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Verscaj CP, Smith C, Homeyer M, Matalon DR. Raine syndrome: Prenatally identified severe craniofacial phenotype with multisuture synostosis and brain abnormalities associated with variants in FAM20C. Prenat Diagn 2024; 44:369-372. [PMID: 38163266 DOI: 10.1002/pd.6506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/20/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
Raine syndrome (MIM 259775) is a rare autosomal recessive disorder, first described by Raine et al. in 1989, with an estimated prevalence of <1/1,000,000. This is due to pathogenic variants in FAM20C characterized by osteosclerosis, typical craniofacial features, and brain calcifications. Here, we report a novel variant in FAM20C, describe a uniquely severe craniofacial and CNS phenotype of Raine syndrome, and correlate it with prenatal findings. Fetal phenotyping was based on ultrasound and MRI. Solo exome sequencing was performed from DNA extracted from postmortem skin biopsy. Targeted parental variant testing was subsequently performed. A homozygous missense variant NM_020223.4 (c.1445 G > A (p.Gly482Glu)) was identified in FAM20C associated with Raine syndrome. The infant had the characteristic dysmorphic features seen in Raine syndrome. He had particularly significant CNS manifestations consisting of multisuture craniosynostosis with protrusion of the brain parenchyma through fontanelles and cranial lacunae. Histological sections of the brain showed marked periventricular gliosis with regions of infarction, hemorrhage, and cavitation with global periventricular leukomalacia. Numerous dystrophic calcifications were diffusely present. Here, we demonstrate the identification of a novel variant in FAM20C in an infant with the characteristic features seen in Raine syndrome. The patient expands the characteristic phenotype of Raine syndrome to include a uniquely severe CNS phenotype, first identified on prenatal imaging.
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Affiliation(s)
- Courtney P Verscaj
- Division of Newborn Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Carly Smith
- Perinatal Diagnostic Center, Stanford Children's Health, Stanford, California, USA
| | - Margaret Homeyer
- Perinatal Diagnostic Center, Stanford Children's Health, Stanford, California, USA
| | - Dena R Matalon
- Perinatal Diagnostic Center, Stanford Children's Health, Stanford, California, USA
- Department of Pediatrics, Division of Medical Genetics, Stanford University, Stanford, California, USA
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Polt M, Graf DA, Brunner S, Helmy N, Tondelli T, Karczewski D, Andronic O. Outcomes of surgical management for tarsal coalitions: a systematic review. Arch Orthop Trauma Surg 2023; 143:6993-7008. [PMID: 37462747 DOI: 10.1007/s00402-023-04982-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/02/2023] [Indexed: 11/11/2023]
Abstract
PURPOSE To analyze the outcome of surgical treatment of tarsal coalition, assess the role of the surgical technique, as well as of coalition size and type on outcomes. METHODS The search followed the Preferred Reporting Items of Systematic Review and Meta-Analysis and was performed in four databases: MEDLINE, Central, Scopus and Web of Science. The protocol has been registered in the international prospective register of systematic reviews. Patient-reported outcomes (PROMs), complications, revisions and radiographic recurrence were collected. Risk of bias was assessed using MINORS criteria. A random-effects model for meta-analysis was applied for analysis of data heterogeneity. RESULTS Twenty-five studies including 760 tarsal coalitions were included and had a weighted average follow-up of 44 months. Studies scored fair to poor on the risk of bias assessment with a mean MINORS score of 67% (44-81%). In 77.8% (37.5-100%) of surgically treated tarsal coalitions, good/excellent/non-limiting or improved PROMs were reported. Calculated data heterogeneity was moderate (I2 = 57%). Open bar resection with material interposition had a clinical success rate of 78.8% (50-100%). Complications occurred in 4.96% of cases. Coalition size did not prove to be a determining factor in postoperative outcome. The influence of the coalition type was not investigated by any of the studies. CONCLUSION Data on outcomes of surgical management for tarsal coalitions is limited to retrospective case series with high risk of bias and moderate data heterogeneity. In about ¾ of cases, open resection and interposition of material results in improved PROMs. The arbitrary margin of ≥ 50% of TC coalition size in relation to the posterior facet has little importance in surgical decision-making. None of the studies reported on the influence of the coalition type on postoperative clinical success.
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Affiliation(s)
- Maksym Polt
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland.
| | - David Alexander Graf
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Samuel Brunner
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Naeder Helmy
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Timo Tondelli
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Daniel Karczewski
- Department of Trauma and Orthopaedics, Charitè University Medicine Berlin, Center for Musculoskeletal Surgery, Charitéplatz 1, 10117, Berlin, Germany
| | - Octavian Andronic
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
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Wall E, Forsyth J, Kinning E, Marton T. Fetal hydrops caused by a novel pathogenic MECOM variant. Prenat Diagn 2023; 43:717-720. [PMID: 37160698 DOI: 10.1002/pd.6353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 05/11/2023]
Abstract
We report a fetus with hydrops, congenital heart disease and bilateral radioulnar synostosis caused by a novel pathogenic MECOM variant. The female fetus was referred for post-mortem examination after fetal hydrops and intrauterine death was diagnosed at 20 weeks gestation. Post-mortem examination confirmed fetal hydrops, pallor, truncus arteriosus and bilateral radioulnar synostosis. Trio whole genome sequencing analysis detected a novel de novo heterozygous pathogenic loss-of-function variant in MECOM (NM_004991), associated with a diagnosis of Radioulnar Synostosis with Amegakaryocytic Thrombocytopenia 2 (RUSAT-2). RUSAT-2 is a variable condition associated postnatally with bone marrow failure, radioulnar synostosis and congenital anomalies. RUSAT-2 is not currently associated with a prenatal phenotype or fetal demise, and was not present on diagnostic NHS prenatal gene panels at time of diagnosis. This case highlights the diagnostic value of detailed phenotyping with post-mortem examination, and of using a broad sequencing approach.
