Bony prominence pain caused by elevated wheelchair seating pressures.
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Exostoses↗
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Heel spur syndrome: a retrospective report on the percutaneous plantar transverse incisional approach.
The purpose of this retrospective study was to investigate patient satisfaction and pain relief of chronic heel spur syndrome via a percutaneous plantar transverse incisional surgical approach. Forty-five patients underwent the procedure between June 1995 and August 1997; 29 responded to a questionnaire. Of the 29 respondents, a 96% success rate was obtained (the procedure met or exceeded patient expectations) at an average of 21 months postoperatively. Based on a 10-point visual analog scale, pain improved from an average of 8.4 +/- 0.3 preoperatively to 1.2 +/- 0.3 at the time of the survey. The surgical technique is also described.
Adult↗
Tibial osteochondroma causing foot pain mimicking tarsal tunnel syndrome: a case report.
Nerve entrapment syndromes of the lower extremity are relatively rare in patients with multiple hereditary osteochondromatosis. A case of tarsal tunnel like symptoms in a 52-year-old woman with a distal tibial osteochondroma is presented. This case emphasizes that the possibility of nerve compression needs to be considered in a patient with multiple hereditary osteochondromatosis and that tibial osteochondromas can be a cause of tarsal tunnel-like symptoms.
Bone Neoplasms↗
Kienböck's disease and multiple hereditary osteochondromata: a case report.
A case of bilateral forearm localization of multiple hereditary osteochondromata and unilateral Kienböck's disease is reported. Ulnar minus variance is frequent in both diseases. Carpal slip is often found in multiple hereditary osteochondromata. In this case, the extremity having both multiple hereditary osteochondromata and Kienböck's disease had no carpal slip. This might have produced an excess load on the lunate, which might have provoked Kienböck's disease.
Adult↗
Pseudomallet finger associated with exostosis of the phalanx: a report of 2 cases.
An exostosis around the distal interphalangeal joint can cause finger deformity that resembles mallet finger. We report 2 cases of pseudomallet finger associated with exostosis, both of which were successfully treated with bone resection.
Child, Preschool↗
Dislocation of the mandibular condyle into the middle cranial fossa: report of a case with 5 year CT follow-up.
A 17-year-old patient suffered a dislocation of the right mandibular condyle into the middle cranial fossa following a motorcycle accident. Reduction was delayed because of serious orthopaedic injuries. The condyle was relocated into the glenoid fossa through a combined neurosurgical and preauricular approach. Five years later the patient presented for removal of wisdom teeth and a CT-scan was done to determine the effects of the trauma and management to the condyle. A fibro-osseous ankylosis had occurred in the right temporomandibular joint. The radiological changes confirm that early management appears to improve the prognosis for these injuries.
Adolescent↗
Histological changes in the rabbit condyle following posterolateral disk perforation.
PURPOSE: To examine changes in condylar cartilage following perforation in the posterolateral region of the articular disk of the craniomandibular joint of a rabbit. MATERIAL AND METHODS: The circular perforation in the left joint of 25 female Japanese white rabbits measured precisely one-sixteenth of a disk. Histological examination, including the immunohistochemical proliferating cell nuclear antigen (PCNA) procedure, was performed on separate sets of five rabbits each 2, 4, 8, 12, and 24 weeks postoperatively. RESULTS: Microscopic examination revealed hypertrophy of the condylar cartilage with osteophyte formation up to 8 weeks after perforation. Proliferative activity then decreased near the condylar surface as the perforation flattened. Twenty-four weeks postoperatively, the condylar surface was found to be fibrous and flattened. Positive PCNA results in cartilage cells indicated proliferation following disk perforation which peaked in the 4th week and then decreased. CONCLUSION: Disk perforation was followed initially by hypertrophy of condylar cartilage, and later by degeneration of the condylar surface. Although osteoarthritic cartilage was found 24 weeks after perforation, degeneration decreased over time. This suggests that remodelling took place after the perforation.
Animals↗
[Sterno-costo-clavicular hyperostosis (author's transl)].
