Intracortical schwannoma of the femur.

Schwannomas are benign nerve sheath tumors most commonly found in soft tissue. Intraosseous schwannomas are rare, and account for <0.2 % of primary bone tumors. The typical radiologic findings, a lytic lesion with a thin peripheral rim of sclerosis, are nonspecific. In all reviewed case reports, the diagnosis was made only after microscopic examination. Among previously described intraosseous schwannomas, there have been no reports of tumors arising within cortical bone. It is important to note that while schwannomas are benign tumors, they can be misdiagnosed clinically and radiographically can be potentially mistaken for metastases or other serious skeletal diseases such as osteomyelitis. Tissue sampling is critical for definitive diagnosis as well as to avoid unnecessary treatment. We present the first reported case of an intracortical schwannoma in a 42-year-old man who presented with an incidental radiographic lesion of the diaphyseal femoral cortex.

Early Comparative Outcomes of Carbon Fiber-Reinforced Polymer Plate in the Fixation of Distal Femur Fractures.

OBJECTIVE: To evaluate the early clinical results of distal femur fractures treated with carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates compared with stainless steel (SS) lateral locking plates. DESIGN: Retrospective comparative cohort study. SETTING: ACS Level I trauma center. PATIENTS/PARTICIPANTS: Twenty-two patients (11 SS, 11 CFR-PEEK) with closed distal femur fractures treated by a single surgeon over a 6-year period. MAIN OUTCOME MEASUREMENTS: Nonunion, hardware failure, reoperation, time to full weight-bearing, and time union were assessed. RESULTS: The CFR-PEEK cohort was on average older (71 vs. 57 years, P = 0.03) and more likely to have diabetes (P = 0.02). Nonunion was diagnosed in 4/11 (36%) patients in the SS group and 1/11 (9%) patients in the CFR-PEEK group (P = 0.12). Hardware failure occurred in 2 SS patients (18%) compared with none in the CFR-PEEK group (P = 0.14). Time to full weight-bearing was similar between groups, occurring at 9.9 and 12.4 weeks in the CFR-PEEK and SS groups, respectively (P = 0.23). Time to radiographic union averaged 12.4 weeks in the SS group and 18.7 weeks in the CFR-PEEK group (P = 0.26). There were 4 reoperations in the SS group and 1 in the CFR-PEEK group (P = 0.12). CONCLUSIONS: CFR-PEEK plates show encouraging short-term results in the treatment of distal femur fractures with a comparable nonunion, reoperation, and hardware failure rates to those treated with SS plates. This data suggest that CFR-PEEK plates may be a viable alternative to SS plates in fixation of these fractures. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.