多发性骨膜软骨瘤1例

患者，男，27岁。大学生，右手左足多发巨大骨肿瘤来院。病史10余年，无家族史；无疼痛，患者右手严重畸形(图1)．但可握笔写字，左足跛行。入院后行X线检查示：右手左足多发巨大骨软骨癌．骨质破坏严重。分别行两次手术治疗。右手食指因骨质破坏严重，从掌指关节处离断．其余各指刮出肿瘸组织，保指治疗。左足拇指切除瘤体后，以     

膝关节骨外软骨瘤1例

正患者,男,41岁,因"右膝前内侧肿物1年"于2010年8月16日入院。患者入院前1年无意中发现右膝部有一肿物,无疼痛及其他不适感,未予治疗。1年以来该肿物缓慢生长,近半年增长较快,现患者为进一步治疗来我院。查体:肌力5级,右膝髌下前内侧肿胀,局部可触及一约6.0 cm×5.0 cm肿物,质硬,活动性尚可,与皮肤无粘连,表皮无红肿,无静脉曲张,皮温正常。右膝关节浮髌试验阴性,内外侧应力试验及抽屉试验阴性,右膝关节屈伸活动正常,双侧腹股沟淋巴结无肿大。实验室检查:术前     

胸椎椎板骨软骨瘤1例

骨软骨瘤很少发生于脊柱,2003年11月本院收治1例胸椎椎板骨软骨瘤患者,现报告如下：     

股骨颈部单发性骨软骨瘤1例报告

患者,男,33岁,左髋部疼痛伴活动受限2年入院。患者2年前体力劳动后出现左股骨疼痛,未予特殊处理,现为减轻疼痛就诊于我院。人院查体：左髋部未触及明显肿块畸形,压痛（＋）,左“4”字征（＋）,左髋关节活动稍受限,浅感觉、末梢血运、肌力基本正常。予骨盆平片示左股骨颈内侧可见一团块状新生物,与骨密度相似（图1a）。双髋关节CT及三维重建示左侧股骨颈部见一带蒂的骨性肿物,骨皮质与股骨颈基底部相连,其内骨密度不均匀,周围软组织被推移（图1b）。初步诊断：左股骨颈部骨肿瘤,考虑骨软骨瘤（osteochondroma）。     

左侧肩胛骨肩胛下窝内侧缘骨软骨瘤1例报告

患儿,男,12岁,因"发现左肩部包块3个月余"入院,2009年6月无明显诱因出现左肩胛角向后突起,肩胛骨下可触及一包块且逐渐增大并左肩部畸形,无疼痛,无发热、不伴恶心、呕吐,无腹痛、腹胀等,为进一步诊疗来院.入院查体:全身一般情况可,左侧肩胛角较对侧明显向后高突,呈"翼状"畸形(见图1),左肩胛骨下缘腹面与肋骨之间可触及5 cm×4 cm大小肿块,质硬.无移动,包块轻压痛,左肩部活动度正常,上肢感觉、肌力及血运正常.     

第1跖骨颈下方巨大鹿角状骨软骨瘤1例

<正>患者,女,56岁。因右足底前部肿痛异物感伴逐渐加重7年入院。患者7年前感右足底前部肿块,进行性增大,推之不移动,逐渐增大,穿鞋不适,伴行走时疼痛和异物感,未予特殊治疗。查体:一般情况良好,右足底前部稍隆起,皮肤无异常,可触及3 cm×2 cm肿块。DR片:右第1跖骨颈下外侧不规则骨样密度影,边界清,骨质密度不均匀。CT片(图1):右第1跖骨颈下外侧不规则骨样密度影,骨质密度不均匀,基底部与跖骨颈部相连,肿块与周围组织分界清晰,跖骨干部骨质密度正常。诊断:右第1跖骨颈下方骨软骨瘤。于2011年9月     