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Affiliation(s)
- Elizabeth Wall
- Department of Clinical Genetics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Joan Forsyth
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Esther Kinning
- Department of Clinical Genetics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Tamás Marton
- Histopathology Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
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Mavrommatis S, LaRoque MC, Cole PA. Resection of Posttraumatic Rib Synostoses Resolves Pulmonary Insufficiency: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00026. [PMID: 36099494 DOI: 10.2106/jbjs.cc.22.00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 30-year-old woman underwent open reduction and internal fixation for multiple segmental rib fractures status post a motor vehicle collision. A year later, the patient presented with extensive intercostal heterotopic ossification associated with multilevel, hemithoracic, rib synostoses compromising her ventilation. The patient subsequently underwent synostoses excision and hardware removal. Pulmonary function tests (PFT), imaging, and patient-reported outcome scores demonstrate resolution of impairment. CONCLUSION Resection of multilevel, intercostal, rib synostoses provided an effective treatment for pulmonary restrictive disorder secondary to traumatic rib synostosis. This is the first patient with documentation of prereconstructive and postreconstructive PFTs for chest wall synostosis excision.
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Affiliation(s)
- Sophia Mavrommatis
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota
- Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota
| | - Michael C LaRoque
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota
- Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota
| | - Peter A Cole
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota
- Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota
- HealthPartners Orthopaedics & Sports Medicine, Bloomington, Minnesota
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Abstract
Treatment of chronic Monteggia fracture-dislocations remains controversial in skeletally immature patients. The present study aimed to review the clinical outcomes of surgical treatment with an Ilizarov mini-fixator for chronic Monteggia fracture-dislocations in children. From April 2003 to March 2014, 5 pediatric patients (4 males, 1 female) with chronic Monteggia fracture-dislocation were treated with an Ilizarov mini-fixator at our institution. The median age at the time of surgery was 9 years (range 5-14 years), median duration from injury to surgery was 31 months (range 2-125 months), and median duration of follow-up was 12 months (range 11 months-10 years). All patients underwent opening wedge osteotomy of the proximal ulna followed by the application of an Ilizarov mini-fixator. Although closed reduction was attempted after ulnar osteotomy and application of the Ilizarov mini-fixator, open reduction of the radial head was required in all patients. In 4 patients, dense scar tissue in the radiocapitellar joint was excised to enable reduction of the radial head; the remaining patient had traumatic radioulnar synostosis, and underwent separation of the synostosis followed by anconeus interposition arthroplasty. No patient received bone grafting at the ulnar osteotomy site, repair or reconstruction of the annular ligament, or temporary fixation of the radial head with transarticular wire. The median period of external fixation was 10 weeks (range 8-13 weeks). Although there were no severe complications such as deep infection and neurovascular disturbance, asymptomatic radial head subluxation occurred in 2 patients. The patient with traumatic synostosis had residual posterior subluxation with limitation of forearm rotation, and another patient with radial head enlargement had residual anterior subluxation. The median postoperative ranges of motion in pronation, supination, extension, and flexion were 90°, 90°, 0°, and 140°, respectively. The median Kim's elbow performance score was 65 (range 50-75) preoperatively, which improved to 94 (range 80-100) at final follow-up. The outcome was rated as excellent in 4 cases, and good in 1. In pediatric chronic Monteggia fracture-dislocations, ulnar osteotomy followed by the application of an Ilizarov mini-fixator is a viable option that is less invasive than plate fixation.
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Abstract
CASE DESCRIPTION Over a 2-year period, 6 horses (4 Selle Français, 1 Hanoverian, and 1 Thoroughbred) were referred for evaluation of forelimb lameness. All horses had radiographic evidence of synostosis of the first and second ribs (SFSR). CLINICAL FINDINGS For 1 horse, the SFSR was considered the probable cause of the lameness (grade 3/5), with a shortening of the cranial phase of the stride in the affected limb. For 3 horses, it was considered a possible cause of the lameness (grade 1/5) for the same reason. For 2 horses, SFSR was considered an incidental finding unassociated with any clinical signs. The 4 horses with lameness suspected as attributable to SFSR had a moderate to severe amount of irregularly marginated new bone formation at the site of the SFSR, with a cranial displacement of the first rib, compared with findings for the 2 horses in which the SFSR was considered incidental. A likely congenital abnormality of the first rib was first suspected on nuclear scintigraphy in the 1 horse for which it was performed or on radiography of the caudal cervical portion of the vertebral column (3 horses) or shoulder joint (2 horses). TREATMENT AND OUTCOME The horse in which SFSR was considered the probable cause of the lameness was retired to the field and remained chronically lame. Two of the 3 horses in which SFSR was considered a possible cause of lameness received an IV infusion of tiludronate disodium and mesotherapy over the caudal cervical and cranial thoracic regions; both returned to competition but with poor results. One of the 2 horses with subclinical SFSR never developed lameness on the affected side. No follow-up information was available for the other 2 horses. CLINICAL RELEVANCE SFSR can be an incidental finding in horses, with or without clinical manifestations. This abnormality should be considered as a differential diagnosis for horses with forelimb lameness and associated shortening of the cranial phase of the stride that fails to improve with diagnostic analgesic techniques.
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Finkler ES, Light TR. Kienböck Disease in a Patient with Congenital Synostosis of the Lunate and the Triquetrum: A Case Report. JBJS Case Connect 2017; 7:e31. [PMID: 29244670 DOI: 10.2106/jbjs.cc.16.00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE We describe the case of a 40-year-old man with Minnaar type-III congenital synostosis of the lunate and the triquetrum who presented with Lichtman stage-I Kienböck disease. Surgical treatment consisted of capitate shortening with a capitate-hamate fusion. CONCLUSION This case demonstrates the tenuous regional nature of the vascularity to the lunate, even in the setting of a complete lunotriquetral synostosis.
