Chondromyxoid fibroma is a rare benign primary bone tumor composed of immature myxoid mesenchymal and cartilaginous tissue. It has a predilection for the metaphyseal area of long tubular bones of lower extremities in young patients. Its occurrence in calcaneus is very rare and few cases of calcaneal involvement have been reported in literature. This mass can mimic other benign and malignant bone tumors owing to its variable histologic features. A case report is demonstrated, discussing the problems of misdiagnosis. A brief review of the literature is presented.

Fracture of femoral neck is a serious complication of transient hip osteoporosis during pregnancy. A case of atraumatic bilateral femoral neck fracture was reported. The diagnosis was made two months after delivery. The patient refused surgery. Spontaneous healing was noted firstly on the right hip and secondly on the left.

This perspective appraises the pathology, etiology, clinical presentation and therapy of osteoporosis, in particular for men, and focuses on implications for oral healthcare

Osteoarthritis, a disabling disease, commonly believed to originate in the articular cartilage of freely moving joints, affects the entire joint, including muscle. This brief highlights the current research being published in this respect, an area of research that is not well documented when compared to related studies of cell biology, tissue engineering, and molecular in vitro studies, among others. To this end, to update a prior analysis, PUBMED, and Web of Science indices were searched for information specifically published between Jan 2015 and April 2017) using the key words: Osteoarthritis and Muscle, among others. Results show, a reasonable body of current science based evidence continues to focus on one or more aspects of muscle structure and/or function in the context of furthering our understanding of the pathogenesis of osteoarthritis disability. Second, while not conclusive, a variety of changes in muscle quality, function, and/or estimates of muscle bulk appear to correlate temporally with features of the pathological processes and extent of disability. Third, well designed carefully construed treatments directed towards improving muscle structure and function in those with symptomatic osteoarthritis appear to hold more promise than not for potentiating favorable disease outcomes. Conversely, failure to identify what component of the muscle system is specifically implicated in the osteoarthritis disease process may produce more negative clinical outcomes than not.

The term hemangioendothelioma is the designation for vascular tumors that have a biologic behavior intermediate between a hemangioma and a conventional angiosarcome; it is associated with a significant risk of recurrence and metastasis.

Epithelioid hemangioendothelioma is a rare vascular tumor; it represents less than 1% of all the vascular tumors. Although it can occur at almost any age, it rarely occurs during childhood, affecting most of the time the liver, the lung, and soft tissues and bones. Because of its heterogeneous presentation, it is often misdiagnosed and not suitably treated.

We report a rare case of hemangioendothelioma epitheloid at the right calcaneus. Through this case and the literature, we will review the problems of differential diagnosis.

A significant increase in physical activity or a recent change in the routine activity level may result with stress fractures, which are seen more frequently in soldiers and athletes due to repetitive activities such as running and marching. Clinical assessment and x-rays are not always enough to diagnose stress fracture, thus further radiological assessment is often needed Here we aimed to present a case of an atypical stress fractures in a soldier seen after a prolonged repetitive activity.

Madelung deformity can be defined as developmental and progressive deformity of the distal radio-ulnar and radiocarpal joints. Although that the exact etiology of the disease is still unknown, the main reasons are considered to be due to delayed growth rate of the medial side of the growth plate of the distal radius causing relatively shortening of the medial side of the radius. In this paper, we present a 22 years old female patient with left side Madelung’s deformity presented with a gradually increasing pain over the years on the dorsal and ulnar side of her left wrist especially during sports activities accompanied by abnormal appearance of the wrist. The deformity was corrected by corrective dome osteotomy. After surgery; pain relieved and range of motion of wrist increased. Distal radius deformities associated with Madelung deformity, can be treated successfully with surgery especially in the presence of pain and cosmetic discomfort.

The compression of the nerve is a known pathology since the late fifties, described for the first time par Thompson & Kopell. Many etiologies have been described, including traumatic aetiology further to a fracture of the scapula by bullet wound, which is never reported in the literature and falls within the framework of a syndrome of trapping. The identification of the NSS lesion requires not only careful clinical examination of the shoulder, but also a detailed neurophysiological evaluation, possibly using imagery.

Diagnosis and treatment of this compression should be as early as possible, before the installation of irreversible amyotrophy. The surgery of different causes of compression has improved the functional prognosis of the injured shoulder.

Aim: To identify the main factors favoring the occurrence of aseptic pseudarthrosis of the humeral shaft Evaluate the reliability of our care.

Patients and Method: This was a continuous retrospective study over a period of 4 years and 6 months, with two Components: etiological factors (out of 22 cases) and evaluation of treatment (out of 22 cases). The mean age was 52.7 years with a male predominance (14 men and 08 women). The etiologies of the initial trauma dominated by traffic accidents. The trait was simple medio-diaphyseal in most cases with surgical treatment in 61.1% of cases. There were 15 cases of eutrophic pseudarthrosis, 2 cases of hypertrophic and 5 cases of atrophic. The management of these pseudarthrosis was surgical by decortication type Judet, re-permeabilization and osteosynthesis with inter-fragmentary compression by wide screwed plate in the 18 cases. There were 17 cases of corticospongy graft and 5 cases of shortening.

