Van Neck-Odelberg disease in a 8-year-old children: a rare case report.

INTRODUCTION: osteochondrosis of ischiopubic synchondrosis (IPS)" also known as van Neck- Odelberg disease (VNOD), is a syndrome characterized by an atypical ossification pattern of the ischiopubic joint. Because of its non-unequivocal radiological features, which can mimic stress fracture, infection disease, neoplasm or post-traumatic osteolysis, these different diagnoses need to be rule out. CASE PRESENTATION: We present an 8-year-old, obese, right limb dominant child that complained only slight groin pain and a limp on left side for more than 20 days. Neither the patient nor his parents recall any trauma. On clinical examination, no swollen lymph nodes were noticeable. After digital pressure, the patients reported a dragging feeling in the left groin, radiating into the medial left thigh and limitation of Range of Motion (ROM) were present. Thus, a plain X-ray and MRI were performed, revealing VNOD on left ischiopubic ramus. The boy was then treated with regular NSAID and pain adapted full weight bearing and a clinical check at 30 and 60 days was performed. At the last visit, the symptoms were completely disappeared and the patient totally recovered left hip function. CONCLUSION: Diagnosis of VNOD is challenging and clinical presentation is not pathognomonic. So, other benign or severe conditions need to be rule out. Once this disease is diagnosed, the prognosis is generally favourable.

Transposition of the Extensor Indicis Proprius (EIP) for inveterate post-traumatic rupture of the Extensor Pollicis Longus (EPL) of the hand. 12 clinical cases.

BACKGROUND AND AIM OF WORK: Subcutaneous tendon rupture of the Extensor Pollicis Longus (EPL) is one of the most frequent injuries of the extensor tendons of the hand. In this paper, we report our experience on 12 cases of atraumatic subcutaneous EPL lesions treated in our hospital with Extensor Indicis Proprius (EIP) transposition. METHODS: This observational study was conducted between January 2015 and December 2018 in the Casa di Cura "Prof. Nobili", Castiglione dei Pepoli (Bologna). Twelve patients were included in the study, nine of whom were females and three were males, with an average age of 72 years (range: 40-84 aa). The average follow-up was 32.4 months. The preoperative diagnosis was subcutaneous atraumatic rupture of the EPL tendon in all cases.  Results: The clinical outcome was excellent in all the patients at the end of follow-up. At the second clinical control, all patients achieved complete active extension of the distal phalanx of the first finger. We did not notice any intra- or extra-operative complications, and the post-operative course was regular in all cases. CONCLUSION: EIP transposition has allowed an almost complete recovery of the ability to extend the first finger in patients treated in our hospital, in line with what is described in the literature. In addition, patients' satisfaction rate was excellent in all cases. Based on the good results and the low rate of complications affecting the donor area, we consider EIP transposition surgery to be a valid option for inveterate EPL ruptures.

Hemi-Castaing ligamentoplasty for the surgical treatment of chronic lateral ankle instability in young athletes: our 7 years experience.

BACKGROUND AND AIM OF THE WORK: in this study we report our 7-years experience (from January 2011 to December 2017) of 35 patients with chronic lateral ankle instability treated with the Hemi-Castaing reconstruction procedure, all performed in our clinic. METHODS: thirty-five patients (F12-M23; median age around 31 yrs, range 18-52 yrs). All patients used to practice amateur sports at competitive level. The procedures were performed in 19 cases on the right ankle whereas in 16 cases on the left ankle. The average follow-up was 54.2 months. RESULTS: of the 35 patients included in our study, all of them were able to practice sport as the same level as before from 80 to 100 days after intervention. Optimal functional results were achieved in all patients and no further episodes of ankle sprain occurred. All patients rated their outcome as good/excellent. No intra-operative complications were observed, whereas we noticed a case of surgical wound dehiscence after surgery. The Hemi-Castaing procedure provided a high lateral ankle stability, with excellent clinical and functional results. In our study, no significant difference in evertor strength was found according to side, and there was no significant change in E/I ratio. Moreover, joint position sense was not impaired. CONCLUSION: According to us, this surgical technique is efficient and safe, providing remarkable outcomes in the treatment of chronic lateral ankle instability.