少见部位骨软骨瘤2例报告

例1,患者,男,16岁。2008年6月不慎碰伤右足趾末端,当时疼痛剧烈,未予特殊关注,于1周内症状缓解。后发现右足趾甲下局部逐渐隆起,初起体积较小,后逐渐增大,遂来院就诊。查体：右足趾甲下见一肿物,约10mm×5mm,质硬,边界清楚,与周围关系密切,无压痛。     

甲下骨软骨瘤一例报告

甲下骨软骨瘤一例报告任志远，张良谓单发性骨软骨瘤好发于长管状骨干骺端，发生在末节指骨者罕见，１９８４年我院收治一例，报告如下：病例，男性．２０岁。左示指末节２年前发现一肿物，米粒大小，无疼痛，质硬，不活动。此后肿物逐渐增大，向外突出性生长，近半年生长...     

颈椎巨大骨软骨瘤1例

1病例资料患者,男,40岁。因发现左颈部无痛性肿块3个月余入院。查体:颈部下段左侧明显肿胀,可触及约5cm×4cm×4cm的肿块,质硬,表面不光滑,活动度不明显,与皮下无粘连。局部无压痛及上肢放射痛,颈部活动轻度受限,以左右侧弯活动受限明显,末梢感觉正常,四肢活动正常。病理征阴性     

Trochanteric hip fracture during cardioversion therapy. A case report

IntroductionTrochanteric hip fractures in elderly patients with osteoporosis are commonly caused by low energy trauma. The cardioversion therapy is an extremely rare cause of this type of fracture.Presentation of caseWe report the case of a woman with hip fracture after cardioversion.DiscussionWe discuss the production mechanism of this injury and the importance of the care of the osteoporotic bone under these therapies.ConclusionThe propofol sedation should be complemented with skeletal muscle relaxants in the cardioversion therapy to avoid hip fracture in select patients with osteoporosis.     

自发性髋关节周围异位骨化1例

患者,男,46岁,发现右髋关节活动受限1周左右入院。入院前曾有在2年间因脑出血2次开颅手术病史,神志不清,偶有癫痫发作。第2次开颅术后曾有约2个月卧床经历。1周前家属发现患者右髋关节活动受限,而就诊于我院。查：右髋关节强直于30°位屈曲畸形,内收、外展等均为0°,双下肢肌肉萎缩,因2次开颅手术,患者查体合作欠佳,故肌力感觉不能很好检查。X线：右髋关节周围及右股骨中上段前外侧软组织可见不均匀密度增高影,边缘清晰（图1）。CT：右侧髋关节周围可见不规则骨性密度影,边界清,无明显骨质破坏（图2）。     

双侧髋关节同时前后脱位1例

患者,男,55岁,敲击拆墙时被侧方倒落墙体压伤致双下肢活动不能及头皮出血2h入院。体检：右下肢内收、内旋、短缩畸形,左下肢外旋、外展屈曲畸形,双侧髋关节弹性固定,不能活动。双下肢感觉无殊,双足背伸跖屈肌力正常,头皮7cm裂伤伴活动性出血。     

Atypical presentation of a glomus tumour: A case report

A 46-year-old man presented with an extremely painful, 1 cm, mobile, nodular mass located on the medial side of his right elbow. Symptoms failed to respond to conservative treatment. Ultrasound and Doppler flow imaging revealed a well-defined, round hypoechoic mass. Under local anesthesia, the mass was resected and the wound closed without complication. Final pathology diagnosed the lesion as a glomus tumour, solid type. Histology staining showed the tumour cells were positive for antibodies to vimentin and muscle actin. It is unusual for a glomus tumour to be located anterior to the medial epicondyle of the right arm. Hand surgeons most commonly encounter glomus tumours in the nailbeds of the fingers.     

