Ostéome ostéoïde de la phalange chez l’enfant et problème diagnostique. À propos d’un cas

Osteoid osteoma is a benign osseous tumor of unknown origin, which affects preferentially the long bones. The localization in the phalanx is unusual and difficult to diagnose. We present a case of a 13-year-old girl, presenting with a painful swelling of the first phalanx of the right middle finger of 5 months duration, not responding to anti-inflammatory drugs. The diagnosis of tuberculosis of the bones was suggested at first (tuberculosis is endemic in our country), but the biology and the bone biopsy did not confirm the diagnosis. The lesion was excised, and the histology confirmed the diagnosis of osteoid osteoma. Through our observation and after a review of the literature, we analyze the clinical and paraclinical appearance of this uncommon localization, the differential diagnosis, and finally the therapeutic possibilities.     

La luxation talocrurale pure ouverte chez l’enfant. À propos d’un cas et revue de la littérature

Pure talocrural dislocation in children is a very rare event, exceptional when associated with a skin opening. We report the clinical observation of a ten year-old boy who presented an opened medial dislocation of the right talocrural articulation without associated fracture.     

L’entorse grave ouverte de la cheville chez le sportif. À propos d’un cas

Severe ankle sprain is frequent in daily practice but the association with a skin opening is exceptional.We report a rare case of severe open ankle sprain in athlete. The mechanism of the injury is reminded with a review of the literature.     

Tumeur neuroectodermique primitive des parties molles de l’index chez l’adulte. À propos d’un cas

The primitive neuroectodermal tumours (PNET) of soft tissues belong to the Ewing's tumors family and affects particularly the child. The localization of the disease at the extremities is very rare within the adult population and raises the problem of differential diagnosis with others tumors of the soft tissues. We report the case of a 48-year-old patient with a localized tumor, at the level of the second right finger, of six months evolution. The biopsy showed the infiltrating nature of the tumour; and the diagnosis of (PNET) was confirmed after the histological and immunohistochemical study. The extension assessment was negative and the patient had an amputation of the second and third rays of the right hand. Four years afterwards, the patient showed no recurrence or metastases.     

Les tumeurs glomiques de l’orteil : à propos d’un cas de tumeur glomique de l’hallux

The Masson glomus tumour is a benign neuromyoarterial growth. Such tumours are rare and are most commonly described in the hand, however there are very rare cases of them in the foot. Tumours are characterised by a triad of clinical symptoms involving pain, tenderness and hypersensitivity. Diagnosis is often late. Although they are benign tumours, an early diagnosis is better as they can have an effect on quality of life. Diagnosis is made based on the clinical presentation, with an MRI scan being an additional optional investigation. These tumours do not respond to classic analgesics, therefore treatment involves their surgical excision. Histological analysis is used to confirm diagnosis. Reoccurrence is rare, but may occur; the patient should therefore be informed of this possibility.     

Séparation traumatique axiale de la médiocarpienne à déplacement palmaire. À propos d’un cas avec revue de la littérature

We report a case of traumatic axial disruption of the radial mid carpal joint. This unusual type of scaphotrapezo-trapezoïdal dislocation occurred after falling from a height. We performed open reduction and wire fixation. At 12 months follow-up, functional outcome was satisfactory with good muscle strength (clamping force, grip strength and pinch grip: 90% compared to the opposite side) and good range of motion was preserved. Work was resumed at the tenth week. Radial midcarpal disruption is uncommon. It includes the separation of the trapezium, trapezoïdal, first and second and third metacarpal bones from the remaining wrist. This pattern of carpal derangement has not been previously described in the literature. Mechanism of the injury and treatment are discussed.     

Tumeur glomique de la capsule antérieure du coude. À propos d’un cas

Glomus tumors are rare tumors, benign but painful and responsible for a major functional impairment. Although their preferential localization is digital, 35% of glomus tumors are extradigital. Ignorance of this disease characterized by atypical clinical signs and the absence of specific imaging are responsible for a significant diagnostic delay, 7 to 10 years in extradigital forms. Treatment by surgical excision simply ensures immediate disappearance of pain without recurrence in 90% of cases. It is therefore necessary to emphasize the existence of this sometimes debilitating condition benefiting from effective therapeutic solution. We report the case of a glomus tumor of the anterior capsule of the left elbow in a 24-year-old woman with a diagnostic delayed by 12 years.     

Les fractures de fatigue de l’extrémité distale de la fibula. À propos de trois cas avec revue de la littérature

Introduction

The stress fractures are injuries that occur following repeated periodical constraints on a normal bone. They are more common on the lower members; the distal fibula localization is rare and it is estimated lower than 6% of all localizations.

