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Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 6-8 | Chirag Borana, Naeem Jagani, Nadir Shah, Lokesh Sharoff, Sunirmal Mukherjee Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5]. [1,2,4] Consultant, Dept of Orthopaedics, Masina Hospital, Byculla, Mumbai. [3] Asst. Professor, Dept of Orthopaedics, Sir […]

Osteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 2-5 | Pérez-Ortiz Sergio, Blas-Dobón JA, Peralta-Nieto J, Gómez-Barbero P Authors : Pérez-Ortiz Sergio [1], Blas-Dobón JA [1], Peralta-Nieto J [1], Gómez-Barbero P [1]. [1] Hospital Universitario Doctor Peset, Valencia, Spain Address of Correspondence Dr. Sergio Perez Ortiz Hospital Universitario Doctor Peset, Valencia, Spain. Email: serperort@gmail.com […]

Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Osteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age

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Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 6-8 | Chirag Borana, Naeem Jagani, Nadir Shah, Lokesh Sharoff, Sunirmal Mukherjee

Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5].

[1,2,4] Consultant, Dept of Orthopaedics, Masina Hospital, Byculla, Mumbai.
[3] Asst. Professor, Dept of Orthopaedics, Sir JJ Group of Hospitals, Mumbai.
[5] Senior Resident, Dept of Orthopaedics, Sir JJ Group of Hospitals, Mumbai.

Address of Correspondence
Dr. Lokesh Sharoff,
42, Madhur Milan Society,14th B Road, Khar West, Mumbai 400052.
Email: drlokeshsharoff@outlook.com

Abstract

Background: Supracondylar humerus fracture with forearm fractures are rare with reported incidence ranging from 3% to 13%.
Materials and Methods: We have treated 10patients with ipsilateral supracondylar humerus fracture with distal radius fracture. One had a Gustilo-Anderson Grade 2 open supracondylar humerus fracture. All displaced fractures were treated with K-wire fixation by aclosed method except the open fracture which warranted wound debridement and subsequent open reduction. A follow-up of at least 6 months is available for all our patients.
Results: All fractures showed signs of union by 6 weeks when K-wires were removed. At6 months, 9 patients had excellent outcome while one patient with recovering radial nerve palsy had afair outcome. No cases of non-union or loss of reduction were seen in the post-operative period. Pin tract site infection was seen in one patient with anopen fracture which resolved after K-wire removal and antibiotic coverage.
Conclusion and Learning: This study recommends screening radiographs of forearm and wrist in patients with supracondylar humerus fractures to rule out any associated forearm/wrist injury. We also recommend closed reduction and K-wire fixation of the displaced supracondylar humerus as well as distal radius fractures.
Keywords: Pediatric fractures; Double fractures; Adolescent fractures; Immature skeletal fractures; upper-extremity fractures.

References

1. McLauchlan GJ, Walker CR, Cowan B, Robb JE, Prescott RJ. Extension of the elbow and supracondylar fractures in children. J Bone Joint Surg Br 1999;81(3):402-405.
2. Dhoju D, Shrestha D, Parajuli N, Dhakal G, Shrestha R. Ipsilateral supracondylar fracture and forearm bone injury in children: A retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ) 2011;9(34):11-16.
3. Siemers F, Obertacke U, Fernandez ED, Olivier LC, Neudeck F. Combination of ipsilateral supracondylar humeral-and forearm fractures in children. ZentralblChir 2002;127(3):212-217.
4. Tabak AY, Celebi L, Muratli HH, Yagmurlu MF, Aktekin CN, Biçimoglu A. Closed reduction and percutaneous fixation of supracondylar fracture of the homers and ipsilateral fracture of the forearm in children. J Bone Joint Surg Br 2003;85(8):1169-11672.
5. Powell RS, Bowe JA. Ipsilateral supracondylar homers fracture and Monteggia lesion: A case report. J Orthop Trauma 2002;16(10):737-740.
6. Rouhani AR, Navali AM, Sadegpoor AR, Soleimanpoor J, Ansari M. Monteggia lesion and ipsilateral humeral supracondylar and distal radial fractures in a young girl. Saudi Med J 2007;28(7):1127-1128.
7. Cobanoglu M, Savk SO, Cullu E, Duygun F. Ipsilateral supracondylar homers fracture and Monteggia lesion with a 5-year follow-up: A rare injury in a young girl. BMJ Case Rep 2015;2015. pii: Bcr2014206313.
8. Peters CL, Scott SM, Stevens PM. Closed reduction and percutaneous pinning of displaced supracondylar homers fractures in children: Description of a new closed reduction technique for fractures with brachialis muscle entrapment. J Orthop Trauma 1995;9(5):430-434.
9. Biyani A, Gupta SP, Sharma JC. Ipsilateral supracondylar fracture of homers and forearm bones in children. Injury 1989;20(4):203-207.
10. Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the homers in children. Sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am 1974;56(2):263-272.
11. Templeton PA, Graham HK. The ‘floating elbow’ in children. Simultaneous supracondylar fractures of the homers and of the forearm in the same upper limb. J Bone Joint Surg Br 1995;77(5):791-796.

