Core decompression and bone grafting provide satisfactory outcome when patients are carefully selected in early stages of the disease, before the stage of collapse.
PF-LCP is not recommended as a definitive implant but can be used as an alternative for the treatment of unstable proximal femoral fractures when there is no option available for other routinely used implants. Despite of its complications, PF-LCP is used where all implants fail.
Chondromyxoid fibroma (CMF) is one of the rarest benign tumors of cartilaginous origin. It accounts for less than 0.5% of bone tumors and less than two percent of benign bone tumors. It is composed of a mixture of chondroid, myxoid, and fibrous tissues. The diagnosis of CMF depends upon its characteristic histological appearance like a lobular pattern with stellate-shaped cells in a myxoid or chondroid background. We present a case of juxtacortical CMF in a 15-year-old male involving the proximal end of the tibia, which was treated with en bloc excision and bone grafting with excellent results on final follow-up.
Coronal plane fractures of the distal femur are less frequent compared to sagittal plane fractures. They were described by Hoffa in 1904 and are known as Hoffa fractures (AO type B3). They are isolated fractures of the femoral condyle and rare in occurrence. The objective in the treatment of these fractures is to achieve anatomical reduction of the articular surface and a stable fixation to prevent joint damage in future and prevent post-traumatic arthritis of the joint. We report the case of a young male patient who had a rare type of medial Hoffa fracture which was treated by open reduction and internal fixation using headless Herbert screws using a posterior approach. The fracture was united in eight weeks, and the patient had a full range of knee movement. We advocate this approach and modality of treatment for Hoffa type II(C) fractures.
Aneurysmal bone cyst (ABC) is a benign, expansile, non-neoplastic lesion of the bone, characterized by channels of blood and spaces that are separated by fibrous septae. Giant ABC is an uncommon condition and can be difficult to handle because of the destructive effect of the cyst on the bones and the compressive effect on the nearby structures, especially in weight-bearing bones of the body. We report a case of a giant aneurysmal bone cyst in the proximal femur of a six-year-old child, which was treated with a sclerosing agent and ender's nail fixation first. There was recurrence after 13 months. It was then curetted out extensively, the cavity was filled with bone graft, and fixation with a dynamic hip screw (DHS) was done. At 19 months follow-up, the lesion had subsided and patient was walking pain-free without any deformity. We suggest this method of treatment to be worthwhile for ABC at this site and at this age.
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