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Affiliation(s)
- Elissa S Finkler
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, Illinois
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Abstract
The peroneal tubercle is an osseous structure on the lateral side of the calcaneus present in 90% of individuals. Hypertrophy of the peroneal tubercle resulting in stenosing peroneal tenosynovitis has been well described in the literature. Repair of this condition involves operative treatment to remove the hypertrophied peroneal tubercle and repair any resulting tendon pathology. The authors report a unique case of a hypertrophied peroneal tubercle with an associated tarsal coalition, resulting in complete bony encasement of the peroneal tendons. In this case, a 50-year-old white man presented with worsening bilateral foot and ankle pain for several years. On examination, he had fixed hindfoot varus and bilateral equinocavovarus feet. Magnetic resonance imaging and weight-bearing radiographs showed a calcaneonavicular coalition. Intraoperatively, the authors discovered complete bony encasement of the peroneal longus and brevis tendons. On examination, the peroneal longus and brevis were severely stenotic, with the peroneal brevis to the point of near laceration. This painful condition was repaired by takedown of the calcaneonavicular coalition, the peroneal tubercle was resected, and the peroneal tendons were freed from their bony encasement. Tenodesis of the peroneus brevis to longus was performed and the hindfoot varus was corrected with wedge osteotomy of the calcaneus. The patient reported excellent postoperative results. At 3 months postoperatively, he was pain-free and his calcaneal osteotomy was well healed. This case appears to be the first of its type to be reported in the literature. The details of the case are presented along with a review of the relevant literature.
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Shen WM, Wang G, Cui J, Chen JB. [Plagiocephaly resulted from frontosphenoidal synostosis and squamosal suture synostosis: a report of five cases]. Zhonghua Zheng Xing Wai Ke Za Zhi 2012; 28:407-410. [PMID: 23520773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate the diagnosis and mapagement of plagiocephaly resulted from For frontosphenoidal synostosis, frontosphenoidal synostosis and squamosal suture synostosis. METHODS orthotic nolding therapy should be selected for patients under 3-month-old. If it can' t make effect after treatment for 3 months, transcranial surgery should be adopted with the horizontal advancement of orbitofrontal bar at the affected side. Patients with squamosal suture synostosis should receive prohotic molding From 2005 to 2012, five patients were therapy for six month, remolding the cap every month. RESULTS treated with satisfactory result, including 3 patients with frontosphenoidal synostosis who received surgery and 2 patiens with squamosal suture synostosis who receive orthotic molding therapy only. CONCLUSIONS Few patients with plagiocephaly are caused by frontosphenoidal synostosis and squamosal suture synostosis. The orthotic molding therapy should be selected at an early time, but mostly, surgery may be needed for
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Affiliation(s)
- Wei-min Shen
- Nanjing Children' s Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China
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Monteiro BP, Gibson T, Bratton A. Successful surgical treatment of mandibulo-zygomatic arch synostosis secondary to trauma in a dog. Can Vet J 2012; 53:395-398. [PMID: 23024386 PMCID: PMC3299509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This is a report of mandibulo-zygomatic arch synostosis in a dog 7 mo after trauma to the maxilla. Advanced diagnostic imaging was considered essential for characterization of the condition and treatment planning. Surgical excision of the bony proliferation and physiotherapy resulted in improved function within 6 wk.
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Affiliation(s)
- Beatriz P Monteiro
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
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Fallahi HR, Naeini M, Mahmoudi M, Javaherforoosh F. Congenital zygomatico-maxillo-mandibular fusion: a brief case report and review of literature. Int J Oral Maxillofac Surg 2010; 39:930-3. [PMID: 20466517 DOI: 10.1016/j.ijom.2010.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 02/23/2010] [Accepted: 04/06/2010] [Indexed: 11/18/2022]
Abstract
Congenital maxillomandibular fusion (syngnathia) is rare. The first case was reported in 1936. By 2004, only 25 cases of syngnathia had been reported including 6 cases with fusion of the ascending rami of the mandible with the maxilla and zygomatic complex. This report concerns a 6-month-old girl with a type of congenital fusion of the ascending rami of the mandible with the upper alveolar arch and zygomatic complex that leads to restriction of mouth opening. The clinical features of this anomaly and a brief review of literature are presented.
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Affiliation(s)
- H R Fallahi
- Department of Oral and Maxillofacial Surgery, Jondishapour University of Medical Sciences, Imam Khomeini Medical Center, Ahvaz, Iran.
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Kernbach KJ, Barkan H, Blitz NM. A critical evaluation of subtalar joint arthrosis associated with middle facet talocalcaneal coalition in 21 surgically managed patients: a retrospective computed tomography review. Investigations involving middle facet coalitions-part III. Clin Podiatr Med Surg 2010; 27:135-43. [PMID: 19963175 DOI: 10.1016/j.cpm.2009.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Symptomatic middle facet talocalcaneal coalition is frequently associated with rearfoot arthrosis that is often managed surgically with rearfoot fusion. However, no objective method for classifying the extent of subtalar joint arthrosis exists. No study has clearly identified the extent of posterior facet arthrosis present in a large cohort treated surgically for talocalcaneal coalition through preoperative computerized axial tomography. The authors conducted a retrospective review of 21 patients (35 feet) with coalition who were surgically treated over a 12-year period for coalition on at least 1 foot. Using a predefined original staging system, the extent of the arthrosis was categorized into normal or mild (Stage I), moderate (Stage II), and severe (Stage III) arthrosis. The association of stage and age is statistically significant. All of the feet with Stage III arthrosis had fibrous coalitions. No foot with osseous coalition had Stage III arthrosis. The distribution of arthrosis staging differs between fibrous and osseous coalitions. Only fibrous coalitions had the most advanced arthrosis (Stage III), whereas osseous coalitions did not. This suggests that osseous coalitions may have a protective effect in the prevention of severe degeneration of the subtalar joint. Concomitant subtalar joint arthrosis severity progresses with age; surgeons may want to consider earlier surgical intervention to prevent arthrosis progression in patients with symptomatic middle facet talocalcaneal coalition.
