Scarf osteotomy without internal fixation to correct hallux valgus.

Scarf osteotomy of the first metatarsal bone to correct hallux valgus deformity has benefited from a number of improvements over the past two decades, most notably regarding the internal fixation method. Internal fixation was deemed mandatory by the authors of early case-series studies. Maestro suggested eliminating the proximal screw by locking the two fragments distally: a notch was created via a medial extension of the cephalic part of the osteotomy, the plantar fragment was displaced laterally, and the distal end of the proximal fragment was then fit into the notch (secondary cut and interlocking joint technique). To further develop this concept and to increase the potential range of translation, we developed an original technique involving distal locking without shortening and proximal stabilisation by impaction of a cortical-cancellous bone graft taken from the medial overhanging edge of the proximal fragment. This original technical variant has not been reported previously.

Pigmented villonodular synovitis of the midfoot.

A 60-year-old man presented with a longstanding slowly growing swelling at the dorsal aspect of the left midfoot. The lesion was imaged with CT, ultrasound, and MR. On CT bony erosions were evident. On MR the lesions appeared bifocal and one component was hypointense on T2 weighted images suggesting hemosiderin deposits. The other component was hyperintense on T2 which is more unusual for PVNS. Imaging findings, however, suggested PVNS which was pathologically confirmed. A unique finding in this case is the late age of presentation of the disorder. Also the bifocal nature of the lesion is relatively uncommon.

Myositis ossificans in an infant.

We report a 15-month-old girl with myositis ossificans at the shoulder. Because of the unusual presentation at this age the differential diagnosis with osteomyelitis or a tumoral process had to be considered. It had a benign evolution without specific treatment.