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Introduction: Giant cells tumor (GCT) of the bone is usually seen in young adults between the ages of 20 and 40. When occurring in older patients, diagnosis and therapeutic specific feature are to be considered. We underline those aspects through this case report., Case Presentation: We report the case of a 73-year-old man presenting with a painful swelling knee. The diagnosis of GCT of proximal tibia was retained and the patient underwent extensive curettage, subchondral bone grafting and cementation of the residual cavity. The long-term results show a good functional outcome and no recurrence., Discussion: In this age group, other lesions have similar clinical and radiological presentations as GCT of bone. The diagnosis of a metastatic carcinoma is to be carefully ruled-out in this situation. While the option of large resection with joint arthroplasty is better accepted in ageing patients as a treatment of GCT of bone, this case suggests that jointpreserving methods should also be considered especially when there are no signs of osteoarthritis. While polymethylmethacrylate cementation is an efficient adjuvant in order to reduce recurrences, it may cause secondary osteoarthritis. Subchondral grafting seems to be a good alternative to prevent this complication., Conclusion: Malignancies should be ruled-out before retaining the diagnosis of GCT of the bone after the age of 50. Conservative surgical treatment is always an option in this age group., Competing Interests: Conflict of interest statement None declared. The authors have no financial, consultative, institutional, and other relationships that might lead to bias or conflict of in terest., (Copyright © 2024. Published by Elsevier Ltd.)

Giant cell tumour is a benign lesion classified as a fibrocystic tumour whose localization in Hoffa's fat pad is very rare. Clinical symptoms are insidious and non-specific causing a frequent confusion and delay in diagnosis therefore it should be distinguished radiologically from other similar conditions such as Hoffa´s disease and lipomas. We report a case of a 37-year-old patient, with no relevant history, who complained of a right knee pain for 5 years. Magnetic resonance imaging showed a small nodular mass in Hoffa's pad which was excised through a direct approach. Histologic examination of the specimen revealed a giant cell tenosynovial tumour. One year after surgery, the patient was asymptomatic with no local recurrence. The surgical removal of the tumour is the ideal treatment. The choice between open surgery and endoscopy depends on the site, size, and extent of the tumour., Competing Interests: The authors declare no competing interests., (Copyright: Youssef Othman et al.)

Distal femur fractures account for less than 1% of all fractures and about 3 to 6% of all femoral fractures. Several classifications have been described but some types of distal femur fractures escape them such as the cleavage intercondylar fracture of the femur. To our knowledge, there have been only four cases reported in the literature. The authors report a case of a 32-year-old woman who presented at the emergency department with a cleavage intercondylar fracture of the left femur. The patient was treated with a long leg cast for 6 weeks, followed by physiotherapy and full weight-bearing. After 4 months, the evolution was favorable: the patient was asymptomatic and regained full knee range of motion. After 10 years of follow-up, there was no clinical or radiological evidence of knee osteoarthritis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Chaouch et al.)

Primary musculoskeletal echinococcosis is rare and accounts for 2-3% of the patients with hydatid disease. We report a case of giant primary hydatid cysts of the thigh and the gluteal region in an 82-year-old female, who presented with a painful multiple palpable mass. The diagnosis was confirmed by imaging and serology. Total resection was performed through an extended lateral approach of the thigh and intraoperative findings revealed infected giant hydatid cysts. The postoperative outcome was uneventful. Albendazole drug (400mg per day) was given for the next 3 months. At 6 months follow-up, the patient was satisfied with no complications or recurrence., Competing Interests: The authors declare no competing interests., (Copyright: Saber Rabhi et al.)

In view of the multiplicity of the proposed techniques for hallux valgus correction, we recommend to evaluate scarf osteotomy associated or not with phalangeal osteotomy and/or Weil osteotomy. We conducted a retrospective study of 29 patients, including a bilateral case, undergoing scarf osteotomy of the first ray with associated treatments in 80% of cases between 2011 and 2016. Results were analyzed on the basis of patients' satisfaction, Groulier index and radiological measurements. The overall Groulier score showed good objective assessment of the end results based on radiological and anatomical data influencing the end results in case of insufficient correction. The mean follow-up period was 3 years and 5 months. A significant reduction in phalangeal valgus (from 34.17% to 16.1%), in metatarsus varus (from 15.13% to 9.93%) and the distal metatarsal joint angle (17.63% to 12.73%) were obtained. Patients were satisfied and very satisfied in 83% of cases. Complications were dominated by hypocorrection in 13.3% of cases and no case of pseudarthrosis or of M1 head necrosis was reported. Our results are comparable to those reported in the literature. We particularly insist on the functional role of hallux valgus surgery that should be included in overall forefoot deformity correction. Scarf osteotomy requires rigorous technique. It gives reliable results, with limitations related to major deformities, especially of the distal metatarsal joint angle., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts.

