Iatrogenic Bladder Rupture Resulting From the Modified Stoppa Approach for Acetabular Fracture: A Case Report.

Iatrogenic bladder rupture is a rare yet serious complication associated with orthopedic surgical procedures, particularly those involving the modified Stoppa (MS) approach for acetabular fractures. We present a case of a 65-year-old patient who experienced iatrogenic bladder rupture during surgery for acetabular fracture fixation using the MS approach. Despite the challenges posed by this complication, prompt diagnosis and repair during the same surgical intervention led to favorable outcomes. Our case underscores the importance of perioperative vigilance in detecting and managing such injuries to mitigate the risk of urinary tract complications and late infections. Understanding the anatomical nuances and employing meticulous surgical techniques are essential for minimizing the risks associated with the MS approach.

A Rare Case of Cavernous Intramuscular Hemangioma of the Forearm.

Cavernous intramuscular hemangiomas are a part of a group of rare benign tumors. This case report outlines a unique instance involving a 72-year-old patient who sought medical advice at our department due to a progressively enlarging mass in the posterior aspect of her right forearm. Physical examination revealed a painless, mobile mass with no apparent skin abnormalities. Radiographs showed normal results, and an MRI raised suspicion of a fibrous tumor. A subsequent biopsy confirmed the diagnosis of cavernous hemangioma. The patient underwent a total excision procedure, resulting in favorable outcomes with no observed functional impairment or tumor recurrence over four years. This case is notable for its singularity, involving both the advanced age of the patient and the uncommon location of the tumor.

Right adductor compartment intramuscular myxoma: A rare case report.

INTRODUCTION: Extracardiac intramuscular myxomas are exceedingly rare benign tumors, necessitating well-planned management for optimal outcomes. CASE PRESENTATION: We report the case of a 63-year-old male with no prior medical history, presenting with a progressively enlarging mass within the adductor compartment of the right thigh. Physical examination revealed a mobile and painless mass measuring 70 mm by 50 mm at the level of the adductor compartment of the right thigh, devoid of signs of inflammation or skin lesions. The patient showed no cachexia, asthenia, or weight loss. Imaging exams confirmed the characteristic features of intramuscular myxoma, leading to the decision for complete surgical excision. Subsequent histological analysis confirmed the diagnosis, and the patient experienced no postoperative complications, showing positive long-term follow-up results. CLINICAL DISCUSSION: In the presence of an intramuscular mass, thorough questioning and meticulous clinical examination enable us to propose a diagnosis of intramuscular myxoma. MRI is the preferred imaging modality, supporting diagnostic reasoning. However, histopathological analysis remains essential to confirm the mass's nature and rule out potential malignant differential diagnoses. Complete surgical resection is considered the gold standard, ensuring favorable results with a low risk of recurrence. CONCLUSION: Extracardiac intramuscular myxomas are exceptionally rare; MRI and histopathological analysis combined help rule out potential malignant differential diagnoses. Total surgical excision yielded good results with a low risk of recurrence.

Bilateral Total Hip Prosthesis in Coxarthritis of Inflammatory Origin: Technical Features and Intraoperative Complications Encountered in Five Cases.

Total hip arthroplasty remains the treatment of last resort in inflammatory coxarthritis, where joint destruction is bilateral as well as the treatment which must be bilateral. We present in this work the experience of our orthopaedic department with a series of five cases (10 hips) operated for total hip arthroplasty. the first particularity observed in this series is the abnormal bone fragility present in 55% of the cases. For this reason, we had two other intraoperative complications that are related to this bone fragility, during the preparation of the acetabulum, we had a destruction of the medial wall by the burr that went unnoticed intraoperatively and was discovered during the patient's recovery from acute ischemia secondary to the burr, which led to an extensive rupture of the common femoral vein and partial sectioning of the common femoral artery. We also had an exceptional incident in a case with two ankylosed hips; in fact, when the approach was performed, the sciatic nerve was found pressed against the posterior surface of the greater trochanter, which was unusual but was explained by the retraction of the structures of the gluteal region secondary to prolonged immobilization. Thus, there was one case of cement shock manifested by hypotension occurring immediately after cement placement. In front of this inflammatory disease and ankylosis terrain, the surgeon must always be prepared for any complication and must keep in mind that he is operating on a hip that is anatomically not normal due to ankylosis and retraction of the vascular, nerve, and muscle structures.