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Affiliation(s)
- Klaus J Kernbach
- Department of Podiatry, Kaiser Foundation Hospital, Vallejo, CA 94589, USA
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Apard T, Laumonier F. [Congenital scaphotrapezial synostosis associated with a carpal tunnel syndrome: a case report]. Chir Main 2009; 28:33-6. [PMID: 19147388 DOI: 10.1016/j.main.2008.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 10/28/2008] [Accepted: 11/15/2008] [Indexed: 11/18/2022]
Abstract
This report describes a case of congenital synostosis between two bones of the wrist scaphoid and trapezium in a nine-year-old girl who presented a severe tunnel carpal syndrome treated two years ago by open surgery. This association has not previously been described.
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Affiliation(s)
- T Apard
- Unité d'orthopédie pédiatrique, CHU d'Angers, 4 rue Larrey, Angers cedex, France.
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Schell-Apacik CC, Cohen M, Vojta S, Ertl-Wagner B, Klopocki E, Heinrich U, von Voss H. Gomez-Lopez-Hernandez syndrome (cerebello-trigeminal-dermal dysplasia): description of an additional case and review of the literature. Eur J Pediatr 2008; 167:123-6. [PMID: 17483961 DOI: 10.1007/s00431-007-0478-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 03/14/2007] [Accepted: 03/15/2007] [Indexed: 11/25/2022]
Abstract
Gomez-Lopez-Hernandez syndrome is a very rare genetic disorder with a distinct phenotype (OMIM 601853). To our knowledge there have been seven cases documented to date. We report on an additional male patient now aged 15 8/12 years with synostosis of the lambdoid suture, partial scalp alopecia, corneal opacity, mental retardation and striking phenotypic features (e.g., brachyturricephaly, hypertelorism, midface hypoplasia and low-set ears) consistent with Gomez-Lopez-Hernandez syndrome. In early childhood the patient demonstrated aggressive behavior and raging periods. He also had seizures that were adequately controlled by medication. Magnetic resonance imaging (MRI) revealed rhombencephalosynapsis, i.e., a rare fusion of the cerebellar hemispheres, also consistent with Gomez-Lopez-Hernandez syndrome. In addition a lipoma of the quadrigeminal plate was observed, a feature not previously described in the seven patients reported in the literature. Cytogenetic and subtelomere analyses were inconspicuous. Microarray-based comparative genomic hybridization (array-CGH) testing revealed five aberrations (partial deletions of 1p21.1, 8q24.23, 10q11.2, Xq26.3 and partial duplication of 19p13.2), which, however, have been classified as normal variants. Array-CGH has not been published in the previously reported children. The combination of certain craniofacial features, including partial alopecia, and the presence of rhombencephalosynapsis in the MRI are suggestive of Gomez-Lopez-Hernandez syndrome. Children with this syndrome should undergo a certain social pediatric protocol including EEG diagnostics, ophthalmological investingation, psychological testing, management of behavioral problems and genetic counseling.
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Affiliation(s)
- Chayim Can Schell-Apacik
- Institute of Social Pediatric and Adolescent Medicine of the University of Munich, Munich, Germany.
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Nalaboff KM, Schweitzer ME. MRI of tarsal coalition: frequency, distribution, and innovative signs. Bull NYU Hosp Jt Dis 2008; 66:14-21. [PMID: 18333823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Tarsal coalition is uncommon, but not rare. Since it may present with chronic symptoms and since prior studies have shown that magnetic resonance (MR) has a high accu- racy for diagnosis, we evaluated the prevalence, frequency, location, and types of coalition, as well as secondary signs, as seen in a large clinical MR population. SUBJECTS AND METHODS Initially a "word search" program was used to ind all diagnoses of "tarsal coalition" in our RIS database as part of 27,483 ankle MRIs performed over a ten-year period. We revaluated 101 of 169 identiied cases for location (calca- neonavicular vs. talocalcaneal/subtalar) and type (osseous, cartilaginous, or ibrous, utilizing previously described MR criteria) of coalition. Additional imaging indings, including marrow edema and fractures, and associated secondary signs, such as talar "beaks," the "anteater" (hyperplastic anterior calcaneal process) sign, and the innovative "reverse anteater" (hyperplastic navicular) and "drunken waiter" (hypo/dysplastic sustentaculum tali) signs, were reported as well. As a second part to the study, in order to more ac- curately determine prevalence in a population requiring an MRI of the ankle, two observers reviewed 667 consecutive ankle MRIs performed on 640 patients. Patients less than 12 years of age (N = 20, 3.0%) or with nondiagnostic exams (N = 73, 10.9%) were excluded. Note was made: 1. if a coalition was present, 2. if it was deinite or possible, 3. of the location, 4. of the type, 5. of secondary signs, and 6. the frequency of bilaterality. RESULTS In the initial retrospective study, coalitions were identiied in 0.6% of exams performed, including 78 calcaneonavicular coalitions. Seven fractures were seen, all in the ibrous calcaneonavicular subgroup. We found only eight cases (10.3%) of the "anteater" sign, while identifying 19 cases (24.4%) of the "reverse" anteater sign in the calcaneonavicular group. Talar "beaks" were seen in 15 cases (19.2%) of the calcaneonaviuclar group and nine (39.1%) of the subtalar group. Sixteen (69.6%) of the subtalar cases demonstrated the "drunken waiter" sign, a dysplastic sustentaculum. We saw a dramatic difference in frequency of tarsal coalitions when we applied a prospec- tive approach; 11.5% of all patients (66/574) had a coali- tion, while 12.2% of studies (70/574) demonstrated tarsal coalitions: 25.7% (18/70) were subtalar, 71.4% (50/70) were calcaneonavicular, and 2.9% (2/70) had both. The calcaneonavicular coalitions were roughly evenly divided between the cartilaginous (56%) and ibrous (44%) subtypes, without any osseous coalitions being identiied. The subtalar coalitions were also nearly evenly divided between osse- ous/partially osseous (33.3%), cartilaginous (27.8%), and ibrous (38.9%). Talar "beaks" were seen in 25 cases (50%) of the calcaneonavicular group and ive (27.%) of the sub- talar group. We identiied six cases (12%) of the "anteater" and nine cases (18%) of the "reverse anteater" signs in our calcaneonavicular group. CONCLUSION Tarsal coalitions ap- pear to be more common than previously described. This is likely to be because ibrous and cartilaginous coalitions are infrequently recognized by plain radiography. The frequency of tarsal coalitions may be as high as 11%. We also found a disproportionately higher relative frequency of calcaneo- navicular coalitions, either because subtalar coalitions are more subtle on MRI or because calcaneonavicular coalitions can be overly diagnosed. Calcaneonavicular coalitions tend to be overwhelmingly nonosseous, while there is a more even distribution for subtalar coalitions. Newly described signs, such as the "reverse anteater" and "drunken waiter," are commonly seen in calcaneonavicular and subtalar coali- tions, respectively.