How to Cite this Article: Borana C, Jagani N, Shah N, Sharoff L, Mukherjee S. Osteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age. International Journal of Paediatric Orthopaedics Jan-June 2017;3(1):6-8.

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Osteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 2-5 | Pérez-Ortiz Sergio, Blas-Dobón JA, Peralta-Nieto J, Gómez-Barbero P

Authors : Pérez-Ortiz Sergio [1], Blas-Dobón JA [1], Peralta-Nieto J [1], Gómez-Barbero P [1].

[1] Hospital Universitario Doctor Peset, Valencia, Spain

Address of Correspondence
Dr. Sergio Perez Ortiz

Hospital Universitario Doctor Peset, Valencia, Spain.

Email: serperort@gmail.com

Abstract

Background: The common peroneal nerve (CPN) or external popliteal nerve is the most frequently involved nerve in entrapment syndromes in the lower extremities. Its proximity to the head of the fibula makes it particularly susceptible to damage by different injury mechanisms. Osteochondromas arising from the proximal fibula are a rare cause of common peroneal nerve injury.
Methods: We report a case of a 13-year-old Caucasian male patient referred to our hospital with drop foot and palpable mass in the head of the right fibula. Physical examination revealed a severe paresis, grade 2 objectified by the scale of the Medical Research Council (MRC) in the extensor hallucislongus, extensor digitorumlongus and tibialis anterior muscles and hypoesthesia in the dorsal surface of foot and portions of the anterior, lower-lateral leg. In magnetic resonance imaging (MRI) a tumor in the head of the fibula compressing the CPN is observed. Electromyographic studies confirmed the presence of severe partial axonotmesis of the right peroneal nerve.
The patient underwent surgery for decompression of the peroneal nerve and resection of the proximal fibula osteocartilaginousexostosis. The histopathological analysis confirmed the diagnosis of osteochondroma.
Results: At the 12-month postoperative follow-up the patient recovered sensitivity and presented, according to the MRC scale, muscle strength of 4 out of 5 in thepreviouslynamed muscles, being able to walk without orthotic devices. In the electromyography, subacuteaxonotmesis with important signs of active reinnervation observed
Conclusions : Osteochondroma in the head of the fibula is a rare cause of CPN injury, that can go easily unnoticed and has to be considered in the differential diagnosis of the drop foot in pediatric ages. Diagnosis and treatment should not be delayed to get a good neurological recovery because, otherwise, it could be irreversible.
Keywords: Drop foot, peroneal palsy, osteochondroma, tumor, nerve injury, surgery, nerve decompression, tumor of the fibula, pediatrics.

