RESUMEN
INTRODUCTION AND IMPORTANCE: This report described the management of a lady with a rare finding of a large size of Os intermetatarseum in a bizarre location. This unique condition resulted in a splay foot which was rarely discussed in the literature. CASE PRESENTATION: A lady in her early fifth decade has complained of foot swelling and difficulty wearing shoes for the last two years. Her main concern was the worry of a malignant condition. CLINICAL DISCUSSION: She had an unusually huge articulated lump in the third web space. Also, it showed a central foot splay. A full battery of radiological investigation gave a narrow list of possible differential diagnoses. The final diagnosis showed that it was Os intermetatarseum. Surgical treatment involved enucleating the mass and correcting foot splay using a mini-tight rope®. The histopathology report confirmed the diagnosis of Os intermetatarseum. The central forefoot splay was treated by a known surgical tool differently. Post-operatively she was put on physical therapy. Five years follow-up showed improved foot anatomy and functional outcomes with no recurrence. CONCLUSION: Awareness of this rare condition as a differential diagnosis. Complete excisional biopsy of the lump will be a valid option for this condition, as well as using a mini-tight rope® in dealing with central foot splay.
RESUMEN
INTRODUCTION: Slipped upper femoral epiphysis (SUFE) is a common condition affecting adolescent boys and girls. It is classified as acute, chronic or acute on chronic. The slip can be mild, moderate or severe. MATERIALS AND METHODS: We present a case of chronic severe SUFE in a 16-year-old male with significant fixed bilateral deformities requiring osteotomy of proximal femur and stabilisation with short locking Gamma nail(®). To our knowledge, this device has not been used in stabilisation of osteotomies in chronic SUFE. CONCLUSION: The purpose of this paper is to describe the results of our fixation method and also to increase the awareness in orthopaedic surgeon about the usefulness of Gamma locking nail(®) in these difficult situations.