BackgroundHydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown.Case presentationWe deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow. Meticulous examination and preoperative imaging did not reveal other localizations. Patient was admitted for surgery where total excision of cyst was done without intraoperative spillage and a cutaneous skin flap was subsequently required to make up for soft tissue loss.ConclusionPrimary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications.
Hydatid cyst of the psoas is rare even in countries endemic to hydatidosis. We hereby report a case of hydatid cyst of the psoas in a 69 years old patient with a history of hypertension and had received left nephrectomy due to a renal abscess 2 years prior to his admission.
BackgroundHemangiomas are benign tumors usually found in the lower extremity yet their surgical management on the location in the foot is rarely documented.Case presentationWe report a case of a plantar intramuscular hemangioma in 25-year-old patient with a history of percutaneous therapy. Patient had undergone intralesional sclerotherapy 3 years prior to his admission with persistent pain on weight bearing activities.MRI demonstrated a multi lobulated lesion of the 1st IMS with a peripheral enhancement on gadolinium injection. The patient underwent elective surgery with complete excision and no functional impairment at the last follow-up 3 years after surgery.ConclusionIntramuscular hemangiomas are rare occurrences. Steroid injection and sclerotherapy are effective non-operative methods. Complete excision of isolated hemangioma lesions allows definite diagnosis with no recurrence.
The management of pink pulseless limbs in supracondylar fractures has remained controversial, especially with regards to the indication for exploration in a clinically well-perfused hand. We reviewed a series of seven patients who underwent surgical exploration of the brachial artery following supracondylar fracture. All patients had a non-palpable radial artery, which was confirmed by Doppler ultrasound. CT angiography revealed complete blockage of the artery with good collateral and distal run-off. Two patients were more complicated with peripheral nerve injuries, one median nerve and one ulnar nerve. Only one patient had persistent arterial constriction which required reverse saphenous graft. The brachial arteries were found to be compressed by fracture fragments, but were in continuity. The vessels were patent after the release of obstruction and the stabilization of the fracture. There was no transection of major nerves. The radial pulse was persistently present after 12 weeks, and the nerve activity returned to full function.
Background
Giant cell tumours are common primary long bone tumours with femoral neck locations infrequent and notorious for pathological fractures. Treatment with simple curettage often results in local recurrence. Aggressive treatment that combines tumour resection with cement filling and internal fixation aims at preserving native joint function.
Case report
The authors intend to illustrate the short falls of such conservative approach through a case report of a femoral neck giant cell tumour in a 37 year old patient. Patient had undergone curettage-cavity filling with screw fixation for a pathological femoral neck fracture. Total hip arthroplasty was undertaken following implant failure and severe hip impairment 3 years after initial surgery.
Conclusion
Intralesional curettage and cavity cementation with internal fixation of giant cell tumour of the proximal femur allows joint preservation. Mechanical failure, local recurrence and degenerative changes hinder long term outcomes especially in the setting of pathological fractures. Further studies are required to delineate the benefits of joint sparing techniques vis-a-vis total hip replacement for giant cell bone tumours of the femoral neck.
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