Avulsion fractures of the tibial tubercle in adolescent athletes are uncommon injuries, believed to be a result of forceful extension of the knee against a fixed leg. Concomitant injury to the ipsilateral patella tendon is even more rare, with few cases reported in the literature. The mechanisms responsible for this association are not well understood. The significance of this double insult to the knee extensor mechanism is the potential deleterious effect of misdiagnosis and/or mismanagement. In this case report, the pathophysiology, mechanism of injury, classification, diagnosis, and management of concomitant injury are reviewed. [Orthopedics. 2016; 39(3):e561-e564.].
Snapping scapula syndrome is a rare condition characterized by crepitus of the scapula on motion of the ipsilateral upper extremity. It may be quite painful and disabling. The majority of cases are due to bursal and muscular disorders. Snapping scapula syndrome secondary to an underlying osteochondroma is an even more infrequent phenomenon. The case presented highlights the unusual post pubertal growth of an osteochondroma of the scapula that progressed to develop a snapping scapular syndrome. Review of the literature revealed less than fifty reported cases of this phenomenon secondary to an underlying osteochondroma.
Well leg compartment syndrome refers to the occurrence of compartment syndrome in an uninjured limb in the absence of an underlying systemic predisposing cause. It is a rare phenomenon with devastating clinical consequences resulting from commonly utilized operative positions and requires a high index of suspicion for diagnoses. There are only a few reports in the literature and a lack of awareness of the condition. Identifying patients with at risk predisposition and increasing surveillance in these patients may allow for early detection and decrease the morbidity and potential mortality associated with well-leg compartment syndrome.
Dysplasia epiphysealis hemimelica, also known as Trevor's disease, is a rare developmental disorder with osteocartilagenous overgrowth of the epiphysis or epiphyseal equivalent. The condition bears similarities to osteochondroma in terms of its radiographic appearance, but differs in its pathobiology and geographic occurrence. Unlike the metaphyseal occurrence of osteochondromata, it arises from the epiphysis. The clinical presentation is wide and varied, but mechanical symptoms and deformities predominate. Early reports of the condition suggested involvement of the lower limbs only. However, since then, numerous reports have indicated a more generalized distribution. Difficulties in management and recurrence rates seem to hinge on whether its origin is intra-articular or extra-articular. A new classification system to include these parameters is discussed. [Orthopedics.2016; 39(5):e967-e969.].
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