Dislocation of the first metatarsophalangeal joint is a relatively rare and still poorly known injury. The current classification includes only the dorsal variety of this lesion; thus, as further cases of other varieties are reported, a larger understanding of this entity is required. We report the case of a young male with dorsal dislocation of the first metatarsophalangeal joint treated by closed reduction. The clinical outcome at the 2-year follow-up point is reported. A review of the published data of the variations of this injury reported to date is included, and a new summarizing classification is suggested., (Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occurs as a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of the lesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximal femur. This case report documents how a 14-year-old boy, who presented with an avulsion of the lesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a track and field event, was diagnosed and successfully treated with a conservative approach., Competing Interests: Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Acute osteomyelitis of the clavicle accounts for less than 3% of osteomyelitis cases, with its usual location in the middle third. It may be hematogenous, due to contiguity, or secondary to catheterization of the subclavian vein or neck surgery. The diagnosis is often delayed, and clinical symptoms may simulate obstetric brachial plexus palsy in young children. We report a new case of osteomyelitis of the clavicle in a 30-day-old newborn., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Distal clavicle fracture accompanied by coracoid process one is a rare injury. Surgical and/or conservative treatments are proposed. We report the case of a 49-year-old woman presenting a distal clavicle fracture associated with a coracoid process one due to a fall on the left shoulder. Both injuries are treated surgically. Per operatively, and through an anterior "strap" approach, the coracoclavicular ligament was seen intact. The distal clavicle fracture was fixed with K-wires and cerclage and the coracoid process was secured by a screw. Active-assisted rehabilitation of the shoulder was initiated 3 weeks after surgery. At the last follow-up of twelve months, the patient had painless full shoulder functions and X-rays show bony union. Early recovery to normal life is possible with surgical treatment in patients with distal clavicle fracture combined with coracoid fracture.

We report an unusual case of a type I Monteggia equivalent lesion in a 6-year-old girl consisting of fracture of the ulnar diaphysis and fracture of the neck of the radius without dislocation of the radial head. Manual reduction and immobilization in a plaster cast were performed. At 10 years of follow-up, the patient had regained full flexion and extension of the elbow, and nearly full pronation and supination. In the literature, this lesion has been reported only in two paediatric patients indicating that this is an extremely rare trauma.

Congenital infantile fibrosarcoma is a rare soft tissue neoplasm in the infant of which only a few cases are reported as congenital. This tumor has a rapid growth and extensive local invasion, but metastasis rarely occurs. Distal extremities involvement is more common and metastasis are rare. We report a case of a congenital infantile fibrosarcoma of the forearm, which was initially confused with a hemangioma, treated successfully by surgical resection., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Li Fraumeni Syndrome (LFS) is a rare autosomal disorder characterized by a familial clustering of tumors. Analysis of several series of LFS families have shown that 70% of such families are attributable to germ-line mutations in TP53. We report the case of a patient who had a first degree family antecedent of cancer in young ages. At the age of 31 years, the patient was operated of bladder papillary superficial carcinoma; five years later, he was treated for a high grade pleomorphe sarcoma of the left thigh and treated by surgery, adjuvant chemotherapy and radiotherapy. At the age of 38 years, after abdominal pain, radiologic examination reveled pancreatic tumor with bone and lymphatic metastases. The patient died one month later from pulmonary embolism. Sequencing revealed a germiline mutation of this patient that was confirmed in a member of his family in codon 1009C>T, protein Arg337Cys, exon 10 of TP53 gene this mutation was revealed in his nephew (died at the age of 20 from bone sarcoma).

Intraosseous ganglion (IOG) cyst of the scaphoid is an infrequent cause of hand and wrist pain. Intraosseous ganglia located in the scaphoid have rarely been described in the literature. We report the case of a 30-year-old right-handed woman who presented with a more than 24-month history of progressive right-wrist pain. No history of trauma was reported.Conservative treatment with anti-inflammatory medications before referral was unsuccessful. Examination revealed a small palpable mass in the carpal navicular region with no limitation of normal wrist motion. An IOG cyst of the scaphoid was found on standard radiograph and CT-scan of the wrist. Treatment consisted in curettage of the cyst followed by packing of the defect with autologous cancellous bone graft harvested in the distal end of the radial metaphysis. Satisfactory functional recovery was achieved. The clinical, radiographic and therapeutic aspects of this rare condition are discussed by the authors., (2010 Published by Elsevier Masson SAS.)

