Asian Journal of Orthopaedic Research

Chondroma of the Distal Phalanx of the Fingers: Clinical and Therapeutic Features: About 3 Cases

Sbai Mohamed Ali — 2020-07-22

Introduction: Chondromas are benign bone tumors that develop at the expense of the cartilage of skeletal tissue. The localization of chondromas in the hand is very frequent and represents 50 to 90% of cases. The localization in the distal phalanx is very rare. Clinically, it can be misleading and evoke digital hippocratism, which can make us think about several general diseases. Their diagnosis must imperatively be based on the comparison of clinical, radiological and histopathological data. The chondroma can be recurrent and can rarely degenerate into malignant lesions.

Methods: We are sharing 3 cases of chondroma of the distal phalanx of the hand of patients who consulted in Taher El Maamouri hospital of Nabeul during these late 10 years.

Results: The analysis of the 3 cases showed the almost constant presence of pain and deformity of the nail which looks like digital hippocratism.

X-rays showed osteolytic lesions in the 3 cases. 1 case was about the thumb, 2 were about the index.

The diagnosis is evoked depending on clinical data and X-rays. The confirmation was made by the histopathological study. Surgical excision associated with a bone graft allowed us to have good results, without recurrence at the last follow-up. We have not seen any cases of malignant degeneration.

Conclusion: At the end of this study, it was concluded that the request for a systematic X-ray in front of every distal deformation of the fingers is necessary. The clinical and radiological data, the surgical biopsy excision with histopathological confirmation, represents the best attitude for the management of bone chondromas in the hand. Post-operative monitoring can detect a recurrence that depends on the quality of the surgical excision. Malignant degeneration is rare for solitary chondromas.

Short Term Outcome of Ponseti Treatment Method for Clubfoot at a Referral Orthopedic Centre in Rwanda

Jean Paul Ngirinshuti — 2020-07-28

Aims: The aim of this study was to assess the short term outcome of the Ponseti Method among children with clubfoot treated at Gatagara orthopedic and rehabilitation hospital from July 2017 To March 2019.

Study Design: This was a Retrospective analysis.

Place and Duration of Study: The study was conducted at Gatagara Orthopedic and Rehabilitation Hospital in Rwanda (GORH) from July 2017 To March 2019.

Methodology: All information needed were collected using a questionnaire. Part of information was extracted from patients’ files while the remaining was directly obtained from the parents/guardians. Data were analyzed using SPSS version 20. Descriptive analysis was done. Informed consent was obtained from the parents or care givers before being included in the study.

Results: Fifty five children (91 feet) were involved in the study. Good short term outcome of Ponseti method was observed in 72.5% of cases. The mean initial Pirani score on Right foot decreased from 4.7(SD 1.14) to 0.6(SD 0.94) at the time of consultation. On the left foot the initial Pirani score mean decreased from 4.6 (SD 1.17) to 0.8(SD 1.2). The difference in both means was statistically significant (P ˂.001). Full time adherence on SFAB was reported in 43(78.2%) patients. Main challenges faced were late presentation for treatment, poor compliance with the treatment regime and financial constraints.

Conclusion: The difference between pre-treatment and post-treatment Pirani score means showed a statistically significant improvement (P˂.001). The success of the treatment in this study was estimated at 72.5% and the poor outcome was 27.5%. Main challenges faced at GORH were financial constraints, poor compliance with clinic appointment and the use of brace.