RESUMEN
INTRODUCTION: Synovial chondromatosis is a rare synovial disorder characterized by the presence of benign loose bodies in the joint space. The affliction of the hip joint is rare. This entity usually goes undiagnosed as it is largely asymptomatic till complications such as secondary osteoarthritis secondary to degenerative changes, subluxation of hip, and fracture neck of femur ensue. CASE REPORT: A 46-year-old farmer presented with a 9-year long history of the left hip pain with restriction in flexion, extension, and internal rotation. He was diagnosed with synovial chondromatosis and had a history of undergoing arthroscopic debridement following which he was asymptomatic but relapsed after 6 months. We performed excision with uncemented modular bipolar hemiarthroplasty after confirming the diagnosis on plain radiographs and computed tomography. Significant recovery in the range of motion was noted postoperatively and the patient showed no signs of relapse in the follow-up period of 18 months. CONCLUSION: Treatment of synovial chondromatosis of the hip joint poses a challenge due to its complex anatomy.
RESUMEN
Extension-block pinning is a popular surgical treatment method for mallet fractures but is associated with several pitfalls. Transfixation Kirschner wires used in the extension-block pinning technique may cause iatrogenic nail bed injury, bone fragment rotation, chondral damage, or osteoarthritis. The objective of this study was to determine the result of the delta wiring technique in mallet fractures with fracture fragment involving more than one-third of the distal phalanx articular surface. The authors are reporting 5 cases of mallet fractures treated with delta wiring technique with good functional and radiologic outcomes. Radiologic outcomes were evaluated on the basis of postoperative and follow-up x-rays and functional outcomes were evaluated using Crawford's criteria. Five patients (4 males, 1 female) with a mean age of 26.8 years (range, 20 to 33 y) were included. The mean time between the injury and surgery was 5 days (range, 3 to 7 d), and the mean follow-up period was 8.6 months (range, 8 to 10 mo). Radiographic bone union was achieved in all patients within an average of 6.4 weeks (range, 6 to 7 wk). At the final follow-up, the distal interphalangeal joint had an average degree of flexion of 73 degrees (range, 70 to 75 degrees) and an average extension deficit of 5.40 (range, 0 to 8 degrees). According to Crawford's criteria, 1 patient had excellent results and 4 patients had good results. No patient reported pain at the final follow-up with a visual analog scale score mean of 0.6 (range, 0 to 2). Satisfactory clinical and radiologic outcomes were obtained with the delta wiring technique. Future prospective and randomized studies are justified to confirm the efficacy of this technique.