The authors report a case of shoulder bilateral posterior fracture dislocation in a 42-year-old man with osteogenesis imperfecta history. The importance of the communition, the large size of articular surface involved and the poor quality of the bone indicate a bilateral total shoulder arthroplasty. At midterm outcome, a good range of motion of both shoulders was registered., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

Total extrusion of the talus is an unusual injury, and the obvious risks of reimplantation of the extruded bone include infection and avascular necrosis. In this article, the authors present the case of a 34-year-old man who sustained an open ankle injury with complete extrusion of the talus. The talus was recovered at the scene of the accident, and subsequently reimplanted along with ankle stabilization with pins and an external fixator. At 6 weeks following the osseous surgery, final soft tissue reconstruction with a suralis flap was performed. At 3 years after the injury, radiographs revealed spontaneous fusion of the tibiotalar and subtalar joints, and the clinical examination and history indicated satisfactory weight-bearing function of the involved foot and ankle. The definitive treatment of this serious lower extremity injury remains controversial, and the use of large allogeneic bone grafts, vascularized bone grafts, and tibiocalcaneal fusion, as well as reimplantation of the extruded talus have been recommended., (Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Pyogenic sacroiliitis is a rare entity in children. Diagnosis is often delayed because of its variable clinical presentation, low suspicion by the examining physician, and rare findings on radiographs. Delayed diagnosis, however, results in complications such as iliopsoas abscess. We report the case of a 12-year-old girl hospitalized with a 21-day history of fever, pain in the left iliac fossa, and flexion contracture of the hip. On examination, she had fever (38.9 degrees C), psoitis, localized tenderness at the left sacroiliac joint, and pain elicited by lateral compression of the pelvis. The abdominal examination was normal. The erythrocyte sedimentation rate was 130 mm in the first hour, C-reactive protein was 186 mg/l, and the white blood cell count was 18,400/mm(3), with 79% neutrophils. Urinalysis was normal. Blood cultures were negative. Radiographs of the pelvis showed irregular left sacroiliac borders. The CT scan provided the diagnosis of sacroiliitis complicated by an ilioapsoas abcsess. Treatment was based on antibiotic therapy associated with surgical drainage. Bacteriologic investigation revealed Staphylococcus aureus. The patient's temperature returned to normal on the second day. Antibiotics were continued for 3 months, leading to full recovery., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

Osteomyelites, bone infections of a hematogenous origin, are rare in the pelvis (2.3%) and are extremely rare in the ischium. Ischiatic osteomyelitis is usually found in children and adolescents, but has rarely been described in adults. The clinical presentation varies and the diagnosis is based on magnetic resonance imaging (MRI). The most frequently isolated germ is the staphylococcus, while Escherichia coli has been found in a few cases. We report a case of osteomyelitis from E. coli in a 46-year-old woman revealed by persistent fever. The point of entry was a septicemia from gastrointestinal origin, related to colon polyps. The clinical picture was also complicated by an antiphospholipid antibody syndrome (superior mesenteric vein and splenomesenteric branch thrombosis). The course was favorable thanks to appropriate antibiotic treatment and surgical debridment of the infection.

Purpose of the Study: Osteomyelitis of the scapula is uncommon, often with a misleading clinical presentation. We report four cases of osteomyelitis of the scapula to illustrate the particular clinical imaging findings and treatment related to this location., Case Reports: Between 1996 and 2006, four children were treated for osteomyelitis of the scapula, three boys and one girl, with a mean age of 8 years (range, 5-11 years). The time from symptom onset to hospitalization was 2 days. Pain was noted for all patients and total functional incapacity of the upper extremity was noted for three patients. The diagnosis of osteomyelitis of the scapula was established on the basis of imaging (ultrasound and CT scan). All patients were given medical treatment and underwent surgery. A positive bacteriology was noted in all patients. The bacterium isolated from blood cultures (two cases) and local samples obtained at the surgical site (four cases) were Meti-S Staphylococcus aureus., Results: The results were analyzed by studying the anatomic and functional outcome at a mean follow-up of 36 months (range, 16-60 months). The patients were pain-free and had full range of motion in their shoulders. There were no complications., Discussion: Few reports are available in the literature on osteomyelitis of the scapula. We discuss the specific clinical and imaging features as well as the treatment for this location.