Hydatid Cyst of the Inguinal Region: An Exceptional Localization.

Cystic echinococcosis (CE), stemming from the larval stage of the cestode Echinococcus granulosus, stands as a widespread parasitic zoonosis primarily afflicting the liver and lungs. However, instances in the inguinal region are exceptionally infrequent. We present a distinctive case involving a 49-year-old female with a progressively enlarging inguinal mass over a five-year period, characterized by the absence of hepatic or pulmonary involvement. This case underscores the unique clinical presentation and diagnostic intricacies associated with extrahepatic and extrapulmonary expressions of CE. The presented case contributes to advancing our comprehension of unconventional hydatid disease presentations, highlighting the imperative for a multidisciplinary approach in both diagnosis and treatment. Ongoing research endeavors and collaborative efforts are pivotal for refining strategies and enhancing outcomes in patients with rare manifestations such as inguinal hydatid cysts.

Bilateral Inverted V-shaped High Tibial Osteotomy: A Case Report.

The article describes the case of a young patient with bilateral genu varum deformity, limiting her mobility. The therapeutic decision was a staged reverse V-shaped tibial osteotomy on both knees at a six-month interval. The surgery faced infectious complications on the left side, requiring additional treatment. Despite this, the patient achieved successful correction, with wound healing and bone consolidation. Preoperative planning was crucial, determining specific correction angles for each knee. The reverse V-shaped osteotomy demonstrated satisfactory functional outcomes compared to other techniques. The conclusion emphasizes the effectiveness of reverse V-shaped high tibial osteotomy (HTO) in addressing varus tibial deformities, providing an alternative before considering total knee arthroplasty. Multicenter studies and long-term evaluations are recommended to refine this surgical procedure.

Achilles Tendon Tear Following an Unusual Pattern of Open Pure Ankle Dislocation: A Case Report.

We present a rare case of concurrent open Achilles tendon tear and pure subtalar dislocation in a 20-year-old male following a motorcycle accident, highlighting the complexity of managing such unique musculoskeletal injuries. The patient was initially admitted with an open and deformed left ankle, underwent prompt primary debridement, and received immediate medical intervention. Despite unsuccessful attempts to reduce the dislocation through external maneuvers, subsequent radiographic evaluation revealed a subtalar dislocation associated with a 90° rotation of the talus. A direct reduction was achieved in the operating room, uncovering a complete tear of the Achilles tendon and a section of the posterior tibial artery during more intensive debridement. The vascular surgery team repaired the posterior tibial artery, followed by Achilles tendon repair using a Kessler suture technique. Postoperative care involved immobilization and adapted rehabilitation, resulting in the patient regaining full range of motion without complications. To the best of our knowledge, this case represents the first reported open lateral subtalar dislocation associated with an open Achilles tendon tear. The detailed treatment strategies and outcomes offer valuable insights for clinicians facing similar challenges and inspire further research on rare musculoskeletal injuries.

Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation With a Distal Radius Fracture: A Rare Case Report.