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Affiliation(s)
- Kenneth M Nalaboff
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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16
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de Ribaupierre S, Czorny A, Pittet B, Jacques B, Rilliet B. Frontosphenoidal synostosis: a rare cause of unilateral anterior plagiocephaly. Childs Nerv Syst 2007; 23:1431-8. [PMID: 17891404 DOI: 10.1007/s00381-007-0469-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Indexed: 11/24/2022]
Abstract
INTRODUCTION When a child walks in the clinic with a unilateral frontal flattening, it is usually associated in our minds with unilateral coronal synostosis. While the latter might be the most common cause of anterior plagiocephaly, it is not the only one. A patent coronal suture will force us to consider other etiologies, such as deformational plagiocephaly, or synostosis of another suture. To understand the mechanisms underlying this malformation, the development and growth of the skull base must be considered. MATERIALS AND METHODS There have been few reports in the literature of isolated frontosphenoidal suture fusion, and we would like to report a series of five cases, as the recognition of this entity is important for its treatment. CONCLUSION Frontosphenoidal synostosis must be searched in the absence of a coronal synostosis in a child with anterior unilateral plagiocephaly, and treated surgically.
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17
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Mathieu L, Ollat D, Versier G. [Fracture of the two forearm bones and congenital radioulnar synostosis: a case report]. Rev Chir Orthop Reparatrice Appar Mot 2007; 93:511-4. [PMID: 17878844 DOI: 10.1016/s0035-1040(07)90335-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
We report a case of shaft fracture involving both forearm bones in an 18-year-old male presenting congenital radioulnar synostosis. The mechanism of fracture involved both direct blunt trauma and forced supination on forearm frame blocked in 30 degrees pronation. Emergency osteosynthesis was performed using a standard procedure without any attempt to modify the ankylosis position. Congenital radioulnar synostosis appears to produce a rather vulnerable forearm due to restrained torsion. This notion must be taken into account in such subjects participating in contact sports which solicit pronation-supination.
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Affiliation(s)
- L Mathieu
- Service de Chirurgie Orthopédique et Traumatologie, hôpital d'Instruction des Armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé.
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18
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Chodos MD, Campbell JT. Intra-articular calcaneal fracture with tarsal coalition treated with open reduction, internal fixation, and isolated subtalar arthrodesis: a case report. Foot Ankle Int 2007; 28:1017-20. [PMID: 17880878 DOI: 10.3113/fai.2007.1017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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19
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Affiliation(s)
- Y Nabeshima
- Department of Orthopaedic Surgery, Himeji St. Mary's Hospital, Hyogo, 670-0801, Japan.
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20
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Imade S, Takao M, Nishi H, Uchio Y. Unusual malleolar fracture of the ankle with talocalcaneal coalition treated by arthroscopy-assisted reduction and percutaneous fixation. Arch Orthop Trauma Surg 2007; 127:277-80. [PMID: 16871393 DOI: 10.1007/s00402-006-0196-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Indexed: 11/27/2022]
Affiliation(s)
- Shinji Imade
- Department of Orthopaedic Surgery, Shimane University School of Medicine, 89-1, Enya, Izumo, Shimane, Japan.
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21
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Affiliation(s)
- S L Viana
- Clinica Radiológica Vila Rica, Magnetic Resonance Department, Brasilia, Brazil.
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22
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Louaste J, Amhajji L, Rachid K. [Pisiform-hamate synostosis with ulnar neuropathy. Case report]. ACTA ACUST UNITED AC 2007; 26:170-2. [PMID: 17532245 DOI: 10.1016/j.main.2007.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Revised: 03/13/2007] [Accepted: 03/17/2007] [Indexed: 11/29/2022]
Abstract
Entrapment of the ulnar nerve at the wrist is rare compared with the more commun site at the elbow. This condition was secondary to reccurent blunt trauma, ganglion cyst, vasculitic disorders, and fibrous bands. Compression of the ulnar nerve caused by pisiform-hamate coalition is rare entity. One case of this condition is reported.
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Affiliation(s)
- J Louaste
- Service d'orthopédie traumatologie, hôpital militaire Moulay-Ismail, BP S15, Meknès, 50000, Maroc.
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23
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24
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Hanypsiak B, Bergfeld JA, Miniaci A, Joyce MJ. Recurrent compartment syndrome after fracture of a tibiofibular synostosis in a National Football League player. Am J Sports Med 2007; 35:127-30. [PMID: 17130245 DOI: 10.1177/0363546506295698] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Bryan Hanypsiak
- Orthopaedic Associates of Long Island, Long Island, New York, USA.