Background: Trochanteric fractures are a major source of mortality, morbidity and functional impairment in the elderly. Morbidity is closely related to the degree of instability and comminution and is substantially influenced by the quality of reduction and internal fixation. Advanced age and associated co-morbidities are two decisive factors of mortality secondary to trochanteric fracture., Objectives: This prospective study examined the epidemiological profile of trochanteric fractures and assessed mortality and morbidity with the aim of establishing management guidelines and improving prevention strategies., Material and Methods: One hundred patients were included; 60% were male. Mean age was 76 years (range, 60-96 yrs). One, or more than one, co-morbidities were present in 68% of cases. The fractures were caused by a simple fall in 90% of cases. Fractures were classified according to the criteria of Ramadier and the ones of Ender. Sixty-five percent of these fractures were unstable. A dynamic hip screw was systematically used as the standard means of internal fixation., Results: Anatomic and functional results were analyzed in 82 patients (18 had died within the first year following fracture occurrence). Mean follow-up period was 24 months (range, 12-36 months). Bone healing was achieved in 96% of cases. There were numerous postoperative complications (four cases of thromboembolism, fourteen immobility-related complications, two infections, six secondary displacement combined to loss of fixation, four non-unions, and nine malunions). At 2 years follow-up, 28 patients had died. Mortality was strongly correlated with older age (over 90 years), associated co-morbidity and fracture instability. Good functional outcomes (72%) correlated with younger age (60-74 years), fracture stability, adequate reduction and internal fixation., Discussion: In stable trochanteric fractures, osteosynthesis by dynamic screw-plate is more effective than alternative techniques (blade-plate, nail-plate, Ender nail or even trochanteric nail). In unstable trochanteric fractures, delayed weight-bearing should be preferred to avoid mechanical complications. In fractures that are unstable or extend far below the lesser trochanter, trochanteric nailing is indicated since providing enhanced stability, but sometimes at the cost of insufficient reduction. The treatment objective should be the complete resumption of weight-bearing as early as possible with the fewest possible complications. Prevention consists in detecting and treating osteoporosis and countering the causes of falls in elderly subjects (muscular reinforcement and correction of neurosensory deficit)., Level of Evidence: Level III: Prospective diagnostic study., (2009 Published by Elsevier Masson SAS.)

Palmar dislocation of the metacarpophalangeal joint of the long finger is a rare injury. The authors report a case of palmar dislocation of the metacarpophalangeal joint of the ring finger. The presumed mechanism is a combination of active flexion and forceful hyperextension. The dislocation was treated successfully by closed reduction shortly after injury. Closed reduction should be attempted in all cases of this injury.

We present the case of a patient with a fracture-dislocation of the fifth metacarpal and a dislocation of the metacarpophalangeal joint (floating fifth metacarpal) combined with a fracture of the fourth metacarpal. The mechanism of injury and management of this uncommon injury is reported. The "floating fifth metacarpal" and the fourth metacarpal fracture were reduced by closed techniques with percutaneous fixation. Twelve months later, the patient had a full range of wrist and finger movement, he was pain-free and without any residual disability.

Solitary osteochondroma is a rare benign tumour of the hand arising from the cortical surface. The important differential diagnoses, which should be considered, are Nora's lesion, florid reactive periostitis and Turret exostosis. The authors report an unusual case of osteochondroma of the metacarpal bone with a deficit of extension. The diagnosis was made using imaging techniques and confirmed by histological examination. The treatment is surgical, namely complete excision.

Intercondylar fracture of the distal humerus in youth is an extremely rare injury. Three cases have been reported in the literature to date. We describe two cases, aged 15 and 14 years, both of whom were boys. The stability in this injury allowed non-operative treatment and a favorable outcome.