A case is described in which bilateral subclavian vein occlusion was caused by fusiform expansion of the clavicle with hyperostosis, ankylosis of the sterno-clavicular joint, widening and thickening of the sternum and ossification of the costal cartilage of the first ribs. Histologically this proved to be due to an hyperostotic spongiosclerosis.
Ankylosis↗
[Paraglenoid hyerostosis: shoulder arthrosis or occupational?].
Amongst 300 examinations of the shoulder in miners working with compressed air, degenerative changes were found in 44. Particularly striking was the frequency of acromioclavicular arthrosis and of paraglenoid hyperostosis. Five patients with paraglenoid hyperstosis were re-examined several years later. The authors regard these changes as a sign of shoulder arthrosis, analgous with hyperostosis of the head of the radius or of a rib and with labrum ossification of the hip joint.
Exostoses↗
[Active and passive vascular involvement in tumours and tumour-like processes in the extremities (author's transl)].
Angiography for tumours of the extremities may demonstrate active or passive involvement of vessels by the tumour. This technique has been used for a considerable time for the diagnosis and differentiation of bone tumours. Angiography is particularly suitable for distinguishing between benign and malignant tumours of soft tissues. Non-neoplastic space-occupying lesions which can be elucidated by angiography include aneurysms, haematomas, inflammatory processes and abscesses.
Angiography↗
[Spinal cord compression by a cervical oseteocartilaginous exostosis: surgical strategy aspects].
AIM: The authors present the therapeutic management of a 12-year-old boy with known hereditary multiple exostosis syndrome (HME), who developed spinal cord compression symptoms caused by an exostosis of the C2 lamina. A perinatal brain lesion with tetraparesis delayed the recognition of the spinal cord compression substantially, which resulted in an extensive spur-like growth of the exostosis. METHOD: In comparison with already published cases, this growth pattern was rather unique and required consideration on the best surgical management. We decided to monitor the spinal cord function from positioning of the patient to skin closure and to modify the surgical steps of the laminectomy with initial lateral cutting of both hemilaminae. RESULTS: Electrophysiological monitoring helped to avoid spinal cord compression by inadequate head anteflexion during positioning. Lateral cutting of the hemilaminae C2 resulted in spontaneous extrusion of the exostosis with immediate improvement of the electrophysiological findings. The boy experienced a prompt improvement of his neurological deficits. CONCLUSION: The good surgical and clinical result confirm the value of the applied management concept.
Cervical Vertebrae↗
[Correction of forearm deformities in children with multiple cartilaginous osteochondromas].
AIM: Deformity of the forearm with shortening and bowing is common in children with multiple cartilaginous osteochondromas. The objective of this study was to evaluate the benefit of ulnar lengthening using an external fixateur in these patients. METHOD: 9 patients (10 cases) underwent surgery of the forearm between 1995 and 2001 and were evaluated using a standard protocol. The mean follow-up was 33.6 months, the mean age at operation 8.9 years. All patients were treated with ulnar lengthening, in 6 cases combined with an excision of the osteochondromas. RESULTS: Four out of ten patients did show an improvement in postoperative forearm rotation, two deteriorated and 4 presented unchanged. Wrist motion improved in 7 patients and remained unchanged in 3. The postoperative radial articular angle showed an improvement in 6, the carpal slip in 9 of the patients. The preoperative radial head dislocation in one patient remained unchanged postoperatively. CONCLUSION: The authors advocate this therapeutic concept for the correction of forearm deformity in multiple hereditary osteochondromas to prevent a progression of the deformity and to establish carpal stability. A significant improvement of forearm and wrist function could not be reached.
Bone Lengthening↗
[Exostosis of the internal auditory canal in a patient with myotonic dystrophy].
A 53-year-old patient with myotonic dystrophy presented to our clinic with progressive bilateral hearing loss. The ENT status and particularly the otological examination were without pathological signs. Pure tone audiograms showed a bilateral moderate to severe sensorineural hearing loss. Routinely performed computed tomography of the temporal bones revealed the rare picture of exostosis of the internal auditory canals and the medial surface of the petrous bones. To our knowledge, this is the first report describing exostosis of the internal auditory canal in a patient with myotonic dystrophy, although at present it remains unclear in how far there is a causal connection between these two pathologies.