Bilateral hip heterotopic ossification with sciatic nerve compression on a paediatric patient–An individualized surgical approach: A case report

BACKGROUNDNeurogenic heterotopic ossification is an acquired serious complication described in patients with central nervous system disorders and defined by bone formation in non-osseous tissue.CASE SUMMARYWe present an unusual case of a 13-yr-old boy presenting with hip pain and severe gait impairment 5 mo after the diagnosis of hemiplegia following a spontaneous intracerebral haemorrhage. Computed tomography revealed bilateral heterotopic ossification of both the paretic and the non-paretic limbs, with entrapment of the sciatic nerve. The choice of surgical or nonsurgical management of such patients depends on the timing of diagnosis, the symptoms, and the extent of maturation of the ossified lesions. Surgical resection remains the only treatment with proven, evidence-based effectiveness. The choice of surgical approach largely depends on the location of the ossified lesions.CONCLUSIONWe believe the plane of dissection presented is a satisfactory option for resection of a posteromedial mass and sciatic nerve release.     

Total hip prosthesis complication,periprosthetic infection with external fistulizing due to Enterobacter cloacae complex multiple drugs resistance: A clinical case report

IntroductionThe Enterobacter cloacae is a microorganism found in the intestinal flora of the majority of animals, including humans. Primary infections caused by E. cloacae are rare in immunocompetent patients, but are very common in hospital settings in newborns and immunocompromised patients, and can be aggravated by the insurgence of antibiotic resistance. The incidence of periprosthetic hip infections is just below 2%.Case presentationA 76 year old woman with multiple comorbidities underwent surgical implantation of intermediary total hip prosthesis of the left hip, in a different health facility, in February 2014, after the basicervical fracture of the upper femur extremity due to trauma. After an episode of dislocation of the prosthetic implant, in September 2014, she underwent a surgical operation to implant the acetabular component. A month later not in our facility, following a re-hospitalization for the dislocation of the arthroprosthesis, an infection from E. cloacae complex was discovered. After 2 years of chronic infection she came to our attention; the clinical picture featured coxalgia and secreting fistula in the surgical wound. Following a specific antibiotic therapy, carried out intravenously over the course of a month, we decided to intervene removing the left hip arthroprosthesis and placing an antibiotic spacer following the direction deduced from the antibiogram study of August 2016.ConclusionThe patient was hospitalized in our facility and 2 months later she underwent another operation to remove the antibiotic spacer and to place a new total hip arthroprosthesis. Multiple swabs showed the complete healing from the infection, which was confirmed a couple of months later.     

左髋关节滑囊囊肿1例

患者,女,40岁,因“发现左腹股沟区包块半年,增大伴疼痛3个月”入院。查体：左侧腹股沟韧带中点偏内侧下方可扪及3．0cm×3．5cm×4．5cm大小包块,质韧,有压痛,移动度小,挤压后包块不消失,局部皮肤色泽正常。活动左髋关节包块不移位,过伸左髋关节左大腿前侧放射性痛。血象正常。B超示：左大腿根部一3．0cm×3．5cm×4．0cm大小液性暗区,     

Surgical treatment of osteochondroma on the first rib by double clavicle osteotomy and internal fixation with a reconstruction plate: A case report and literature review

IntroductionThe accepted indication for surgical removal of osteochondroma is when a lesion becomes symptomatic. There have been no established standard surgical approaches to remove osteochondroma on the first rib and no report on management after that. This report aims to present a novel approach by double clavicle osteotomy followed with internal fixation.Case presentationA 17-year-old female presented with a gradually enlarged bony mass with tenderness at the supraclavicular area. Radiographic images revealed a bony mass attached to the first rib. The provisional diagnosis is osteochondroma. The tumor was approached by osteotomy at the proximal and distal shaft of the clavicle. After removing the entire tumor, the direct reduction and internal fixation of the clavicle were performed.DiscussionBoth, size of the mass and mobilization of the clavicle are factors in determining the surgical approach. Clavicular osteotomy, especially two sites, is considered when the lesion is extremely large. A possible complication after the clavicular osteotomy is nonunion or malunion. A proper technique of reduction and method of fixation contributes to reducing complications.ConclusionThe double clavicle osteotomy is an effective route for removing a large tumor at the first rib. Plate fixation following clavicular osteotomy contributes to bone union and excellent functional outcomes postoperatively.