Acta Orthop Belg
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Case Reports
Presentation of compartment syndrome without an obvious cause can delay treatment. A case report.
Compartment syndrome is a serious condition which leads to chronic morbidity unless an urgent decompression of the affected area is performed. An increased intra compartmental pressure commonly occurs after a physical insult though rarer causes have been identified. We report an atypical presentation of compartment syndrome and subsequent delayed intervention where there was no identifiable aetiological factor. Frontline medical staff must rule out compartment syndrome early so that complications secondary to compartment syndrome can be avoided.
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A sixty-year-old woman was admitted with an acute subclavian artery pseudoaneurysm after a closed fracture of the middle third of the right clavicle. This manifested itself a few days after the injury as a slowly growing, pulsatile and purple tumour-like mass in the right supraclavicular fossa. The distal pulses were normal, but this observation does not exclude a vascular trauma. This is an uncommon but potentially dangerous complication as it jeopardizes both the extremity and the life of the patient.
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The authors report a case of chondroblastoma which was localised in the distal femoral epiphysis in a 16-year-old boy. The lesion was large, rapidly expanding and extended into the knee joint. After diagnostic evaluation including tru-cut biopsy, the lesion was treated surgically with curettage and grafting with coralline hydroxyapatite. ⋯ He was followed up for thirty-five months with routine radiographs and physical examination. He had no recurrence, no pain, and regained full range of motion of his knee. Most chondroblastomas involve the medullary cavity; they may rarely involve the cortex but to the best of our knowledge, no cases with soft tissue involvement have been reported in the literature.
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Case Reports
Talus fracture associated with a fracture dislocation of the distal tibia in an immature skeleton.
A 12-year-old boy with a severe injury of his right ankle was treated in the accident unit. The local condition was an extensive open wound with parts of the fractured bones prominent. ⋯ After proper debridement the fractured bones were reduced and fixed. Eleven years later both fractures are completely healed without any sign of avascular necrosis, the patient has full painless ankle movement and he can perform his demanding occupation without any problem.
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Ten percent of all osteoid osteomas are located in the spine; they represent the most common cause of painful scoliosis in adolescents. The recommended treatment is surgical excision of the nidus. Nine patients with osteoid osteoma of the spine underwent surgical treatment between 1996 and 2002. ⋯ All patients had immediate and complete relief of pain after surgery. There were no complications and no local recurrences after a follow-up of two years. In the authors' opinion, removal of the nidus by open surgical technique remains a valid method of treatment for osteoid osteoma of the spine.