Material and methods

It is about a retrospective study of three cases of stress fractures of distal fibula collected in the archives of the orthopedic department of our hospital. The average age was of 29 years (25–36 years) with a male predominance; in two cases the right ankle was affected. Pain was present in all cases, extending up to threeweeks in two cases and to ten days in one case. The anamnesis helped in the diagnosis, whereas the physical examination was poor. Imaging helped the diagnosis; ultrasound also contributed formally to it on this superficial localization of a bone like distal fibula. The conventional treatment is mainly based on immobilization of ankle by orthosis, avoiding all physical activities and taking rest. Results: The fractures in all cases healed within six to eight weeks.

Conclusion

The new therapeutic modes (stimulation of the osseous consolidation) are under assessment and would be promising to athletes.     

Métastases osseuses d’un épendymome d’emblée de double localisation. À propos d’un cas

A case of cerebral and sacral ependymoma revealed by cerebellar syndrome and sciatica in a 68-year-old man is reported. Bone metastases were diagnosed seven months after surgical excision of the brain tumor.     

Multiples fractures de contrainte chez une jeune fille atteinte d’arthrite chronique juvénile. À propos d’un cas

The occurrence of stress fractures in patients with long standing rheumatoid arthritis (RA) is widely known. Osteoporosis, corticosteroid therapy, joint stiffness, contracture, angular deformity of the joint and failed joint reconstruction – all together or separately – predispose to bone loss and stress fractures. In the present report we describe the history of a girl with juvenile idiopathic arthritis (JIA) having multiple stress fractures. The relationship between corticosteroid therapy and immobilisation in the treatment of fractures is discussed.     

Rupture de coiffe de la hanche. À propos d’un cas de rupture du moyen fessier révélée par une tendinite rebelle

We report a case of gluteus medius tear in a patient who presented with an 11-month history of severe trochanteric pain. Neither magnetic resonance imaging nor ultrasonography visualized the tear, the only findings being inflammatory thickening of the tendon and bursitis. A glucocorticoid injection into the bursa under fluoroscopic guidance and three glucocorticoid injections at the contact of the tendon failed to relieve the pain. At surgery, a 2- by 4-cm tear was found in the tendon of the right gluteus medius muscle. Partial tendon reconstruction was followed by prompt and lasting pain relief, in accordance with the few similar reports in the literature. This paucity of publications is in sharp contrast with hip fracture surgery findings suggesting that at least 10% of patients older than 60 years of age may have painless hip rotator cuff tears.     

Myiase scrotale chez l’enfant : à propos d’un cas

We present observations of a 4-year-old child, who was received for an inflammatory and pruritic scrotal swelling that had been evolving for 7 days. The physical examination found a scrotal mass centered by a whitish opening evoking a fistulized abscess or a furunculoide lesion. The bidigittal compression of the tumefaction had allowed the extraction of a maggot with the help of forceps leaving an 8 mm wound in place. The review parasitologist had concluded to a larva of anthropophaga cordylobia. The patient had received anti-inflammatory and antibiotic treatments associated with local care. This trend was favorable after a two-week decline. We will study the epidemiological, diagnostic and therapeutic aspects of this condition so rare in children simulating a furunculoide lesion or parietal abscess.     

Synovite villonodulaire pigmentée de la métatarsophalangienne de l’hallux

Villonodular pigmented synovitis is a benign, idiopathic proliferative and locally aggressive disorder of the synovium that have been reported to manifest within joints, tendon sheaths, and bursae. Usually, only one joint is affected, especially the knee. The localization in the foot is rare. The authors present a case of a villonodular synovitis of the metatarsophalangeal joint of the hallux. A review of the literature highlights this case.     

L’hallux varus congénital chez l’enfant: une pathologie inhabituelle (à propos d’un nouveau cas)

Hallux varus is a forefoot deformity consisting of medical deviation of the first metatarsophalangeal joint. The congenital form is rare and occurs in some malformative or syndromic conditions. According to its origin, the management is different. We report a case of a 9-year-old boy with congenital hallux varus neglected since childhood. The surgical procedure is described. An aesthetically acceptable, painfree and functionally adequate foot was achieved. We present here the literature data.     

Fracture-avulsion de la tuberosité calcanéenne : à propos d’un cas

An avulsion fracture of the tuberosity of the calcaneus is a very rare, but recognized, occurrence. In the majority of cases, it is accompanied by displacement of the torn fragment, and usually surgery is required to treat the displaced fracture. Basic surgical fixation using foam-type screws is commonly used.We are reporting on a case of an avulsion fracture of the tuberosity of the calcaneus in a male, aged 70. Through this case and a review of the literature discussing its etiology, we are proposing mechanisms and treatment methods for this type of lesion.