Results: Based on the criteria of STEWART and HUNDLEY, we had 16 very good results, 3 good results, 2 average results and 1 bad result. Six radial nerve lesions were observed, 4 of which were regressive

Discussion and Conclusion: Pseudarthrosis of the humerus is a non-negligible complication of the fractures of the diaphysis whose main cause is an initial defective management. Our technique is a very effective method with the possibility of nervous complications usually transient.

Purpose: To determine the clinical and radiological variables that are associated with the undertaking of the Latarjet procedure, rather than a Bankart procedure, for anteroinferior shoulder instability.

Methods: Clinical and radiological (CT scan) data was evaluated retrospectively, on a cohort of 66 patients who had undergone surgery for recurrent anteroinferior, glenohumeral instability.

Odds ratios (95%confidence intervals) were calculated for each variable to determine its association with performance of the Latarjet procedure as opposed to an arthroscopic soft-tissue reconstruction.

Results: Linear glenoid bone loss and ipsilateral, previous stabilization surgery were the two variables demonstrated to be associated with a significantly higher likelihood of the patient undergoing a Latarjet procedure.

Age at surgery, treating surgeon, and sports involvement were not associated with an increased likelihood of the patient undergoing a Latarjet procedure.

Conclusion: None of the clinical parameters analyzed demonstrated an association with an increased likelihood of undergoing a Latarjet procedure for anteroinferior shoulder instability.

Consistent with the published literature, we identified 19% linear glenoid bone loss as our cut-off for undertaking a Latarjet procedure for anteroinferior shoulder instability.

Level of evidence: IV

We present the case of a 26-year-old patient who came to the emergency department for aggression with a puncture injury (ice picking) at the T12 thoracic vertebra.

Introduction: Popliteal artery injuries are frequently encountered in case of fractures, dislocations or after penetrating trauma. Lower limb blunt traumas are associated to popliteal artery injuries in 28 to 46% of cases.

Objective: Our objective was to report this particularity.

Clinical examination: The evaluation of the tibial plateau fracture was performed with the Schatzker classification. The nervous injury was classified according to the Seddon classification. We did not find a classification for post-traumatic acute arterial injury

Results: There was a motor deficit of the common fibular nerve without sensitive deficit. The radiological examination showed a complex bicondylar fracture Schatzker 5.

An open reduction and internal fixation with a buttress plate was planned and performed 4 days following the trauma.

The postoperative follow-up was marked by the appearance of a distal necrosis of the 1st and 4th toes with coldness of the forefoot one week after the operation; the pedal and retro-tibial pulses were diminished. Doppler ultrasound and Angio-scan revealed a narrow stenosis of imprecise etiology due to artefacts related to the osteosynthesis material, however, there was a substitute blood network. The patient received curative-dose anticoagulants combined with Sintron and Aspegic.

Discussion: Penetrating trauma is the main cause of vascular lesions in the extremities. They are followed by closed trauma including traffic accidents, falls and crushing. In addition, closed trauma can lead to slow progression of arterial insufficiency.

Inadequate initial examination and delayed vascular repair lead to amputation in 60-80% of cases. It is therefore of paramount importance to evaluate the vascular state not only at the initial examination but above all repeatedly in the following hours and days. In our patient, edema was one of the factors which made difficult the proper monitoring of the distal pulse. Therefore, it seems appropriate to include in the monitoring of knee trauma, whether or not there is a fracture of the tibial plateau, more tests such as Doppler ultrasound, angiography, Angio-scan and MRI.

Conclusion: The dogma which recommended the realization of MRI or even Angio-scan of the knee only after dislocations should be extended to the fractures of the tibial plateau especially in a context of high velocity and this at the beginning and at the end of the management.

This report is of a 20-year-old woman with an osteochondroma of the proximal fibula with scalloping of tibia who presented with chronic pain and swelling in the right popliteal fossa that had been present from 3 years. Magnetic resonance imaging findings can’t enable accurate diagnosis because of the similarities between osteochondroma and low-grade chondrosarcoma. Thus, biopsy of this tumor was necessary. Extemporaneous Histopathological examination confirmed the benign nature of osteochondroma, thus, we performed debulking of the tumour with complete excision.

Objectives: The aim of this multicentre study was to determine the effect of oral alendronate over 2 years on Bone Mineral Density (BMD) and bone turnover in patients with Ankylosing Spondylitis (AS).

Methods: 180 patients were randomised to receive alendronate 70 mg weekly or placebo. Change in BMD over 2 years was assessed by Dual X-Ray Absorptiometry (DXA) scan, bone turnover by serum markers (Procollagen Type 1 Amino-Terminal Propeptide (P1NP) and Carboxy-Terminal Collagen Crosslinks (CTX)) and vertebral fracture by bone morphometry.

