Journal of Bone and Joint Surgery - British Volume Case Report

[Case Report] Non-operative management of femoral neuropathy secondary to a traumatic iliacus haematoma in an adolescent

Patel, A., Calfee, R., Thakur, N., Eberson, C. — 2008-09-30

Iliacus haematoma is a relatively rare condition, which may cause a local compressive neuropathy. It is usually diagnosed in adults with haemophilia or those on anticoagulation treatment and may occur after trauma. We present the case of a healthy 15-year-old boy with a femoral neuropathy due to an iliacus haematoma which resolved following conservative treatment.

[Case Report] Open medial dislocation of the ankle without fracture

Tarantino, U., Cannata, G., Gasbarra, E., Bondi, L., Celi, M., Iundusi, R. — 2008-09-30

A 20-year-old man sustained an open medial dislocation of the ankle without an associated fracture after a low-energy inversion injury. Prompt debridement and reduction with primary wound closure of the skin were performed without suture of the capsule. Immobilisation in a non-weight-bearing cast for 30 days followed by ankle bracing for two weeks and subsequent physiotherapy, produced full functional recovery by three months. At follow-up at one year there was a full range of pain-free movement, although the radiographs and MR scan showed early post-traumatic degenerative change at the medial aspect of the tibiotalar and the calcaneocuboid joints.

[Case Report] Sural nerve grafting for long defects of the femoral nerve after resection of a retroperitoneal tumour

Tsuchihara, T., Nemoto, K., Arino, H., Amako, M., Murakami, H., Yoshizumi, Y. — 2008-07-31

Most injuries to the femoral nerve are iatrogenic in origin and occur during resection of large retroperitoneal tumours. When the defect is considerable a nerve graft is mandatory to avoid tension across the suture line. We describe two cases of iatrogenic femoral nerve injury which recovered well after reconstruction with long sural nerve grafts.

The probable reasons for success were that we performed the grafting soon after the injury, the patients were not too old, the nerve repairs were reinforced with fibrin glue and electrical stimulation of the quadriceps was administered to prevent muscle atrophy. Good functional results may be obtained if these conditions are satisfied even if the length of a nerve graft is more than 10 cm.

[Case Report] Osteonecrosis of the femoral head following an electrical injury to the leg

Vanderstraeten, L., Binns, M. — 2008-07-31

We report a case of osteonecrosis of the femoral head in a young man who is a carrier of the prothrombin gene mutation. We suggest that an electrical injury to his lower limb may have triggered intravascular thrombosis as a result of this mutation with subsequent osteonecrosis of the femoral head. No case of osteonecrosis of the femoral head secondary to a distant electrical injury has previously been reported.

[Case Report] Dysplasia epiphysealis hemimelica with involvement of the hip and spine in a young girl

Haddad, F., Chemali, R., Maalouf, G. — 2008-06-30

Dysplasia epiphysealis hemimelica of the left proximal femur was diagnosed in an eight-month-old girl. At the age of 18 months, radiographs of the hip and MRI showed overgrowth and loss of containment of the femoral head. She underwent resection of the superior portion of the head and neck of the femur at the age of 2.5 years. Six months later further radiographs and an MR scan show that the mass has increased in size and that hip containment has been lost. Further plain radiographs have shown that the left knee, ankle and spine were involved.

To the authors’ knowledge, this is the first report of dysplasia epiphysealis hemimelica involving both the lower limb and the spine. A review of the literature is presented.