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Results of Antegrade Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children

Volume 9 | Issue 1 | January-April 2023 | Page: 26-32 |Piyush Gadegone, Wasudeo Gadegone, Vijayanand Lokhande DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.152 Authors: Piyush Gadegone [1] MS Orth., DNB Orth., Wasudeo Gadegone [1] MS Gen. Surg., MS Orth., MNAMS Orth., SICOT (Fellow), Vijayanand Lokhande [1] MS Orth., DNB Orth. [1] Trauma and Orthopaedics Hospital, Chandrapur, Maharashtra, India. Address […]

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Volume 9 | Issue 1 | January-April 2023 | Page: 33-36 | Sitsabesan Chokkalingam, Arunan Murali, Roy Santhosham, Gopinath Menon DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.153 Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho. [1] Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher […]

Results of Antegrade Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

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Results of Antegrade Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children

Volume 9 | Issue 1 | January-April 2023 | Page: 26-32 |Piyush Gadegone, Wasudeo Gadegone, Vijayanand Lokhande

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.152

Authors: Piyush Gadegone [1] MS Orth., DNB Orth., Wasudeo Gadegone [1] MS Gen. Surg., MS Orth., MNAMS Orth., SICOT (Fellow), Vijayanand Lokhande [1] MS Orth., DNB Orth.

[1] Trauma and Orthopaedics Hospital, Chandrapur, Maharashtra, India.

Address of Correspondence

Dr. Wasudeo Gadegone
Consultant Orthopaedic Surgeon, Trauma and Orthopaedics Hospital, Chandrapur, Maharashtra, India.
E-mail: gadegone123@yahoo.co.in

Abstract

Objective: The objective of this study is to present a new method of Antegrade elastic wires, which is a minimally invasive surgical approach to treat displaced fractures in the distal radial metaphyseal and dia-metaphyseal fractures in children.
Materials and Methods: We conducted a retrospective analysis of 18 patients who received antegrade elastic wires treatment for distal radial fractures from January 2019 to January 2023. The surgical indications encompassed closed, significantly displaced, and unstable fractures located in the metaphysis or diaphyseo-metaphyseal region of the radius. The fractures were stabilized using two prebent short elastic nails that were introduced from the diaphysis to the metaphysis. In instances when an ulnar fracture was present, a traditional anterograde nailing procedure was also carried out. A long or short arm plaster cast was administered for a duration of 3 weeks.
Results: The group consisted of 15 boys and 3 girls, with an average age of 10.8 years (ranging from 7 to 16 years). The right hand was implicated in 12 instances, whereas the left hand was implicated in 6 instances. The mean duration of follow-up was 7.8 months, with a range of 4 to 28 months. Out of the 18 patients, 2 individuals experienced skin irritations, which were resolved after the removal of the radial nails. All patients had complete restoration of their range of motion and experienced successful bone healing without any problems.
Conclusions: An antegrade elastic wire fixation is a very efficient, secure, and readily replicable technique for treating unstable fractures of the distal radius, while also preventing harm to the physeal plate. It successfully attains favorable functional and radiological outcomes and allows early mobilization.
Keywords: Distal radius, Metaphyseal fracture, dia-metaphyseal fractures, Elastic wires, Antegrade.

References

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20. Gadegone P, Gadegone W, Lokhande V, Jawrani N. Distal Radial Fracture Fixation in Adults using Intramedullary Elastic Wires Augmented with either Cast Immobilization or External Fixation. *Malays Orthop J.* 2021 Nov;15(3):36–44. doi: 10.5704/MOJ.2111.006.
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How to Cite this Article: Gadegone P, Gadegone W, Lokhande V Results of Antegrade | Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 26-32 | https://doi.org/10.13107/ijpo.2023.v09.i01.152

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Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Volume 9 | Issue 1 | January-April 2023 | Page: 33-36 | Sitsabesan Chokkalingam, Arunan Murali, Roy Santhosham, Gopinath Menon

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.153

Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho.

[1] Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
[2] Department of Radiology, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.

Address of Correspondence

Dr. Sitsabesan Chokkalingam,
Department of Trauma & Orthopaedics, (SRIHER) Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
E-mail: sabesan101@gmail.com