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25
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Abstract
In rare instances, tarsal coalition leads to cavovarus foot deformity, although the pathologic mechanism leading to this deformity is not clear. This article reports a case of a 14-year-old boy presenting a severe cavovarus deformity of the right foot with talocalcaneal and calcaneonavicular coalitions, and a mild cavus deformity of the left foot with a single talocalcaneal coalition. Computed tomography and postoperative histologic analysis demonstrated a synostosis between talus and calcaneus and a fibrous calcaneonavicular coalition with partial ossification. Instrumented gait analysis revealed a limited range of ankle plantar flexion and increased external rotation of the ankle. Associated skeletal malformations including incomplete hemimelia of the forearm and scoliosis raised the possibility of a teratologic condition, but neurologic examination, spinal magnetic resonance imaging, and nerve conduction velocities were normal. The progressive ossification of combined coalitions during growth of the foot may have been one factor leading to this complex foot deformity. The fine-wire electromyogram showed normal tibialis anterior and posterior muscle activity. Small soft tissue tears in the sinus tarsi may have led to a mild reflexive increase of the muscle tone and tendon shortening, which pulled the forefoot into adduction and the heel into varus, and raised the medial arch. Mechanical alterations of the ankle appear secondary to the heel varus and to the progressive deformity of the talus. Three-dimensional computed tomography reconstruction and gait analysis appeared to be helpful additional parameters to understanding the pathomechanics of this complex foot deformity and for preoperative planning of triple arthrodesis.
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MESH Headings
- Adolescent
- Arthrodesis
- Biomechanical Phenomena
- Ectromelia/complications
- Electromyography
- Foot Deformities, Acquired/complications
- Foot Deformities, Acquired/diagnostic imaging
- Foot Deformities, Acquired/physiopathology
- Foot Deformities, Acquired/surgery
- Forearm/abnormalities
- Gait/physiology
- Humans
- Imaging, Three-Dimensional
- Male
- Ossification, Heterotopic/complications
- Ossification, Heterotopic/diagnostic imaging
- Ossification, Heterotopic/physiopathology
- Ossification, Heterotopic/surgery
- Osteotomy
- Preoperative Care
- Scoliosis/complications
- Synostosis/complications
- Synostosis/diagnostic imaging
- Synostosis/physiopathology
- Synostosis/surgery
- Tarsal Bones/abnormalities
- Tarsal Bones/surgery
- Tomography, X-Ray Computed
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Affiliation(s)
- Yann Philippe Charles
- Service d'Orthopédie Pédiatrique, Centre Hospitalier Universitaire, Hôpital Lapeyronie, 371 Avenue du Doyen G. Giraud, 34295 Montpellier Cedex 5, France.
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26
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Lenin Babu V, Leninbabu V, Shenbaga N, Komarasamy B, Paul A. Proximal tibiofibular synostosis as a source of ankle pain: a case report. Iowa Orthop J 2006; 26:127-9. [PMID: 16789462 PMCID: PMC1888597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We report the case of a 61-year-old man who presented with ankle pain of unknown etiology. The actual cause for his pain was missed during his two initial visits when only ankle radiographs were taken. During his third visit, a full-length tibia film revealed a proximal tibiofibular synostosis. He successfully underwent a fibular osteotomy with complete symptomatic relief. A literature review of this topic is presented.
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Abstract
In a series of 48 patients with Williams syndrome examined from 1984 to 1988, 3 physical manifestations were noted which have not been emphasized in previous reports of this condition. Unusual sacral creases were found in 25/48 patients, a linear array of hemangiomas (nevus flammeus) on the back in 3/48, and limitation of supination in 5/48.
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Affiliation(s)
- C A Morris
- Department of Pediatrics, University of Nevada School of Medicine, Las Vegas 89102
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28
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Abstract
BACKGROUND Premature closure of the metopic suture results in deformation of the anterior portion of the calvarium, which can vary from mild to severe. In mild forms, there is only prominent ridging of the metopic suture; more severe forms result in a marked narrowing of the frontal and temporal regions that in turn affects the supraorbital rims and produces hypotelorism. METHODS The authors retrospectively reviewed 39 consecutive cases of metopic synostosis treated over a 12-year period. RESULTS The average age at referral was 5 months, with surgery performed at an average age of 7.5 months. Fifteen infants had other congenital anomalies, with eight having synostosis of other sutures. Follow-up ranged from 7 months to 6 years, with an average of 29 months. In three mild cases, burring of the metopic ridge was performed with excellent aesthetic results in all cases. The other 36 patients had significant deformity of the supraorbital ridges and temporal regions, with obvious hypotelorism for over 50% of the time. In these cases, the patients underwent craniofacial reconstruction to normalize their appearance. In addition, the lateral aspect of the sphenoid ridges, including the orbital roof and lateral orbital wall to the infraorbital fissure, was removed to free the cranial base. The average blood loss was under 400 ml and the average hospital stay was 3.6 days. Results were considered good to excellent in all except three cases, which had recurrence of a prominent metopic ridge; two required a second operation after 6 months for burring of this ridge, whereas the third was treated conservatively with an orthotic headband. CONCLUSION Mild forms of metopic synostosis can be successfully treated with burring of the metopic ridge alone. Severe forms require craniofacial reconstruction and may be associated with other congenital abnormalities, additional synostosis, and developmental delay. In all cases, the operative procedure must be tailored to the nature and severity of the deformity.
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Affiliation(s)
- Henry E Aryan
- Division of Neurosurgery, University of California Medical Center, San Diego, 92103-8893, USA.
