Intramuscular desmoid tumor of the leg leading to external popliteal sciatic neuropathy: A case study and literature review.

INTRODUCTION AND IMPORTANCE: Desmoid tumors (DT), rare benign neoplasms of soft tissues, exhibit local aggressiveness and high recurrence rates. Originating from myofibroblast proliferation, complete surgical intervention is the preferred treatment. Despite their benign nature, these tumors are infrequent, predominantly affecting women between 15 and 60, with a higher incidence in adolescence. CASE PRESENTATION: A 44-year-old woman with a DT in the leg mimicking external popliteal sciatic neuropathy. Diagnosis confirmed by biopsy, surgery performed with preservation of the external popliteal nerve, ensuring optimal nerve function. Two-year follow-up with no recurrence, demonstrating the success of the surgical intervention. CLINICAL DISCUSSION: DTs, although rare, exhibit three distinct genomic mutations, with the 45F genotype associated with the highest risk of recurrence. Generally sporadic, these tumors can be linked to familial adenomatous polyposis (FAP) and influenced by states of hyperestrogenism. DTs typically present as deep-seated masses, with frequent local recurrence despite complete resection. CONCLUSION: DTs pose diagnostic and therapeutic challenges, often requiring complete surgical intervention. Management depends on symptomatology, with careful monitoring for small asymptomatic tumors and adjuvant radiotherapy in case of incomplete resection. Despite surgical success, frequent recurrence underscores the need for in-depth research to enhance therapeutic approaches.

Compression of the posterior interosseous nerve secondary to a synovial cyst: Case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Posterior interosseous nerve syndrome secondary to compression by a synovial cyst at the elbow is a rare and often unrecognized pathology. Early management relies on complete neurolysis to achieve satisfactory functional recovery. Increasing awareness among the orthopedics will help in the early diagnosis of the disease and in the initiation of early and proper treatment. CASE PRESENTATION: In this article, we report the case of a 32-year-old patient with posterior interosseous nerve syndrome secondary to compression by a synovial cyst of the elbow. Surgical management combined with post-operative rehabilitation resulted in indolence with good functional recovery. CLINICAL DISCUSSION: Posterior interosseous nerve syndrome secondary to compression by a synovial cyst at the elbow is a rare entity. Anatomically, the deep branch of the radial nerve or posterior interosseous nerve passes through the Fröhse's arch or arch of the supinator muscle at the elbow, then travels between the two heads of this muscle. Several anatomical structures may compress the NIOP. Clinically, it presents as paralysis or paresis of the extensor muscles of the fingers and the abductor muscle of the thumb. Limitation of the ulnar extensor carpi may be responsible for radial deviation of the carpus in some cases. MRI is the radiological examination of choice. Electromyography plays a contributory role in diagnosis prior to surgical exploration. Surgical excision is the treatment of choice. It may be combined with radial neurolysis for better recovery. Progression after surgical treatment is generally favourable. CONCLUSION: Ignorance of posterior interosseous nerve palsy syndrome frequently leads to misdiagnosis. Early management relies on complete neurolysis to achieve satisfactory functional recovery.

What is the optimal (neo)adjuvant strategy of extremity high-risk soft tissue sarcomas (ESTS)?

Currently, the standard treatment for extremity high-risk soft tissue sarcomas (ESTS) combines surgery and pre- or post-op radiation therapy (RT). In some selected cases, chemotherapy (CT) is incorporated into the therapeutic algorithm as a neoadjuvant approach to enable conservative management. Given the risk of local or metastatic relapse, this paper discusses the potential benefits of CT and RT in high-grade ESTs. The role of adjuvant chemotherapy in addition to neoadjuvant CT, the prognostic value of the pathological response to neoadjuvant treatment, and the role for an adjuvant "boost" following resection after pre-operative radiotherapy will be discussed.

[Patella cubiti detected after a trauma: about a case and literature review]. / La patella cubiti découverte à la suite d'un traumatisme: à propos d'un cas et revue de la littérature.

Patella cubiti is a very rare anomaly characterized by the non-union of olecranon and proximal ulna. We here report the case of a 27-year old patient admitted with a trauma of the elbow. Diagnostic examination revealed patella cubiti mimicking olecranon fracture. The patient underwent excision of bone fragment. Three months after surgery, the patient was satisfied because the foreign body that he felt at the level of the elbow had disappeared.

[Spontaneous simultaneous bilateral rupture of the quadriceps tendon in patients with parathyroid adenoma: case report and literature review]. / Rupture bilatérale spontanée et simultanée du tendon quadricipital dans l'adénome parathyroïdien: à propos d'un cas et revue de la littérature.

Spontaneous as well as bilateral and simultaneous rupture of the quadriceps tendon is rare. We report the case of a 53-year old patient followed up for parathyroid adenoma complicated by renal failure, admitted for spontaneous bilateral rupture of the two quadriceps tendons. He underwent surgical repair allowing him to maintain his autonomy.

[Direct medical costs of hospital treatment of fractures of the upper extremity of the femur]. / Le coût médical direct de la prise en charge hospitalière des fractures de l'extrémité supérieure du fémur.

