Giant Cell Tumor of Thumb Proximal Phalanx-A Case Report.

Introduction: The prevalence of giant cell tumor (GCT) of bone is approximately 5% of all primary osseous tumors. It accounts for <2% of the total cases as far as the involvement of the hand is concerned. Numerous studies stated that <1% of cases have phalangeal involvement of the thumb. Case Report: This case is delineated for its unusual location (thumb proximal phalanx) in a 42-year-old male patient managed by single-stage en-bloc excision, arthrodesis, and web-space deepening procedure without donor-site morbidity. It is known for its notorious nature for reoccurrence (10-50%) and transformation into malignancy (10%); therefore, meticulous dissection is a prerequisite. Conclusion: GCT of the thumb proximal phalanx is quite an unusual presentation. Although very rare, it is thought to be one of the most aggressive varieties of benign bone tumor observed to date. Amid a high rate of recurrence, careful preoperative planning is pivotal for fruitful outcome both anatomically and functionally.

Evaluation of Results of Ponseti Technique in Idiopathic Clubfoot using Clinical Evaluation and Radiological Assessment.

Background: Congenital clubfoot (congenital talipes equinovarus) occurs in approximately one in 1000 live births and is one of the most common congenital birth defects. The Ponseti method is at present a well-established method of treatment for idiopathic clubfoot deformities. Aim: The aim of the present study was to evaluate the results of serial casting in clubfoot deformity with Ponseti method on the basis of Pirani's scoring and radiological findings before and after completion of treatment. Materials and Methods: A total of 30 patients were enrolled in the study and were treated with Ponseti's casting after grading the severity of deformity clinically by Pirani's scoring and radiological assessment by calculating the talo-first metatarsal angle in anteroposterior (AP) view and talocalcaneal angle in AP and lateral views. The same clinical and radiological assessment was done at the end of treatment before putting a patient on foot abduction orthosis (FAO). Results: The average number of casts applied before full correction was 5.56 (range: 5-8). The average duration of treatment was about 6.65 weeks before the patient was put on FAO. Pirani score significantly improved from an average of 5.50 (range: 4-6) on presentation to 0.24 (range: 0-2) after correction of deformity. Conclusion: The Ponseti method is an excellent method for the correction of all four deformities associated with congenital idiopathic clubfoot, and we found that the addition of radiographic to clinical evaluation helps in the better assessment of correction. It provides statistically significant results both clinically as measured by Pirani severity score and radiologically assessed by talocalcaneal and talo-first metatarsal angle.