Giant Lipoma in the Index Finger of a 60-Year-Old Patient: A Rare Case Report and Review of the Literature.

Introduction: Lipomas are the most common benign mesenchymal tumors found on the head, neck, shoulder, and back, but they are rarely encountered in the fingers, constituting <1% of such tumors. Case Report: This case report presents an exceptional location of a giant lipoma on the proximal phalanx of a 60-year-old Caucasian male's rightindex finger, alongside a literature review that identified 20 similar cases. The patient, with no significant health issues, reported that the growthhad been asymptomatic for 2 years before seeking consultation due to aesthetic concerns and impaired finger extension. Diagnostic imaging, including magnetic resonance imaging preoperatively, and histopathological analysis after surgical excision confirmed the diagnosis of a maturelipoma. Conclusion: This case contributes to the scarce documentation on finger lipomas, emphasizing the diagnostic challenges they present and the effectiveness of surgical removal in averting recurrence. It also highlights the unusual demographic occurrence, given the predominant presentation in middle-aged females, and underscores the necessity of considering lipomas in the differential diagnosis of finger masses. The literature review expands on the rarity of this condition, providing an analysis of 20 other cases, thereby enriching the understanding of lipoma manifestations in rare locations.

Delayed onset of Corynebacterium simulans infection following open reduction and internal fixation of a trimalleolar fracture.

Surgical site infections (SSIs) following open reduction and internal fixation (ORIF) of ankle fractures can lead to significant disability. This case report emphasizes a unique instance of SSI caused by Corynebacterium simulans, following ORIF of a trimalleolar ankle fracture in a 55-year-old female patient. To our knowledge, this is the first reported case of C. simulans infection after ORIF in the literature. The pathogen was detected after surgical debridement, removal and sonication of the hardware, and identified through matrix assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Specific intravenous antibiotic regimen was administered for a total duration of 4 weeks. During the 12th month follow-up, the patient presented no signs of infection and an excellent clinical outcome. This case report underscores the need for alertness regarding atypical pathogens in postoperative complications and the critical role of precise microbial diagnosis in managing rare orthopaedic infections.

Patella Fracture After Total Knee Arthroplasty: A Review.

The management and underlying causes of patellar periprosthetic fractures (PPF) after total knee arthroplasty (TKA) constitute an issue of growing importance given the rising frequency of these procedures. Patella periprosthetic fractures, though relatively rare, pose significant challenges and are a frequent indication for revision surgeries. Despite a decrease in overall incidence, PPFs remain the second most common type of periprosthetic fractures after TKA. Several factors have been identified and associated with patient-specific factors, surgical technique errors, and implant-related causes. Currently extensor apparatus integrity, bone stock, and component loosening are the major concerns and indications for the selective treatment approach. In this study, a thorough review of the existing literature was performed summarizing the epidemiology, clinical manifestation, treatment approach, and functional outcome of PPF. This review aims to underline the significance of such predisposing factors, point out the severity of PPF, and offer insights into the optimal intra- and post-operative management of the patella.

Cervical Spinal Epidural Abscess: Diagnosis, Treatment, and Outcomes: A Case Series and a Literature Review.

Although recent diagnostic and management methods have improved the prognosis of cervical epidural abscesses, morbidity and mortality remain significant. The purpose of our study is to define the clinical presentation of cervical spinal epidural abscess, to determine the early clinical outcome of surgical treatment, and to identify the most effective diagnostic and treatment approaches. Additionally, we analyzed studies regarding cervical epidural abscesses and performed a review of the literature. In this study, four patients with spinal epidural abscess were included. There were three men and one woman with a mean age of 53 years. Three patients presented with motor deficits, and one patient was diagnosed incidentally through spinal imaging. All the patients had fever, and blood cultures were positive. Staphylococcus aureus was the most common organism cultured from abscesses. All patients underwent a surgical procedure, and three patients recovered their normal neurological functions, but one remained with mild neurological disability that was resolved two years postoperatively. The mean follow-up period was 12 months, and no deaths occurred in this series. Furthermore, we identified 85 studies in the literature review and extracted data regarding the diagnosis and management of these patients. The timely detection and effective management of this condition are essential for minimizing its associated morbidity and mortality.

Complete disruption of vastus intermedius tendon and partial rupture of vastus medialis tendon.

Quadriceps tendon ruptures are common injuries, however isolated ruptures are rare. Particularly, reports for isolated vastus intermedius ruptures are very scarce. We present a case of a 62-years-old male patient who sustained a complete rupture of vastus intermedius tendon with a partial rupture of vastus medialis while rectus femoris tendon was intact, after a fall from standing height. Due to lag in extension, surgical treatment was performed, consisted of an end-to-end Krakow suture technique accompanied with two anchors placed on osseous attachment to the superior pole of the patella. A hinged knee brace locked in full extension was applied for 4 weeks. Gradual range of flexion was suggested after the 3rd postoperative week. Full range of motion was achieved in the 7th postoperative week.

Isolated Avulsion Fracture of the Lesser Trochanter in an Adolescent: A Case Report and Review of the Literature.

Avulsion fractures of the lesser or greater trochanter or the iliac crest are uncommon injuries in adolescents. The anterior superior iliac spine, ischium, and anterior inferior iliac spine are the most frequently affected sites. We report a rare case of a 14-year-old boy who sustained an avulsion fracture of the lesser trochanter while playing soccer. No malignancy or associated metabolic bone disease was detected. Conservative treatment was suggested, consisting of a non-weight-bearing period and analgesics. Routine follow-up was performed at one, three, and six months after the injury. Radiographs were utilized to confirm fracture healing. Full recovery and return to a pre-injury functional level were observed at six months. Within this timeframe, a thorough literature review is performed.