Unusual Presentation of Foreign Body Granuloma of the Foot After Sharp Injury Mimicking a Malignant Lesion: A Case Report.

Foot foreign body granulomas can mimic malignancies, especially when the history and unusual location pose a diagnostic dilemma. We report the case of a 33-year-old male with delayed-onset progressive swelling over the foot dorsum after a sharp injury through the plantar aspect of the foot. The unusual presentation and radiolucency warranted further radiologic evaluation, which revealed a benign foot swelling. An excision biopsy and histopathologic examination revealed a rubber body granuloma. No recurrence of the granuloma was noted during the 11-month follow-up period after removal of the offending agent. The nature of the injury, immunologic response to the rubber fragment, and lack of infection led to the delayed presentation at an unusual site, mimicking malignancy. Rubber body granuloma has rarely been reported in published studies. A high index of suspicion of retained radiolucent fragments and astute radiologic evaluation with magnetic resonance imaging are required for management of sharp injuries occurring through footwear. We reviewed the approach for evaluating such cases of foot swelling that can mimic malignancies.

Isolated Radiopalmar Dislocation of Fifth Carpometacarpal Joint: A Rare Presentation.

Carpometacarpal (CMC) joint dislocations are uncommon injuries that account for less than 1% of hand injuries. Dorsal dislocations of the CMC joints are more frequent than volar dislocations. Palmar dislocations can be either ulnopalmar or radiopalmar. There are very few reports of isolated radiopalmar dislocations of the fifth CMC joint in the English-language literature. In our case of radiopalmar dislocation, diagnosis was delayed, and attempts at closed reduction were unsuccessful. Therefore, it was treated by open reduction and Kirschner-wire fixation. This article reports a rare type of injury and discusses its management.

Bilateral pathological subluxation of hips secondary to tuberculosis in an adult: a rare presentation.

Clinical descriptions of tuberculosis date back to antiquity. Extra-pulmonary involvement is noted in approximately 14% of patients, with 1% to 8% having osseous disease. In literature, some cases of bilateral traumatic dislocations have been described, but reports on bilateral pathological subluxations or dislocations of hip joints, that too in adults, are extremely rare. Tuberculosis can present in myriad ways and it can mimic any disease. The sole purpose of writing this article was to report one of the extremely rare presentations of skeletal tuberculosis.

Management of Unstable Thoraco-Lumbar Fractures with Pedicular Screw Instrumentation: A Series of 30 cases.

INTRODUCTION: Trauma to spine is one of the grave injuries. They cause infinite morbidity and disability to the patient. Lately consensus is evolving across the world for stabilization of unstable spines with fusion and instrumentation even though most authors agree that neurological recovery is independent of treatment modality. Objectives of this study are to evaluate effectiveness of spinal stabilization with pedicular instrumentation in the management of thoraco-lumbar fractures to restore structural stability, early ambulation and improving neurological status of the patient Material and Methods: During the period from October 2009 to September 2010, 33 cases of thoraco-lumbar spine fractures were treated operatively with posterior decompression and pedicular screw instrumentation. Of these, 3 cases were lost to follow up. Hence the results of 30 cases were evaluated. All patients were treated by posterior decompression and pedicular screw instrumentation. Neurological and radiological parameters were assessed during serial follow-ups. OBSERVATION AND RESULTS: The mean duration of follow-up was 11 months. Of the 30 patients 24 showed neurological improvement by at least 1 grade and average grade of improvement was 1.5 grades. Mean pre-operative sagittal angle (SA) was 19.9 degrees and sagittal index (SI) was 0.54. Mean post-operative SA was 9.3 degrees and SI was 0.72. Mean SA and SI during the final follow-up were 10.9 degrees and 0.69 respectively. DISCUSSION AND CONCLUSION: Neurological recovery and maintenance of radiological correction in our study were comparable to other studies. The results in our short series of 30 cases have been encouraging. But there is need for more cases and longer follow-ups to come to categorical conclusion.