This article describes a case of a 11-year-old boy with an osteochondroma of the peroneal head causing peroneal nerve palsy. Physical examination disclosed large exostoses palpated at the right fibular head. Neurological examination revealed paresis of the tibialis anterior, lateral peroneal, and extensor digitorum muscles with a muscle strength grade of 2. Electrophysiological studies confirmed denervation of the muscles supplied by the right peroneal nerve. Radiological examination showed an osteochondroma in the head of the right fibula. The patient underwent surgical decompression of the right peroneal nerve after resection of the bone tumor. At 36-month follow-up, there was a complete recovery of the deficits. Peroneal mononeuropathy in children is uncommon. Osteochondroma is a benign tumor consisting of projecting bone capped by cartilage. These tumors may be solitary or multiple and occur in hereditary multiple exostoses syndrome. The conjunction of this lesion with peroneal nerve palsy has been exceptionally reported for children, usually linked to hereditary multiple exostoses syndrome. Most peroneal nerve trauma occurs at the fibular head, where the common nerve has not yet divided into its deep and superficial peroneal nerve and where most peroneal nerve lesions, therefore, involve both branches, although motor deficits are more frequently involved than sensory ones. Surgical treatment should not be delayed because neurological improvement may be achieved if surgery is performed before severe neurological deficits become irreversible.

Traumatic hip dislocation is rare in children. The purpose of this study was to investigate the epidemiological features, dislocation types, treatments, and clinical and radiological outcomes. Seven cases of traumatic hip dislocation in children treated between 1996 and 2006 were included in this study. There were six boys and one girl with a mean age of 6.5 years. Six children had a low-energy injury. One child had a road traffic accident. All had a posterior dislocation of the hip without any associated fracture. All children underwent closed reduction of their dislocation. The mean time interval between dislocation and reduction was 4 hours and 50 minutes. Following reduction, they were immobilised for six weeks: skin traction was applied for 3 weeks, followed in six children by a hip spica cast and in one child by non weight bearing mobilization. The mean follow-up was 6.7 years. After clinical examination the hip was classified as normal in 6 children. One child had a stiff hip and a radiograph showed signs of avascular necrosis. The severity of injury was related to the age at the time of injury. Factors predisposing to avascular necrosis were delayed reduction and severity of trauma.

We report the case of a left superior pubic ramus osteochondroma occurring in a 29-year-old man. The patient consulted for a multiple exostoses disease revealed by a painful induration at the base of his penis. This induration was increasing in volume and causing discomfort during sexual intercourse and when sitting for a prolonged period of time. CT-scan examination showed a pedunculated osteochondroma of the left superior pubic ramus compressing the urethra. Surgical resection of the tumor confirmed the diagnosis of osteochondroma. At a 2-year follow-up delay, all symptoms had regressed with no evidence of recurrence.

The authors report two cases of concomitant scaphoid and distal radial fractures, a rare combination of lesions in children. The first case was in a 14-year-old boy who presented a midscaphoid fracture associated with a distal forearm fracture. The second case concerned a 13-year-old boy who presented a midscaphoid fracture associated with a Salter type II distal radial fracture. Both fractures were reduced under general anaesthesia. The total period of immobilisation was 3 months, using a large arm thumb cast. Associated scaphoid fractures should be suspected with all types of distal forearm injuries in children. Reduction of the radius fracture should be done carefully to avoid possible displacement of the scaphoid fracture.

Introduction: The authors report 7 cases of acute tibial tubercle avulsion fractures. The fracture occurred in 6 out of the 7, after an abrupt tension of the patellar tendon in male sporting adolescents (age 13-17 years). Two patients presented symptoms of homolateral Osgood-Schlatter's disease before the lesion., Method: According to Ogden's classification, the tibial tubercle avulsion fracture was not displaced in 3 cases (stage IA) and was treated conservatively by immobilization for 6 weeks. In 4 cases, the fracture was displaced and necessitated an internal fixation with plaster for about 6 weeks. A torn patellar tendon was noted in one adolescent having a stage IIIB avulsion fracture., Result: The mean follow-up was of 4.5 years (1.5-7.5 years). The results were satisfactory: complete functional recovery, resumption of sport at the previous level and absence of recurvatum.

Background: Physical exercise has beneficial effects on a number of physiologic systems, including the skeleton. However, combined with potential risk factors, unwise training practises may harm theses systems. A stress fracture represents one from of breakdown in the skeletal system., Aim: Assess the usefulness of MRI and kinesitherapy., Methods: 14 patients in military circles had a stress facture. Most of the fractures are located at the upper metaphysis of the tibia., Results: The radiography was poor, the MRI was the investigation of choice. The images show a FREDERICSON grade 4 lesion. Treatment is mainly non or partially weight bearing until consolidation., Conclusion: Although stress fracture results from unbalance between the bone and the forces applied, the injury occurs as a result of summation of various extrinsic and intrinsic factors at a given point in time.