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29
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Wiesner R. [A hairy condition]. MMW Fortschr Med 2004; 146:57. [PMID: 15529679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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30
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Abstract
Bone marrow failure syndromes can be associated with abnormalities of the forearms. We observed a neonate with congenital thrombocytopenia who had bilateral radio-ulnar synostosis and fifth finger clinodactly. We performed an evaluation of the mechanism causing the thrombocytopenia using a combination of direct and indirect measures of thrombopoiesis. These tests indicated decreased platelet production. This entity of congenital hyporegenerative thrombocytopenia with bilateral radio-ulnar synostosis and fifth-finger clinodactly is an uncommon but easily recognizable form of congenital amegakaryocytic thrombocytopenia (CAMT). This entity can be distinguished from the TAR syndrome (thrombocytopenia and absent radii) by the distinctive orthopedic issues, different underlying genetic mutations, and a more worrisome prognosis for CAMT than for TAR.
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Affiliation(s)
- Martha C Sola
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA
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31
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Masuko T, Kato H, Minami A, Inoue M, Hirayama T. Surgical treatment of acute elbow flexion contracture in patients with congenital proximal radioulnar synostosis. A report of two cases. J Bone Joint Surg Am 2004; 86:1528-33. [PMID: 15252105 DOI: 10.2106/00004623-200407000-00026] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Tatsuya Masuko
- Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
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32
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Abstract
A case of tibiofibular synostosis stress fracture is reported with its clinical and radiographic appearance as well as treatment.
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Affiliation(s)
- Frank Horst
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
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33
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34
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Abstract
A 9-month-old neutered male cat was referred because of left forelimb lameness. Physical examination, laboratory analysis, and radiographic examination of the entire skeleton were performed. The radiographic diagnosis was bilateral radio-ulnar synostosis with secondary elbow malformation. A comparison between clinical and radiographic findings of the cat and those described in children affected by radio-ulnar synostosis is reported. Correlations and differences are discussed.
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Affiliation(s)
- Federica Rossi
- Veterinary Clinic dell'Orologio, Sasso Marconi, Bologna, Italy
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35
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36
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Oğün TC, Sarlak A, Arazi M, Kapicioğlu MIS. Posttraumatic distal radioulnar synostosis and distal radial epiphyseal arrest. Ulus Travma Derg 2002; 8:59-61. [PMID: 11881314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Tunç Cevat Oğün
- Selçuk University, Medical School, Department of Orthopaedics and Traumatology, 42080, Konya, Türkiye
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37
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Abstract
The association of bone marrow failure and skeletal defects has been frequently noted, however, the genetic basis for most of these syndromes remains unclear. We describe a previously uncharacterized autosomal dominant syndrome of amegakaryocytic thrombocytopenia associated with radial-ulnar synostosis. The clinical features of this syndrome appear to be distinct from other similar conditions, including Fanconi's anaemia and thrombocytopenia-absent radii (TAR). The physical findings at diagnosis and clinical management of each case are detailed, as well as a discussion of this disorder in the context of other syndromes in which marrow failure and skeletal defects are prominent features. We also review recent developments in molecular genetics that may provide important clues to the underlying aetiology of this condition.
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Affiliation(s)
- A A Thompson
- Departments of Paediatrics, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA.
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38
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Abstract
BACKGROUND Iatrogenic synostosis of the tibia and fibula following an operation on the leg in a child has been reported rarely in the literature, and the effects of this complication on future growth, alignment, and function are not known. This is a retrospective case series, from one institution, of crossunions of the distal parts of the tibia and fibula complicating operations on the leg in children. The purpose is to alert surgeons to this possible complication. METHODS The senior author identified eight cases of iatrogenic tibiofibular synostosis seen in children since 1985. The patients had various diagnoses and were from the practices of four pediatric orthopaedic surgeons. Synostosis developed in six patients after osteotomies of the distal parts of the tibia and fibula, in one after internal fixation of distal tibial and fibular metaphyseal fractures through a single incision, and in one after posterior transfer of the anterior tibialis tendon through the interosseous membrane combined with peroneus brevis transfer to the calcaneus. Medical records were reviewed, and preoperative and follow-up radiographs were analyzed for changes in the relative positions of the proximal and distal tibial and fibular physes and in the alignment of the ankle. RESULTS Five patients were symptomatic after crossunion; they presented with prominence of the proximal part of the fibula, ankle deformity, or ankle pain. Three patients were asymptomatic, and a synostosis was identified on routine follow-up radiographs. Intraoperative technical errors caused two of the crossunions; the cause of the others was unknown. Following tibiofibular synostosis, growth disturbances were noted radiographically in every patient. The normal growth pattern of distal migration of the fibula relative to the tibia was reversed, resulting in a decreased distance between the proximal physes of the tibia and fibula as well as proximal migration of the distal fibular physis relative to the distal part of the tibia. Shortening of the lateral malleolus led to greater valgus alignment of the ankle. CONCLUSIONS Tibiofibular synostosis can complicate an operation on the leg in a child. After crossunion, the normal distal movement of the fibula relative to the tibia is disrupted, resulting in shortening of the lateral malleolus and ankle valgus as well as prominence of the fibular head at the knee. The synostosis also interferes with the normal motion that occurs between the tibia and fibula with weight-bearing, potentially leading to ankle pain.
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Affiliation(s)
- S L Frick
- Department of Orthopaedic Surgery, Children's Hospital--San Diego, California 92123-4208, USA.
