Non-traumatic bilateral comminated acetabular fracture

High-energy trauma has been confirmed as a cause of bilateral acetabular fracture. However, there are few reports on nontraumatic bilateral acetabular fracture. We report a case of bilateral acetabular fracture that occurred acutely with no preceding trauma in a 50-year-old man with osteoporosis. The case shows the significance of regular annual calcium and vitamin D screening of patients at a high risk of pathological fracture.

Multidisciplinary management of solitary hypervascular metastatic recurrence of renal cell carcinoma presenting with pathological femoral fracture

Renal cell carcinoma (RCC) frequently presents with osseous metastasis, predominantly lytic and prone to pathological fracture. The metastatic lesion in the extremity presents with local swelling, pain and immobility due to pathological fracture. The solitary or oligometastatic lesions should be treated with curative intent, which can help the patient to lead a more prolonged and disability-free life. The RCCs and their metastases are hypervascular with an exuberant arterial supply. Surgery can lead to uncontrolled life-threatening haemorrhage. Preoperative transarterial embolisation reduces tumour vascularity significantly and reduces intraoperative blood loss. We present a 46-year-old male patient with solitary hypervascular metastatic recurrence of RCC with a pathological femoral fracture with an infeasible initial surgery due to profuse haemorrhage. He was successfully treated by preoperative transarterial embolisation, followed by surgical resection and implantation of a megaprosthesis. Multidisciplinary management reduces patient morbidity and mortality with successful treatment in solitary hypervascular metastasis from RCC.

Outcomes of Surgery for Enchondromas within the Hand

Background. Enchondromas are the most common benign bone tumours found in the hand. They are usually accidentally diagnosed on an X-ray, because they grow asymptomatically. In some cases, a pathological fracture of the involved phalanx may be the first sign. The objective of this study was to assess the results of operative treatment of enchondromas involving hand phalanges and metacarpals. Material and methods. The study group consisted of 24 patients, 16 women (67%) and 8 men, (33%), aged a mean of 31 years, who were operated on at our centre. The surgery consisted in curettage, and - in most cases - filling the bone defect with either a bone graft or a bone substitute. Follow-up assessment was performed over the telephone in 17 patients (79% of the group) at a mean of 2 years after surgery. Results. Half of the patients were asymptomatic and fully recovered functionally, whereas the other half complained of some not troublesome symptoms such as scar discomfort, limitation of finger movement or cold sensitivity. No differences were observed with regard to the material used for filling of the bone defect following curettage. Two cases of recurrence were noted after surgery: one in the bone substitute group and one in the bone graft group. Conclusions. 1. Enchondromas are the most common benign bone tumours encountered in bones of the hand. 2. The first line treatment in these lesions is curettage and filling of the bone defect with a bone sub­stitute or cancellous bone graft. 3. Both the results of the present study and literature data show that the approach to managing the tu­mour cavity after curettage has no significant effect on outcomes, which are essentially satisfactory.

Prevention of pathological fracture in fibrous dysplasia of proximal femur in a 24-year-old female a rare presentation - a case report

<p class="abstract">Fibrous dysplasia (FD) was historically mentioned in the medical literature in 1938 by Dr. Lichtenstein and in 1942 by Dr. Lichtenstein and Jaffe. The term Jaffe-Lichtenstein syndrome is sometimes used synonymously with monostotic FD or to denote cases of polyostotic FD with café au lait spots, but no endocrine dysfunction. Our case is a 24-year-old female, housewife presented to our hospital with a complaints of right hip pain and backache with difficulty in walking of 6 months duration. She had dull aching pain which increased in intensity with the course of time, there was no radiation, but was aggravated by movements. She was managed with dynamic hip screw along with curettage of the lesion and bone graft, after 9 months of follow up, she had no pain over her hip and there was calcification over the previous lesion, our patient had a very favourable outcome.</p>