Abstract

Introduction: Osteoid osteomas are painful benign bone tumors, accounting for 10% of overall primary bone tumors. Typical osteoid osteomas are located intracortical or intramedullary in the metadiaphyseal region of the long bones. The Atypical ones are the Juxta and Intraarticular type, posing greater challenges in its diagnosis and management. CT and MRI scans have better chances of defining the nidus lesions in Atypical osteoid osteoma of the hip joints. Surgical treatment options include, image guided percutaneous interventions such as Radio frequency ablation, Laser or Cryo ablation. These modalities achieve surgical cure, but lacks the opportunity for a histo-pathological confirmation. Our cases will highlight the ‘wandering nidus’ in hip osteoid osteoma and the possibility of dual pathology (Osteoid osteoma and Osteomyelitis) in the same hip.
Case study: We present two cases of hip joint osteoid osteomas (aged 18 yrs and 10 yrs) to highlight the diagnostic challenges and to discuss the different methodology of treatment. CT scan with additional MRI studies confirmed the radiological diagnosis after a delay of 6-8 months. The first case will highlight the wandering nature of the nidus (explained by the position of the calcific spicule within the nidus with reference to the needle tip), the challenges for needle trajectory with close proximity to femoral vessels and the “coaxial technique using chopstick maneuver” for CT guided needle excision. The second case will highlight the feasibility of percutaneous excision and surgical curettage in the presence of dual pathology.
Conclusion: Both the cases were successfully treated by CT guided n excision biopsy and had the histopathological confirmation. Needle technique allows confirmation of diagnosis and exclusion of other differential pathology.
Keywords: Wandering nidus, Atypical osteoid osteoma hip, Chopstick maneuver, Coaxial technique, Double hip lesion.

References

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[2] Ciftdemir M, Tuncel SA, Usta U. Atypical osteoid osteomas. Eur J Orthop Surg Traumatol. 2015 Jan;25(1):17-27. doi: 10.1007/s00590-013-1291-1. Epub 2013 Aug 23. PMID: 23975583.
[3] Kayser F, Resnick D, Haghighi P, Pereira ER, Greenway G, Schweitzer M, et al. Evidence of the subperiosteal origin of osteoid osteomas in tubular bones: analysis by CT and MR imaging. AJR Am J Roentgenol. 1998;170(3):609–614. doi: 10.2214/ajr.170.3.9490939
[4] Orth P, Kohn D. Diagnostik und Therapie des Osteoidosteoms [Diagnostics and treatment of osteoid osteoma]. Orthopade. 2017 Jun;46(6):510-521. German. doi: 10.1007/s00132-017-3428-0. PMID: 28447111.
[5] Lakdawala A, Carsi B, Lennox CM. Osteoid osteoma of the tibial tubercle–an unusual cause of anterior knee pain. Int J Clin Pract. 2004 Oct;58(10):988-9. doi: 10.1111/j.1742-1241.2004.00181.x. PMID: 15587782.
[6] D. I. Rosenthal, F. J. Hornicek, M. Torriani, M. C. Gebhardt, and H. J. Mankin, “Osteoid osteoma: percutaneous treatment with radiofrequency energy,” Radiology, vol. 229, no. 1, pp. 171–175
[7] Chai JW, Hong SH, Choi JY, Koh YH, Lee JW, Choi JA et al (2010) Radiologic diagnosis of osteoid osteoma: from simple to challenging fndings. Radiographics 30(3):737–749
[8] Davies M, Cassar-Pullicino VN, Davies AM, McCall IW, Tyrrell PN (2002) The diagnostic accuracy of MR imaging in osteoid osteoma. Skeletal Radiol 31(10):559–569
[9] Mungo DV, Zhang X, O’Keefe RJ, Rosier RN, Puzas JE, Schwarz EM (2002) COX-1 and COX-2 expression in osteoid osteomas. J Orthop Res 20(1):159–162
[10] Edeiken J, DePalma AF, Hodes PJ (1966) Osteoid osteoma. (Roentgenographic emphasis). Clin Orthop Relat Res 49:201–206
[11] Hasegawa T, Hirose T, Sakamoto R, et al. Mechanism of pain in osteoid osteomas: an immunohistochemical study. Histopathology 1993;22:487-91.
[12] Aynaci, O., Turgutoglu, O., Kerimoglu, S. et al. Osteoid osteoma with a multicentric nidus: a case report and review of the literature. Arch Orthop Trauma Surg 127, 863–866 (2007). https://doi.org/10.1007/s00402-007-0421-9

How to Cite this Article: Chokkalingam S, Murali A, Santhosham R, Menon G | Atypical Osteoid Osteoma of Proximal Femur and Its Surgical Challenges: A Case Study on ‘Wandering Nidus’ and Double Lesion | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 33-36 | https://doi.org/10.13107/ijpo.2023.v09.i01.153

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Results of Antegrade Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Results of Antegrade Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Full Sized Blog Element (Big Preview Pic)

Results of Antegrade Intramedullary Elastic Wires for Severely Displaced Distal Radial Fractures in Children

Authors: Piyush Gadegone [1] MS Orth., DNB Orth., Wasudeo Gadegone [1] MS Gen. Surg., MS Orth., MNAMS Orth., SICOT (Fellow), Vijayanand Lokhande [1] MS Orth., DNB Orth.

Abstract

(Article Text HTML) (Full Text PDF)

Atypical Osteoid Osteoma of Proximal Femur and its Surgical Challenges: A Technical Note on ‘Wandering Nidus’ and Double Lesion

Authors: Sitsabesan Chokkalingam [1] D Ortho., Arunan Murali [2] MD Rad., Roy Santhosham [2] MD Rad., Gopinath Menon [1] MS Ortho.

Abstract

(Article Text HTML) (Full Text PDF)

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