Results: At 2 years, patients in the alendronate group showed a significant mean increase in BMD of 5.6% at the lumbar spine compared to a mean increase of 1.4% in the placebo group. At all regions of the hip, BMD increased significantly in the alendronate group. There was a non significant decrease at all hip site in the placebo group. Serum markers showed a significant (p<0.001) reduction in bone turnover in the treated group but not in the placebo. No incident morphometric vertebral fracture rates were observed in either group.

Conclusions: Oral alendronate is effective at reducing bone turnover and increasing BMD in patients with established AS. Although not demonstrable in this short study, an effect on fracture risk is likely to be seen in a higher risk group treated over a longer period.

Introduction: Isolated fractures of the sacrum are rare and in principle related to a direct posterior shock. The occurrence of a pseudarthrosis of a sacrum associated with neurological disorders is an exceptional eventuality.

Case: Female subject 38, victim of a traffic accident occurring 3 months previously, consulted for a neglected trauma of the left hemi pelvis with relative functional impotence of the lower left limb. Clinical examination resulted in a painful lameness with a makeshift cane, pain in inguinal palpation and mobilization of the left hip. The gluteus medius muscle was rated at 0. There were no sphincteric disorders.

Observations: The standard X-ray showed a fracture of the left ischiopubic branch. At CT, there was also a vertical fracture of the left hemi-sacrum passing through the sacral holes and a fracture of the anterior column of the homolateral acetabulum.

The electromyogram showed a left L5 and S1 radiculopathy, a truncular involvement of the SPI (myelinic type) and of the left SPE (axonal type).

At 6 months of follow-up and after a medico-physical treatment (analgesic of pallium-II, vitamino-therapy B and functional rehabilitation); the patient fully recovered with pain only squatting and a gluteus medius to 5.

Results and Conclusion: In traumatology of the pelvis, the standard images are often ill-readable, hence the interest of CT. In the absence of displacement and / or root compression, functional treatment is mandatory. The occurrence of a pseudarthrosis associated or not with irreducibility or a persistence of the neurological syndrome indicates a surgical approach.

Introduction: Since 1990, several investigators have reported an increase in the incidence of spinal cord injuries, with penetrating trauma being the leading cause of spinal cord injury in some urban trauma centers [1]. We report a case with an inlet at L4-L5 and a final migration at S1.

Observation: Trader of 28 years, received January 21, 2016 for low back pain and desire to remove a projectile at the level of the spine. The loco-regional examination found a scar of the orifice in projection of the fourth and fifth lumbar vertebra. The radiological assessment carried out showed: on radiography the projectile at the sacral level; And to the computed tomography, an oval hyper dense formation of size 31x15x10 mm extended from the first sacral vertebra to the second sacral vertebra in relation to the evoked ball with a solution of continuity of the right blade facing it.

At the exploration, one noticed the ball buried in the sacral channel pushing back the nerve elements in posterior and with a prominence of a radicular section to the right, and a fracture of the blade to the right.

Discussion: Spinal lesions by firearm are increasingly common. Kuijen et al. [2] were able to identify four cases of bullets left in place with delayed neurological symptoms. However, these bullets remained localized in epidural as in our patient. The only discrepancy is that the symptomatology was early in our clinical case with a motor unilateral motor deficit secondary to an axonal lesion. The decision to leave or remove a fragment lodged in the spinal canal depends on several factors. Given its composition in copper and lead, the risk of further development of neurological complications was evident. He also had other neurological complications, not related to the toxicity of the different components of the projectile, but to its presence in the sacral canal. And this is all the more increased by the narrowness of this channel and by the rather large number of mesh roots found there.

Conclusion: In addition, imaging plays an important role in the initial management of patients with hemo dynamically stable bales regardless of the location of the projectile. CT is very useful to objectify the trajectory of the ball and to make a precise lesional balance thus making it possible to provide valuable information for the management of this condition.

Surgical Site Infections (SSI) is a dreaded complication of orthopedic surgery. The authors report a prospective study to this effect in the orthopedic traumatology department of the Aristide Ledantec hospital over one year from July 2011 to August 2012. The study concerned all the patients operated in emergency during this period and who had developed an infection during their hospitalization period. Among the 266 osteosyntheses performed, we observed 24 early surgical site infections, including 20 which were shallow and 4 deep, were observed. The overall incidence was 9%. There were 17 cases of clean surgeries and 7 cases of contaminated surgery. There were 13 men and 11 women. The time of infection onset after osteosynthesis was 8, 84 days on average. Globally 16 cases of monobacterial infection, 2 cases of polybacterial infection and 6 negative cultures were reported. Klebsiella peumoniae and Escherichia Coli were the most frequently encountered germs. Debridement of the operative wound was performed in 8 cases or 33% associated with antibiotherapy adapted to the antibiogram. Mainly Imipènme was used as antibiotic.

We report a case of primary ulnar intraneural ossification at the elbow. It is the case of a 54-year-old unemployed woman who presented bone metaplasia with thickening and calcification of the ulnar nerve resulting in the disappearance of the fascicles. Only a similar case is found in the literature review.