References

1. Çinar A, Yumrukçal F, Salduz A, Dirik Y, Eralp L. A rare cause of ‘drop foot’ in the pediatric age group: Proximal fibular osteochondroma a report of 5 cases. Int J Surg Case Rep 2014;5(12):1068-1071.
2. Dowson D. Entrapment Neuropathies. 2nd ed. Boston: Boston 7 Little, Brown and Company; 1990.
3. Flores LP, Koerbel A, Tatagiba M. Personal nerve compression resulting from fibular head osteophyte-like lesions. SurgNeurol 2005;64(3):249-252.
4. Mumenthaler M, Schliack H. Peripheral Nerves Lesions – Diagnosis and Therapy. New York: Stuttgart 7 Thieme Medical; 1991.
5. Abdel MP, Papagelopoulos PJ, Morrey ME, Wenger DE, Rose PS, Sim FH. Surgical management of 121 benign proximal fibula tumors. ClinOrthopRelat Res 2010;468(11):3056-3062.
6. Unni K. Dahlin’s Bone Tumors: General Aspects and Data on 11,087 Cases. Philadelphia, PA: Lippincot – Raven Publishers; 1996.
7. Kumar M, Malgonde M, Jain P. Osteochondroma arising from the proximal fibula: A rare presentation. J ClinDiagn Res 2014;8(4):LD01-LD03.
8. Flanigan RM, DiGiovanni BF. Peripheral nerve entrapments of the lower leg, ankle, and foot. Foot Ankle Clin 2011;16(2):255-274.
9. Paternostro-Sluga T, Grim-Stieger M, Posch M, Schuhfried O, Vacariu G, Mittermaier C, et al. Reliability and validity of the Medical Research Council (MRC) scale and a modified scale for testing muscle strength in patients with radial palsy. J Rehabil Med 2008;40(8):665-671.
10. Yildiz C, Erler K, Atesalp AS, Basbozkurt M. Benign bone tumors in children. CurrOpinPediatr 2003;15(1):58-67.
11. Springfield DS, Gebhardt MC. Bone and soft tissue tumors. In: Morrissy RT, Weisnstein SL, editors. Lowell and Winter’s Pediatric Orthopedics. Philadelphia, PA: Lippincott Williams and Wilkins; 2001. p. 507-561.
12. Saglik Y, Altay M, Unal VS, Basarir K, Yildiz Y. Manifestations and management of osteochondromas: A retrospective analysis of 382 patients. ActaOrthopBelg 2006;72(6):748-755.
13. Bovée JV. Multiple osteochondromas. Orphanet J Rare Dis 2008;3(1):1-7.
14. Biermann JS. Common benign lesions of bone in children and adolescents. J PediatrOrthop 2002;22(2):268-273.
15. Kushner BH, Roberts SS, Friedman DN, Kuk D, Ostrovnaya I, Modak S, et al.Osteochondroma in long-term survivors of high-risk neuroblastoma. Cancer 2015;121(12):2090-2096.
16. Marcovici PA, Berdon WE, Liebling MS. Osteochondromas and growth retardation secondary to externally or internally administered radiation in childhood. PediatrRadiol 2007;37(3):301-304.
17. Unger EC, Gilula LA, Kyriakos M. Case report 430: Ischemic necrosis of osteochondroma of tibia. Skeletal Radiol 1987;16(5):416-421.
18. Khosla A, Parry RL. Costalosteochondroma causing pneumothorax in an adolescent: A case report and review of the literature. J PediatrSurg 2010;45(11):2250-2253.
19. Ferriter P, Hirschy J, Kesseler H, Scott WN. Popliteal pseudo aneurysm. A case report. J Bone Joint Surg Am 1983;65(5):695-697.
20. Van den Bergh FR, Vanhoenacker FM, De Smet E, Huysse W, Verstraete KL. Peroneal nerve: Normal anatomy and pathologic findings on routine MRI of the knee. Insights Imaging 2013;4(3):287-299.
21. Paprottka FJ, Machens HG, Lohmeyer JA. Partially irreversible paresis of the deep personal nerve caused by osteocartilaginous exocytosis of the fibula without affecting the tibia is anterior muscle. J PlastReconstrAesthetSurg 2012;65(8):e223-e225.
22. Bunch K, Hope E. An uncommon case of bilateral personal nerve palsy following delivery: A case report and review of the literature. Case Rep ObstetGynecol2014;2014:746480.
23. Mnif H, Koubaa M, Zrig M, Zammel N, Abid A. Personal nerve palsy resulting from fibular head osteochondroma. Orthopedics 2009;32(7):528.
24. Baima J, Krivickas L. Evaluation and treatment of personal neuropathy. Curr Rev Musculoskelet Med 2008;1(2):147-153.
25. Sunderland S, Bradley KC. The cross-sectional area of peripheral nerve trunks devoted to nerve fibers. Brain 1949;72(3):428-449.
26. Cardelia JM, Dormans JP, Drummond DS, Davidson RS, Duhaime C, Sutton L. Proximal fibular osteochondroma with associated personal nerve palsy: A review of six cases. J PediatrOrthop 1995;15(5):574-577.
27. Paik NJ, Han TR, Lim SJ. Multiple peripheral nerve compressions related to malignantly transform hereditary multiple exocytosis. Muscle Nerve 2000;23(8):1290-1294.
28. Bernard SA, Murphey MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology 2010;255(3):857-865.
29. Ozden R, Uruc V, Kalaci A, Dogramaci Y. Compression of common personal nerve caused by an extra neural ganglion cyst mimicking intermittent claudication. J Brachial PlexPeripher Nerve Inj 2013;8(1):5.
30. Pedrini E, Jennes I, Tremosini M, Milanesi A, Mordenti M, Parra A, et al. Genotype-phenotype correlation study in 529 patients with multiple hereditary exocytosis: Identification of “protective” and “risk” factors. J Bone Joint Surg Am 2011;93(24):2294-2302.
31. Chin KR, Kharrazi FD, Miller BS, Mankin HJ, Gebhardt MC. Osteochondromas of the distal aspect of the tibia or fibula. Natural history and treatment. J Bone Joint Surg Am 2000;82(9):1269-1278.
32. Pigott TJ, Jefferson D. Idiopathic common personal nerve palsy – A review of thirteen cases. Br J Neurosurg 1991;5(1):7-11.

How to Cite this Article: Sergio PO, Blas-Dobón JA, Peralta-Nieto J, Gómez-Barbero POsteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age. International Journal of Paediatric Orthopaedics Jan-June 2017;3(1):20-23.

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Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5].

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

Authors : Pérez-Ortiz Sergio [1], Blas-Dobón JA [1], Peralta-Nieto J [1], Gómez-Barbero P [1].

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

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