Fractures of the upper extremity of the femur are serious because of their morbidity and social and/or economic consequences. They have been the subject of several studies of world literature concerning their hospital treatment, evolution and prevention. The increase in the incidence of this pathology seems unavoidable due to population ageing and to the lengthening life expectancy; it is posing a real long-term public health problem whose importance will be further increased by the need to control health care costs. The results of this study show that the average age of onset of fracture of the proximal extremity of the femur is 68,13 ± 16.9 years, with a male predominance and a sex ratio of 1.14. In our study pertrochanterian fractures represented 69.4% of cases. Direct medical costs of the hospital treatment of fractures of the upper extremity of the femur at the Hassan II University Hospital were £387 714,38 in 222 cases, with an average cost of £1757,4 , including costs for patient's stay in hospital, which represented the majority of expenses ( 77% of total costs). It is desirable to raise staff awareness of the costs of consumables in order to reduce treatment costs and to adopt cost-oriented behaviour. Length of stay should be limited to the maximum extent because it only allows to reduce staff and accommodation costs.

[Digital replantation, results and complications: study of a series of 18 cases]. / La replantation digitale, résultats et complications: étude d'une série de 18 cas.

Digital amputations are frequent injuries, the majority of them are caused by workplace accidents. Microsurgical techniques are an alternative option to repair these amputations. This study aims to report our experience in digital replantation through the examination of 18 cases. We conducted a retrospective study of 14 patients with total or subtotal fingers amputation between June 2013 and January 2015. All unidigital and multidigital replantations downstream of the distal insertion of superficial flexor tendon as well as all digital replantations upstream of the distal insertion of superficial flexor tendon were included in our study. These patients underwent surgery according to conventional digital replantation procedures. Five replantations were secondarily regularized. Among the 18 replantations, eight digital replantions evolved favorably since replantation helped restore active range of motion and passive range of motion of the finger operated without revision surgery and early and late secondary complication. In our study we achieved satisfactory results despite the difficult conditions including the initial state of the amputated finger and its delayed management. The development and mastery of microsurgery has helped change the prognosis of these amputations with serious functional and psychological consequences; the results of our study are encouraging with reference to the implementation of the SOS Hand Service in Morocco.

ACETABULAR COMPONENT ORIENTATION IN TOTAL HIP ARTHROPLASTY: THE ROLE OF ACETABULAR TRANSVERSE LIGAMENT

ABSTRACT Objective: The aim of our study is to present the benefit of using the transvers acetabular ligament for intraoperative determination of the anteversion of acetabular component. Methods: Twenty-one total hip arthroplasties were performed. The transverse acetabular ligament was identified and used as a guide to position the acetabular component. Results: The mean anteversion angle was 16.9. None of the patients studied sustained a postoperative dislocation during this short follow-up period. Conclusion: We conclude from this preliminary study that the transverse acetabular ligament can aid positioning of the acetabular component of a THR. It defines the version of the acetabular component without the need for external instrumentation, and is independent of the position of the patient. Level of Evidence IV; Prospective Study.

ACETABULAR COMPONENT ORIENTATION IN TOTAL HIP ARTHROPLASTY: THE ROLE OF ACETABULAR TRANSVERSE LIGAMENT.

OBJECTIVE: The aim of our study is to present the benefit of using the transvers acetabular ligament for intraoperative determination of the anteversion of acetabular component. METHODS: Twenty-one total hip arthroplasties were performed. The transverse acetabular ligament was identified and used as a guide to position the acetabular component. RESULTS: The mean anteversion angle was 16.9. None of the patients studied sustained a postoperative dislocation during this short follow-up period. CONCLUSION: We conclude from this preliminary study that the transverse acetabular ligament can aid positioning of the acetabular component of a THR. It defines the version of the acetabular component without the need for external instrumentation, and is independent of the position of the patient. Level of Evidence IV; Prospective Study.

An unusual cause of medial foot pain: The cornuate navicular.

The accessory navicular bone (ANB) is a secondary ossification center of the navicular bone and is rarely observed. Three distinct types of accessory navicular bones have been described. The type III, known as the cornuate navicular, is a rare morphological entity of the accessory navicular bone. We report the case of a patient, 48 years old, who presented with chronic swelling and pain in her left foot. Radiological examination permitted the diagnosis and showed a conflict between the tibial posterior tendon and the cornuate navicular, responsible for the symptoms. Surgical treatment led to symptoms relief.

Unusual ankle fracture: A case report and literature review.

Fractures of the talus are uncommon, and talar body fractures in the sagittal plane are still rarer. The aim of its treatment is urgent anatomic reduction to restore congruency of the ankle and to reduce the risk of avascular necrosis by preserving any remaining blood supply. We report the case of a body talar fracture in sagittal plane associated with fracture of the medial malleolus in a young adult; the mechanism of the fracture was plantar hyperflexion, internal rotation and axial compression. We perform an open reduction and stabilization with two screws for the talus and screw the medial malleolus. At 14 months following the injury patient had good range of movement with little pain. The mechanism is discussed along with a literature review.

Open fracture of the acromion associated with a supraspinatus tendon rupture: an exceptional case report.

The combination of the acromion Open fracture to a section of the supraspinatus tendon is an exceptional situation. The author reports the case of a young patient with a wound of the posterolateral side of the right shoulder. Screwing was done for the fracture of the acromion after supraspinatus tendon suture with good clinical and radiological outcome after an appropriate rehabilitation.