics. Materials and methods This study performs a retrospective data analysis of 100 consecutive patients with a fracture of the proximal radius treated in a single high-volume pediatric trauma center. Results One hundred patients [mean age 7.5 years (1–15)] were documented with a fracture of the proximal radius between 3/2011 and 12/2019. The gender distribution was 62 girls and 38 boys. Twenty-seven patients had concomitant injuries. Conservative treatment was performed in 63 patients (Judet I = 27; II = 30; III = 6; Mason I = 2) using an above-the-elbow cast for 21 days (6–35). Surgical treatment was performed in 37 patients (Judet II = 3; III = 22; IV = 5; V = 7) using elastic stable intramedullary nailing (ESIN). Open reduction was necessary in five cases, and additional immobilization was performed in 32 cases. Six complications occurred: loss of implant stability (n = 2), healing in malalignment, pseudarthrosis, radioulnar synostosis, and a persisting hypoesthesia at the thumb. As a result, two ESIN osteosynthesis were revised, and one radial head resection was performed. Loss of movement was seen in 11% of cases, overall Mayo elbow performance index (MEPI) was 99.8 (90–100), and none of the patients experienced negative impacts on activities of daily life. Conclusions Proximal radial fractures occur predominately without dislocation. Good results are obtained with conservative treatment throughout. In cases with displacement exceeding growth-related correction, ESIN is the undisputed treatment of choice. Open surgery and long immobilization periods should be avoided whenever possible.

Bilateral Congenital Humeroradial Synostostis Presenting with Bilateral Proximal Radius Fractures: A Case Report

Congenital bilateral humeroradial synostosis (HRS) is a rare condition. It is generally divided into 2 categories. In the first group, which is mainly sporadic, additional upper limb hypoplasia typically coexists. In the second group, which is classically familial, HRS is commonly an isolated upper extremity anomaly. HRS can lead to variable degrees of functional disability. The clinical case reported here illustrates a possibly avoidable presentation of this uncommon condition. In this case report, we present a 6-week-old male who presented with bilateral radius fractures. Radiography revealed congenital HRS at both elbows. No other associated congenital abnormalities were detected, and there was no family history of similar conditions in any first-degree relatives. In cases of congenital HRS, movement at the elbow joint is not possible. Parents who are unaware of this information might try to straighten their infant’s elbows, which in turn may result in fractures of the proximal radius. Hence, early diagnosis and proper parental education could prevent fractures as a sequela of HRS.

Internal Radioulnar Fixation for Treatment of Nonunion of Proximal Radius and Ulna Fractures in a Toy Breed Dog

In this case report, we describe an alternative surgical procedure to treat proximal radius and ulnar nonunion in a toy breed dog. A 14-month-old, Maltese cross-breed dog was referred after previous treatment with external and internal fixation had failed, resulting in a nonunion of a fracture of the proximal radius and ulna with the proximal radius fragment too small and friable to be used for fixation. A craniomedial approach was made to debride the radius nonunion site and a second approach to the lateral aspect of the ulna was made. The fracture was realigned and a titanium locking plate was applied in bridging fashion, fixed to the proximal ulnar fragment with three locking screws in the most proximal plate holes, a fourth screw was inserted in the mid-shaft of the distal ulnar fragment and three locking screws were inserted in the distal most holes of the plate through the distal ulna to engage the distal radial fragment. A recombinant bone morphogenetic protein 2 graft was inserted into the radius and ulna fracture sites. The dog had a successful clinical and radiographic outcome with bridging of the defect 4 weeks postoperatively and complete callus formation 8 weeks postoperatively. Implants have undergone dynamization and then removal. Use of a locking plate as an internal fixator achieving fixation of the proximal ulna and distal radius can be considered an option for the treatment of proximal radioulnar nonunions with a small proximal radial fragment.