George D. Chloros

Outcome of partial medial epicondylectomy for cubital tunnel syndrome.

Partial medial epicondylectomy aims to eliminate potential drawbacks of total epicondylectomy for treatment of cubital tunnel syndrome. In this series, we retrospectively evaluated 80 patients (80 elbows) who had partial medial epicondylectomies for established cubital tunnel syndrome. Our main purpose was to compare clinical outcomes among partial, minimal, and total epicondylectomies. Specific attention was given to the functional outcome in severely impaired patients, and potential postoperative complications of total epicondylectomy, such as elbow instability, and medial elbow pain. Preoperatively, 16 patients were classified as having McGowan Grade I lesions, 40 had Grade II lesions, and 24 had Grade III lesions. The mean followup was 32 months (range, 26 months-4.2 years). There was improvement of at least one McGowan grade in 86.2% of the patients, with a 66.7% improvement in severely impaired patients (McGowan Grade III lesions). There was no ulnar nerve palsy, no ulnar nerve subluxation, or medial elbow instability. However, 45% of patients reported mild pain at the 6-month followup. Partial medial epicondylectomy seems to be safe and reliable for treatment of cubital compression neuropathy at the elbow.Level of Evidence: Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.

Spinal hydatid disease, a rare but existent pathological entity : Case report and review of the literature

Spinal hydatid disease is a not uncommon cause of spinal cord compression in endemic countries; however, involvement of the epidural space with sparing of the vertebral column is rare. Early diagnosis and surgical decompression with total removal of the hydatid lesion, when possible, is generally considered the standard of care for this disease. The authors describe a case of massive epidural hydatid disease without involvement of the vertebral column in a 62-year-old male patient, treated with a 2-stage surgical operation and administration of systemic albendazole. The literature is reviewed regarding the clinical features, diagnosis, treatment and prognosis of spinal echinococcosis.

Unusual presentation of osteoid osteoma of the scaphoid

The small carpal bones are infrequent sites for osteoid osteomas, and their clinical and imaging pictures may be quite confusing leading to suspect other etiologies. The authors present herein an unusual case of osteoid osteoma of the scaphoid superimposed on a wrist injury caused by a fall on the outstretched hand.

Malignant fibrous histiocytoma of bone associated with type-1 neurofibromatosis. A case report.

V on Recklinghausen disease, or neurofibromatosis, is a congenital and familial disorder with an autosomal dominant pattern of inheritance. The disease primarily affects ectodermal tissues arising from the neural crest. It is divided into two basic forms: peripheral (type 1) and central (type 2), characterized by distinct skeletal and soft-tissue manifestations1-6.nnType-1 neurofibromatosis usually manifests in early childhood and is more frequent than the type-2 form of the disease7,8. Skeletal abnormalities and dysplasias, including erosive or pressure bone defects, pseudarthroses, and cranial defects, are diagnosed in approximately 80% of patients with type-1 neurofibromatosis. In addition, multiple nonossifying fibromas that predominantly affect the metaphyseal parts of the long tubular bones tend to develop in patients with this type of the disease1.nnThe most serious, and often fatal, complication of the disease is a malignant peripheral nerve sheath tumor. Most cases are located within the soft tissue of the proximal part of an extremity, the buttocks, or the shoulder girdle. Skeletal involvement usually occurs as a result of secondary invasion by a soft-tissue lesion; a primary malignant peripheral nerve sheath tumor in bone is extremely rare9-12. These malignant tumors are highly aggressive, with a high propensity for distant metastases, especially to the lung, liver, and bones11-13.nnWe are aware of only one reported case of irradiation-induced malignant transformation of a neurofibromatous bone lesion of von Recklinghausen disease to malignant fibrous histiocytoma14. We describe the case of a young patient with type-1 neurofibromatosis in whom a malignant fibrous histiocytoma of bone was diagnosed at the site of fibrous bone lesions without previous irradiation. The patient was informed that data concerning the case would be submitted for publication.nnA thirty-eight-year-old man with von Recklinghausen …

Tendosynovial giant cell tumor of the patellar tendon sheath

A 55-year-old woman presented with a 1-month history of anterior pain of the right knee. Magnetic resonance imaging showed a well-defined soft tissue mass in the fat pad posteriorly to the patellar tendon. An excisional biopsy was performed. Histologic examination showed tendosynovial giant cell tumor of the patellar tendon sheath. At the latest follow-up, there was no local tumor recurrence.ResuméUne femme âgée de 55 ans s’est présentée avec une douleur antérieure du genou droit évoluant depuis un mois. L’imagerie par résonance magnétique a montré une masse à contours nets dans le ligament graisseux. Une excision biopsique a été effectuée. L’examen histologique a montré une tumeur géante tendinosynoviale de cellules de la gaine du tendon rotulien. Au dernier contrôle, il n’y avait aucune récidive.