[Toddler's fracture, case report and review of literature]

INTRODUCTION

The suspected diagnosis of a Toddler's fracture can often be complicated by an unclear history, the lack of specific clinical findings and the absence of obvious changes in the initial radiographs. We present the case of an infant of 3 years and 7 months old with a history of falling from her own height with a rotation mechanism of the left pelvic limb. The purpose of this paper is to describe the etiopathology, diagnosis and therapeutic management of these fractures.

DISCUSSION

The clinical history, physical examination and the use of imaging studies help identify Toddler's fractures, pathology that must be known to medical specialists for an ideal treatment.

[Radiologic correlation between the lateral pillar classification stages and the presence of femoroacetabular impingement in patients with Legg-Calvé-Perthes disease]

BACKGROUND

Lateral pillar classification has proven to be useful for the prognosis and treatment of patients with Legg-Calvé-Perthes disease. Most patients progress to skeletal maturity with some kind of morphologic alteration. Femoroacetabular impingement is a condition that results in early osteoarthrosis. The objective of this study was to determine whether there is a correlation between the initial lateral pillar classification and the presence of final femoroacetabular impingement.

MATERIAL AND METHODS

A retrospective review of 61 patients with Legg-Calvé-Perthes disease was conducted (68 hips); they were classified into three groups according to the lateral pillar classification. At the time of skeletal maturity the radiographic presence of femoroacetabular impingement was determined and the correlation between both variables was analyzed.

RESULTS

The use of the lateral pillar classification resulted in seven hips considered as type A, 37 as type B, and 24 as type C. Three of the type A hips had radiographic findings of cam femoroacetabular impingement, three of pincer femoroacetabular impingement, and one of mixed femoroacetabular impingement. Among type B hips, radiographic data of cam femorocetabular impingement were found in17, of pincer femoroacetabular impingement in 12, and of mixed femoroacetabular impingement in 10. Twenty-three of the type C hips had radiographic data of cam femoroacetabular impingement, 15 of pincer femoroacetabular impingement, and 15 of mixed femoroacetabular impingement.

CONCLUSION

Patients with Legg-Calvé-Perthes disease have a directly proportional relationship between the initial lateral pillar classification and subsequent femoroacetabular impingement.

[Synovial sarcoma in a patient with metal-on-polyethylene total hip replacement. A case report]

We present the case of a synovial sarcoma five years after primary total hip arthroplasty in a male 65 year-old patient who was surgically treated for left hip pain due to coxarthrosis. A 32 mm uncemented prosthesis with metal-on-polyethylene tribology was placed in the patient. The latter developed synovial sarcoma that caused lung metastasis. The association between total hip arthroplasty and malignancy is discussed, as well as its frequency worldwide.

Laparoscopic-assisted resection of a bleeding gastrointestinal stromal tumor

The authors report a case of a 29-year-old male patient with a severe lower gastrointestinal hemorrhage in whom a successful laparoscopic diagnosis and resection (assisted) of an ileal gastrointestinal stromal tumor (GIST) was performed. Laparoscopy can be very useful in the diagnosis and treatment of selected cases of lower gastrointestinal bleeding.