RESUMO
Traumatic rupture of the pectoralis major muscle is a rare concomitant injury in polytrauma patients often resulting in delayed diagnosis. We present the case of a young male patient who, among other injuries, suffered a complete rupture of the right-sided pectoralis major muscle at the humeral insertion point following a motor vehicle accident. Duplex sonography demonstrated an associated thrombosis of the cephalic vein, which was treated initially with intravenous heparin, and long-term with low-molecular weight heparin according to current guidelines. An open refixation of the muscle belly at the humeral insertion point was performed two weeks after the initial trauma. Post-operative follow-up presented a good overall outcome in terms of function and aesthetics. The authors emphasize the need of continuous clinical re-evaluation in the treatment of severely injured patients in order not to overlook relevant injuries.
RESUMO
INTRODUCTION: We report a case of late onset hyperplastic callus formation (HPC) in the right femur in type V osteogenesis imperfecta (OI) mimicking the occurrence of a malignant osteosarcoma. PRESENTATION OF CASE: A 27-year-old female patient consulted us due to swelling in her right femur over 2-3 months without trauma. X-rays looked like an osteosarcoma, blood tests showed increased bone metabolism. A CT scan, a MRI and biopsy were performed, showing late onset HPC due to osteogenesis imperfecta type V. DISCUSSION: OI shows a heterogeneous disease pattern due to a variety of clinical and radiographic findings. HPC is a rare complication of OI type V. Differential diagnosis range from cortical or periosteal osteosarcoma, periostitis, myositis ossificans, subperiosteal hematoma secondary to trauma or osteomyelitis. CONCLUSION: Recognition of HPC as a form of this particular type of OI is important to avoid misdiagnosis like malignant transformation to osteosarcoma. A biopsy and advanced imaging modalities like CT, MRI and scintigraphy are recommended.