Open Access Case Study

Recurrent Giant Cell Tumor of Tendon Sheath: A Case Report

Goh Teik Chiang, Nan Nitra Than, Htoo Htoo Kyaw Soe, Mohamad Fauzlie Bin Yusof, Fabian Chong Tien Fook

Asian Journal of Orthopaedic Research, Page 1-5

Giant cell tumor of tendon sheath (GCTTS) is a benign tumor, yet its recurrence appears to be a concern of many surgeons. GCTTS is commonly seen in the hand, and it presents as a slow-growing, painless mass. The best treatment of GCTTS and its recurrence remains controversial. However, it is recommended to perform tissue diagnosis via fine needle aspiration cytology (FNAC) for preoperative planning, then a complete excision under magnification to reduce the recurrence rate of GCTTS. This article illustrates the management of a case of recurrent GCTTS of the flexor digitorum profundus of the right hand by complete excision.


Open Access Case Study

Infantile Haemangioma of Left Second Toe: A Case Report

Goh Teik Chiang, Mohamad Fauzlie Bin Yusof, Sivapathasundaram A. L. Nadarajah, Mohamed Ashraff Bin Mohd Ariff

Asian Journal of Orthopaedic Research, Page 1-5

Infantile haemangiomas represent the most common type of benign tumours of infancy, with a prevalence of 1-10% worldwide. Even though the disorder is mostly harmless, however, the option of treatment is primarily depending on the progression of this tumour. Some studies reported the disorder in many siblings of the same family, with non-affected parents, pointing out a possible genetic immixture. We represent a case of a one month-old boy, suffering with a huge painless swelling of the left second toe. X-ray examination showed no bony lesion.  Distal interphalangeal joint amputation of left second toe was also performed. The histopathology test result showed pictures constant as haemangioma. To the best of our knowledge, this case is a first report of infantile haemangioma of the toe mimicking vascular haemangioma.

Open Access Case Study

A Case Reports of Intra-Articular Steroid Injection in the Treatment of Bertolotti’s Syndrome

Goh Teik Chiang, Mohd Shahir Bin Anuar, Kamalnizat Bin Ibrahim, Azmi Bin Baharudin, Mohd Hisam Bin Mohd Ariffin

Asian Journal of Orthopaedic Research, Page 1-6

Bertolotti’s Syndrome (BS) is defined as an association between low back pain (LBP) and the congenital malformation of the lumbosacral transitional vertebra (LSTV). There are several treatments have been proposed by literature including steroid injections, resections of the LSTV, laminectomy, and lumbar spinal fusion, however, there is no best treatment has been agreed. Researchers present three case reports diagnosed as BS in Malaysia age from 25 to 30 years with chronic low back pain extending to the gluteal region and just above the ipsilateral sacroiliac joint. Radiographic investigation of these three patients revealed an anomalous enlargement of the left, right and bilateral transverse process of the fifth lumbar (L5) vertebra forming a pseudoarthrosis with the infra adjacent ala of the sacrum. These cases were managed successfully with fluoroscopically guided intra-articular steroid injection with local anaesthetic over the transverse process with ilium articulation and asymptomatic for 6 months on follow up. This case report denoted that a simple non-surgical management for treating symptomatic lumbosacral junction pseudo-articulation that warrants a better mode of management.

Open Access Original Research Article

Primary Bone Tumours at a Tertiary Health Centre in North Central Nigeria: A Ten Year Retrospective Review

A. M. Dauda, P. O. Akpa, K. V. Barka, E. Innocent, A. J. Ochigbo, B. M. Mandong

Asian Journal of Orthopaedic Research, Page 1-8

Aims: This study is aimed at documenting the histopathological pattern of primary bone tumours in a tertiary health care centre in North Central Nigeria. These tumours are classified based on their biological nature and histological types. The gender distribution, age distribution and anatomical site of occurrence were also documented.

Study Design: This is a hospital-based retrospective and descriptive study.

Place and Duration of Study: Department of Histopathology, Jos University Teaching Hospital, Jos, Plateau State in North-Central Nigeria between 1st January 2006 to 31st December 2015.

Materials and Methods: We reviewed all histopathologically diagnosed primary bone tumours diagnosed at the Department of histopathology Jos University Teaching Hospital from 1st January 2006 to 31st December 2015. Corresponding patient demographic data such as age, sex and anatomical site involved were obtained from case files, surgical pathology records and the cancer registry. Archived slides and re-cut slides from tissue blocks were reviewed.

Results: A hundred and twenty-eight cases were included in the study, amounting to approximately 13 cases per year. Benign tumours accounted for 64.8% of cases while 35.2% were malignant. The commonest benign bone tumours diagnosed are Osteochondroma (27.7% of benign lesions) and Fibrous dysplasia (25% of benign lesions). Osteosarcoma was the commonest malignant bone lesion accounting for 55.5% of the malignant lesions. The second decade was the peak period of occurrence of both benign and malignant bone tumours. There was an overall male predominance and the commonest bones affected were the tibia, femur and craniofacial bones.

Conclusion: Primary bone tumours demonstrated a tendency to occur more commonly in young patients with the male gender more frequently affected. The long bones of the lower limb and craniofacial bones were commonly involved.


Open Access Original Research Article

Clinical Impact of Posterior Malleolus Fixation in Trimalleolar Ankle Fracture – A Retrospective Study

Rushi Solanki, Nadeem Lil, Harshil Kansara, Sanjeev Asati, Shashank Ranka

Asian Journal of Orthopaedic Research, Page 1-7

Aims and Objectives: The aim of our study is to evaluate the clinical, functional and radiological outcomes of the patients with the trimalleolar fracture that had posterior malleolus fixation.

Study Design: Level 4, retrospective study.

Place and Duration of the Study: Dept. of Orthopaedics, Smt. NHL Medical College, Ahmedabad, Gujarat, India.  Between Jan 2014 to Dec 2017.

Materials and Methods: A retrospective study was performed on 30 adult patients who sustained a trimalleolar ankle fracture in our hospital. Patients were selected according to  inclusion and exclusion criteria and posterior malleolus was fixed using different modalities in those patients having joint incongruency or instability even after fixation of lateral malleolus fracture. Clinical, radiological and functional outcomes were evaluated using Olerud and Molander score of ankle fractures.

Results: Total 30 patients with a mean age of 48.03 years and mean follow-up of 16 months were operated for trimalleolar fracture. Posterior malleolus fixation was done with buttress plate in 8 patients and with cannulated cancellous screw in 22 patients. Out of 30 patients, according to Olerud and Molander score 14 patients showed an excellent result, 10 patients showed good results, 4 patients fair results and 2 patients showed poor results.

Conclusions: The anatomic reduction of the posterior malleolus is essential for maintaining the tibiotalar alignment and joint congruency, that is achieved by stable fixation of the posterior malleolus fragment regardless of size to improve post-operative function and quality of life.