We present an unusual case involving the simultaneous dislocation of the trans-scapho-retro-lunate in the right wrist and a posterolateral dislocation in the right elbow joint with a distal radius fracture in a 23-year-old male with no notable medical history. These injuries occurred when he fell from a height of around 12 meters onto his outstretched right hand. The patient presented to the hospital in a normal upper limb trauma position with no discomfort to critical functions. Predominant symptoms at the emergency department were discomfort in the right wrist, hand, and ipsilateral elbow, as well as the entire upper limb functional impairment. Both the wrist and the elbow seemed distorted on examination, with considerable edema and loss of bone landmarks. Passive mobilization was hampered by pain, but peripheral pulses were detectable. The radial, ulnar, and median nerves' autonomous sensory-motor domains were intact, with a cutaneous opening classified as stage 2 by the Cauchoix-Duparc classification. The elbow dislocation was successfully treated using a closed reduction method. External manipulation was employed to reduce the trans-scaphoid perilunate dislocation, which was subsequently stabilized through percutaneous screw fixation of the scaphoid using a triquetrum-lunate pin. Additionally, a styloid pin was utilized to address and manage a distal radius fracture, followed by the implementation of a radiometacarpal external fixator. After one year and three months, the patient reported no pain in his elbow and minimal wrist discomfort during heavy lifting.

Pure Open Ankle Dislocation Leading to Isolated Lateral Ligament Complex Tear: A Rare Case.

Pure open ankle dislocation is a rare orthopedic emergency characterized by the absence of associated bony lesions, necessitating prompt and immediate management to prevent disastrous complications. This article details a distinctive case of open pure ankle dislocation in an 18-year-old female following a motorcycle accident, resulting in a 6-cm wound and a dislocated left ankle with a concurrent tear of the anterior talofibular ligament and calcaneofibular ligament. Immediate reduction under sedation was performed, followed by intensive debridement and ligament repair in the operating room. Postoperatively, the patient received antibiotic coverage for five days and underwent immobilization for six weeks. At the 18-month follow-up, the patient exhibited a complete range of motion with no reported pain or instability. This study contributes to the existing literature by presenting a successful treatment paradigm, providing valuable insights for practitioners encountering similar cases.

A Rare Case of Tumoral Calcinosis in a Chronic Hemodialysis Patient.

Tumor calcinosis is a rare condition. It is characterized by the presence of calcified masses in the juxta-articular regions without joint involvement. It particularly affects young adults and adolescents. Its exact pathogenesis remains poorly defined. The diagnosis is suspected clinically and radiologically but confirmed by histological examination. The treatment is mainly surgical, and the prognosis is often good. We report the original case of a chronic hemodialysis patient presenting with tumoral calcinosis by discussing our diagnostic and therapeutic approach according to data from the recent scientific literature.

A Pathological Fracture of the Femoral Neck Revealing Villonodular Synovitis.

Villonodular synovitis is a rare disease of the synovial tissue occurring most commonly in synovial joints such as the knee and ankle joints. We report the case of a patient presenting with villonodular synovitis of the hip revealed by a pathological fracture of the femoral neck, discussing our diagnostic and therapeutic approach with recent scientific data.

An Atypical Presentation of an Osteoid Osteoma of the Lesser Trochanter Resected via the Ludloff Approach.

Osteoid osteoma is a benign bone tumor that frequently affects young adults. The clinical presentation is variable, and the course can lead to spontaneous regression or persistence, necessitating medical or surgical treatment. We report the case of a young patient with an exceptional localization of an osteoid osteoma at the lesser trochanter, exhibiting atypical clinical and radiological features. The tumor was resected via the Ludloff approach. Here, we discuss our diagnostic and therapeutic approach in light of the literature.

Isolated Fracture of the Posterior Tibial Margin: A Case Report.

Isolated fractures of the distal end of the tibia are rare lesions; they can induce numerous complications and the diagnostic approach and management are not always simple. We report the case of a patient with an isolated fracture of the posterior margin of the tibia, exposing the different stages of its treatment compared to data from recent scientific literature.

The Clinical, Radiological, and Histopathological Characteristics of Intramuscular Myxoma: A Case Report.

In this study, we discuss the clinical, radiological, and histopathological characteristics of intramuscular myxomas (IMM), a rare form of benign soft tissue tumors. We report the case of a 47-year-old female patient presenting with a painless, non-inflammatory mass in the right thigh, which was mobile relative to both superficial and deep planes. Imaging, biopsy, and subsequent histopathological study established the diagnosis of intramuscular myxoma. The patient underwent surgical excision of the mass, with a straightforward postoperative course. It is important to distinguish IMM from malignant tumors, such as soft tissue sarcomas, through comprehensive examinations including imaging and biopsy. The recommended treatment is surgery for complete excision of the mass, with an exceptionally low recurrence rate.