Audiometry, Pure-Tone↗
[Cystic angiomatosis: magnetic resonance imaging].
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Adolescent↗
[The incidence, age dependence and sex distribution of the calcaneal spur. An analysis of its x-ray morphology in 1027 patients of the central European population].
In 1027 lateral radiograms of the ankle in a Caucasian population, 161 plantar and/or dorsal calcaneal spurs (15.7%) were diagnosed. Plantar spurs were more common than dorsal spurs (11.2 and 9.3% respectively). Prevalence of both spurs increases considerably with the rising age. Dorsal spurs appear slightly earlier than plantar spurs. The spur frequencies are similar in left and right feet. The plantar spurs were significantly (p < 0.0001) more common in women than in men in general, while dorsal spurs were more frequent in men than in women up to the age of 70. The previously reported higher frequencies of plantar and dorsal calcaneal spurs in women than in men are probably a result of a disproportionally higher number of women in higher age in the groups studied. In forensic medicine, calcaneal spurs provide evidence for identity and age of unknown corpses, and to certain extend their profession, physical activities and constitution during life.
Adolescent↗
[The MRT of osteophytosis in experimental gonarthrosis].
PURPOSE: The value of MRI for the detection of knee osteophytosis was determined in an animal osteoarthritis model. METHODS: 10 dogs with experimentally induced unilateral osteoarthritis of the knee were investigated with MRI including 2-D-spin echo (SE) and 3-D-gradient echo (GE) imaging. The results were correlated with gross and histopathologic findings and with radiography. RESULTS: Osteophyte formation appeared early in the osteoarthritic process. Pathological analysis yielded 65 osteophytes. With 3-D-GE imaging, 91% of the osteophytes were detected, while 68% were visible on 2-D-SE images. With two-level radiography, 43% of the osteophytes were diagnosed. Additional use of tunnel view and conventional tomography increased the detection rate to 65%. Independent of the imaging technique, MRI revealed three different signal patterns of the osteophyte bone structure. Compared with the histologically evident fat marrow content and the grade of bone sclerosis, best agreement was achieved with 2-D-SE sequences. However, a discrepancy remained in 22%. A fibrocartilaginous layer at the osteophyte surface could be delineated especially on 3-D-GE images. CONCLUSIONS: MRI provides the highest standard in non-invasive diagnosis of osteophytes in the knee. 3-D-GE imaging in particular can demonstrate early and small osteophyte formation.
Animals↗
[Therapy-resistant heel pain--an indication for surgery in sports traumatology].
Posterior heel pain can be caused by inflammation or pathology of the achilles tendon, the tendon sheath, the retrocalcaneal and subcutaneous tendoachilles bursa, can be caused by osteophytes or stress fracture of the os calcis and by rheumatoid or metabolic diseases. The majority of patients can be treated successful nonoperatively; however, there is a small group of patients who are refractory to nonoperative managements. In the years 1984 to 422 patients with posterior heel pain were treated conservatively, 26 of these patients were refractory to that management. There were 9 cases of achilles tendinitis and/or tenosynovitis, 7 cases of bursitis, 3 cases of osteophyte of the os calcis. In 7 cases there was seen a combination of these three diseases. The following operative procedures were performed: discision of the tendon sheath, excision of thickened parts by inflammation, excision of degenerative and necrotic pain-producing areas in the achilles tendon, excision of bursa and ostectomy of osteophyte at the posterior-superior angle of the os calcis. The mean follow-up was 2.7 years (range, 1/2 to 5 years). Overall there were 79% good results. In our opinion cases of posterior heel pain refractory to non-operative treatment are an indication of sports surgery, especially in patients who like to continue sports without pain.
Achilles Tendon↗
[A functional disorder of the temporomandibular joint in a newborn infant--preoperative CT-3D diagnosis and postoperative documentation].
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Ankylosis↗