Possible alendronate-induced polyarticular synovitis.

We present a case of polyarticular synovitis following alendronate treatment for osteoporosis. The patient had no evidence of rheumatoid arthritis, pyrophosphate arthropathy, or seronegative/seropositive arthritis. Our main aim in this study is to highlight the potential adverse effects of alendronate and to warn orthopedic surgeons about the possibility of such a side effect that might lead orthopedic surgeons to administer wrong and unnecessary treatments like arthrocentesis. The withdrawal of alendronate is found to be the treatment of choice. Alendronate should be considered as a possible cause of synovitis or polyarthritis in patients treated with this agent in the absence of any other pathology. An association between alendronate and synovitis has rarely been described in the literature. We present a patient who developed polyarticular synovitis after treatment with alendronate and responded to its withdrawal.

Limited distal clavicle excision of acromioclavicular joint osteoarthritis.

INTRODUCTION: Resection of the distal aspect of clavicle has a well-documented treatment modality in case of acromioclavicular joint osteoarthritis resistant to conservative treatment. HYPOTHESIS: Limited (mean ∼0.5cm distal end of clavicle resection) distal clavicle excision of A-C joint arthritis in cases resistant to conservative treatment may reduce the pain and improve the shoulder function. MATERIAL AND METHODS: In this study, we retrospectively evaluated the results of limited distal clavicle excision of acromioclavicular joint osteoarthritis resistant to conservative treatment. All patients were evaluated by using the Visual Analogue Scale (VAS) and UCLA shoulder rating scale (University of California Los Angeles), either before surgery or final follow-up period for pain and functional results, respectively. RESULTS: A total of 110 patients (48 male, 62 female) with AC joint arthritis, treated between the years of 2008-2012, were retrospectively analyzed. A total of 30 patients (12 male, 18 female) who failed to show improvement with conservative treatment underwent limited surgical open excision of distal clavicle. The mean age of the study population was 52.5±1.2 years. The mean follow-up period was 27±1.3 months. The mean preoperative VAS score was 83.6±5.58 (range, 70-90) while mean VAS was 26.6±9.3 (range, 10-50) at the final follow-up. There was a statistically significant difference between pre- and postoperative VAS scores in patients who had treated by surgical approach (P<0.001). The mean UCLA score of the patients increased postoperatively from 11.5 (range, 9-14) to 29.2 (range, 27-32) at the final follow-up. There was a statistically significant difference between the two time periods with respect to UCLA scores (P<0.001). DISCUSSION AND CONCLUSION: In patients with AC osteoarthritis resistant to conservative therapy, the hypothesized limited clavicle excision (mean ∼0.5cm distal end of clavicle resection with preserving coracoclavicular ligaments and inferior capsule) reduced the pain and improved the shoulder function. CONCLUSION: Our midterm follow-up (mean 27 months) results showed that limited distal clavicle excision of patients with AC joint osteoarthritis resistant to conservative treatment (0.5cm distal end of clavicle resection with preserving inferior capsule, and coracoclavicular ligaments) reduced the pain and improved the shoulder function. LEVEL OF EVIDENCE: IV (Retrospective study).

Cavernous hemangioma behaving like peroneal tenosynovitis.

Hemangioma of the tendon sheath is rarely reported. In this case report, a 22-year-old man, who had been seen for peroneal tenosynovitis before (although symptoms remained) was reevaluated. A cavernous hemangioma was located in the peroneal muscle and the tendon. Complete excision was performed.

Malignant transformation of an enchondroma of the hand: a case report.

Secondary chondrosarcomas according to malignant transformations of the solitary enchondromas were extremely rare in the hand. The aim of this study is to present a case of a 43-year-old male having rare malignant transformation of the solitary enchondroma treated with total excision and replacement with iliac bone graft.

Arthroscopic removal of an osteoid osteoma at the talar neck.

The case of a 14-year-old girl with osteoid osteoma of the talar neck that localized subperiostaly with a 1-year history of persistent ankle pain is presented. The diagnosis was made on the basis of clinical appearance, radiography, technetium-99m diphosphonate scintigraphy, and magnetic resonance imaging findings. Subsequently, she underwent arthroscopic excision of the lesion using a motorized burr and curette. After the intervention, there was prompt relief of symptoms and no recurrence during a follow-up period of 22 months. However, pathological study of the arthroscopic shavings failed to confirm the preoperative diagnosis. We concluded that the arthroscopic excision of an osteoid osteoma in an accessible location on the talar neck is an appropriate surgical intervention, but it should be done by using nonmotorized instruments for better pathological examination of the lesion.

Tarsal tunnel syndrome secondary to neurilemoma of the medial plantar nerve.

A neurilemoma of the medial plantar nerve was observed in a 52-year-old Caucasian female. She was diagnosed with tarsal tunnel syndrome by clinical and electromyographic examination. This case was followed up for 18 months and has been presented as a very rare cause of tarsal tunnel syndrome. Relevant literature was reviewed.

[Outcome of surgical treatment for patellar fractures]. / Patella kiriklarinda cerrahi tedavi sonuçlari.

Twenty patients were treated surgically between March 1996 and March 2000. The mean age was 39.5 (18-68) and whom 13 were male and 7 were female. Surgical treatment methods as follows; modified tension band wiring in 10 of the patients with transverse fractures, mini cancellous screw and lag-screw fixation in 7 with vertical fractures and in 2 with distal pol fractures, combination of K wire and circumferential cerclage wire fixation in 5 with comminuted fractures. The average follow-up time was 24 months (6-54 months) and findings were evaluated radiologically and according to scale of Levack. Results were rated as good in 55%, moderate in 35% and poor in 10% of the patients. It was found that modified tension band wiring technique gave the best results. We concluded that majority of the trauma, type of the fracture, surgical technique and post operative rehabilitation were affected the results of patellar fractures treated surgically. In addition to this, patellectomy may be performed in severely comminuted fractures where no major fragments containing of articular surface of the patella exist.

Fractures due to hypocalcemic convulsion.

We report on two cases of patients in whom hypocalcemic seizures during hemodialysis led to right scapular body fracture in one and bilateral femoral neck fractures in the other.