Secretan's Syndrome: It Is Time to Talk About It.

Secretan's syndrome is a rare condition; the exact etiology remains unclear. It has no specific treatment and the care must be multidisciplinary and personalized. We report a case of a young female patient who presented with a unilateral and painful swelling of the dorsum of the right hand. The diagnosis and treatment of this patient were challenging.

Primary Hydatid Cyst of the Trapezius Muscle: An Unusual Location and Review of the Literature.

Hydatidosis is a cosmopolitan anthropozoonosis common to humans and many mammals, caused by the development in the body of a dog tapeworm called Echinococcus granulosus. As accidental intermediate hosts, humans contract the infection either directly through contact with dogs or indirectly by ingesting contaminated food. They represent an epidemiological dead-end. Hydatid cysts are typically associated with the liver and lungs and, more rarely, with bones, the brain, eyes, heart, kidneys, and spleen. We present an unusual case of a hydatid cyst located in the trapezius muscle of a 76-year-old woman. Clinical, biological, and radiological data allow us to evoke the diagnosis and avoid an inopportune puncture. Treatment was exclusively surgical, with the removal of the cyst without cyst breach.

Aseptic Osteonecrosis of the Femoral Head: The Effect of Corticosteroid Therapy and Long COVID Syndrome.

SARS­CoV­2 infection remains a hot topic; it is characterized by its multi-systemic involvement. Corticosteroid intake has been the subject of worldwide attention as a potentially effective treatment against coronavirus disease 2019 (COVID-19). Corticosteroids are registered on the WHO list of essential medicines, easily accessible for a low price, and particularly useful for different categories of people. The authors highlight the impact of corticosteroid administration for COVID-19 treatment on the occurrence of aseptic osteonecrosis in the femoral head. They also examine the pace of onset in comparison to corticosteroid usage unrelated to COVID-19. This article presents a patient with osteonecrosis of the femoral head after taking corticosteroid therapy in the treatment of COVID-19. The dose taken by the patient is 90 mg of dexamethasone equivalent to 600 mg of prednisone. The patient experienced the onset of OTA, and the duration of development was three months, indicating a relatively brief period. Comparison was made with data from the literature from 6 months to 1 year after taking corticosteroids in a context outside of COVID-19.

A Rare Case of Leiomyosarcoma Next to the Iliac Crest.

Leiomyosarcoma is an aggressive soft tissue cancer frequently seen in the female gastrointestinal and genital tracts due to the preponderance of smooth muscle. We report the case of a patient with leiomyosarcoma next to the iliac crest, discussing this rare location with data from the literature.

A Partial Frontal Fracture of the Humeral Trochlea: A Case Report.

Fractures of the lower end of the humerus are uncommon but serious, potentially compromising elbow function. This article reports the case of a young patient with a fracture of the inner cheek of the humeral trochlea, resulting from a public road accident. The diagnosis was established by radiography and CT scan, confirming a displaced fracture associated with an avulsion fracture of the coronoid process. Surgical treatment was carried out with fixation of the osteochondral fragment and evacuation of the intra-articular fragments. Two months after the operation, the patient regained good joint function with a resumption of professional activity.

Osteochondroma of Distal Femur Managed With Complete Excision: A Case Report.

Osteochondromas are benign bone tumors that usually occur between the ages of 10 and 30, with no marked gender preference. These lesions result from the separation of the epiphyseal growth plate and are categorized as growth plate development abnormalities rather than true neoplasms. It is important to note that long-term solitary osteochondromas can evolve into osteosarcomas, with chondrosarcoma being the most common among them. However, the risk of recurrence is considerably reduced if the tumor is completely resected from its original site, with no residual perichondrium or cartilage cap left in place. In this context, a 29-year-old man with osteochondroma in the distal femur was successfully treated with complete resection, showing a favorable evolution.