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39
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Abstract
OBJECTIVE To assess the sensitivity and specificity of the C sign, a C-shaped line created by the outline of the talar dome and the inferior margin of the sustentaculum tali on lateral ankle radiographs, for patients with both flatfoot deformity and specifically talocalcaneal (TC) coalition. DESIGN AND PATIENTS All patients in this retrospective study were under 35 years of age and had a lateral ankle radiograph and follow-up CT scan for a non-traumatic indication. Forty-eight cases over the past 5 years fulfilled these criteria. Two masked musculoskeletal radiologists determined the presence or absence of the C sign for each lateral radiograph by consensus. Each CT study was then assessed by a third musculoskeletal radiologist for the presence of tarsal coalition. Observations were correlated with clinical history regarding presence or absence of flatfoot deformity. RESULTS Ten cases of TC coalition were diagnosed, four of which demonstrated a C sign (40%). Eight cases with a C sign were encountered, four of which had TC coalition (50%) and four did not. All patients with a positive C sign had a flatfoot clinically (100%), while only eight of 24 flatfooted patients had a C sign (33%). CONCLUSION The C sign is specific, but not sensitive, for flatfoot deformity, and is neither sensitive nor specific for subtalar coalition.
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Affiliation(s)
- R R Brown
- Department of Radiology, Hospital for Joint Disease/NYU Medical Center, 301 E. 17th Street, New York, New York, USA
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40
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Abstract
Isolated non-osseous tarsal coalition of the medial cuneiform-first metatarsal joint is rare. Resection of the coalition was performed in a 32-year-old patient, with excellent results. This procedure is an effective option for treatment of small lesions.
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Affiliation(s)
- Y Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.
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41
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Affiliation(s)
- A A Thompson
- Department of Pediatrics, Division of Hematology/Oncology, Gwynne Hazen Cherry Memorial Laboratories, University of California, Los Angeles School of Medicine, Los Angeles, California, USA.
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42
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Kaneko K, Matsumura K, Maruyama Y. Congenital synostosis between the scaphoid and the trapezium as a cause of tenosynovitis simulating de Quervain's disease. Chir Main 2000; 19:187-90. [PMID: 10989763 DOI: 10.1016/s1297-3203(00)73478-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This report describes a case of congenital synostosis between the scaphoid and the trapezium resulting in tenosynovitis simulating de Quervain's disease, an association not previously reported.
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Affiliation(s)
- K Kaneko
- Department of Orthopaedic Surgery, Juntendo University, Izunagaoka Hospital, Shizuoka, Japan
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43
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Blakemore LC, Cooperman DR, Thompson GH. The rigid flatfoot. Tarsal coalitions. Clin Podiatr Med Surg 2000; 17:531-55. [PMID: 10943504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Tarsal coalitions are the major cause of painful rigid flatfoot deformity in children and adolescents. Talocalcaneal and calcaneonavicular coalitions are the most common sites. They are often bilateral and may be asymptomatic. They represent a failure of fetal mesenchymal differentiation, and onset of symptoms in children often corresponds to the time of ossification of the fibrous or cartilaginous coalition. The most common presenting symptom is pain, and diagnosis is aided by plain radiographs and computerized tomography. Some patients respond to conservative measures, but surgical treatment is often required. Resection and interposition of fat or tendon (talocalcaneal) or muscle (calcaneonavicular) are the most common operative treatments, with arthrodesis reserved for symptomatic recurrences, patients with degenerative changes, and those with multiple coalitions.
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Affiliation(s)
- L C Blakemore
- Division of Pediatric Orthopaedics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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44
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Affiliation(s)
- S L Urben
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI 48202-2689, USA
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45
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Jakubowski L, Sabatowska M, Filipiak-Miastkowska I, Nadratowski P, Rutkowska A, Nowakowska D, Kałuzewski B. [Neurological aspects of two patients with non-mosaic and mosaic polysomy of the X and Y chromosomes]. Neurol Neurochir Pol 1999; 33:169-75. [PMID: 10399734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Clinical features were compared of a patient with the 48,XXYY karyotype and a case of 47,XXY/48,XXYY mosaicism. In the former patient tremor of the upper extremities of unclear aetiology was present. In both cases epilepsy was suspected. Similarly as in other cases of 48,XXYY karyotype the first patient had skeletal anomalies, abnormalities of dermatoglyphics and personality changes. These features are rarely found in Klinefelter syndrome. The differences in relation to the syndrome were less evident in the case of mosaicism 47,XXY/48,XXYY.
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Affiliation(s)
- L Jakubowski
- Zakładu Genetyki Medycznej, Instytutu Endokrynologii AM w Lodzi
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46
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Bruzzo M, Braccini F, Cacès F, Vallicioni JM, Chays A, Magnan J. [Fixed mallear head syndrome]. Ann Otolaryngol Chir Cervicofac 1998; 115:279-83. [PMID: 9881175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Fixed head malleus syndrome is a rare anatomoclinical entity first described by Goodhill in 1966. We present a series of 9 patients who underwent surgery between 1991 and 1997 and discuss the technical procedures used and functional outcome. Ossicular mobility can be re-established with two surgical methods. The more simple method consists in a classical incus transposition with malleus neck section. The more physiological method consists in drilling the synostosis fixing the malleus without disrupting the ossicular chain; stapedotomy is associated in certain cases (Type III).
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Affiliation(s)
- M Bruzzo
- Service d'ORL et de chirurgie Cervico-faciale, Professeur Magnan-Hôpital Nord, Marseille
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47
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Abstract
Symptomatic tarsal coalition is often considered to be synonymous with peroneal spastic flatfoot. The association of the cavovarus foot type with tarsal coalition is less well established and has been described only in children. This article describes a case of an adult female with symptomatic cavovarus feet with talocalcaneal coalition. The authors theorize about the pathology of muscle spasm and pain in patients with this condition.
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Affiliation(s)
- H P Knapp
- New York College of Podiatric Medicine, NY 10035, USA
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48
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Abstract
While most pediatric patients with peroneal spastic flatfoot demonstrate tarsal coalitions, not all do. The absence of coalition may present a diagnostic challenge and make appropriate treatment difficult. Past and present etiologic theories, diagnostic modalities, and treatments are outlined in this article. The common peroneal nerve block is of great value in the diagnosis and treatment of peroneal spastic flatfoot with or without coalition. With adjunctive treatments, increased motion and decreased symptomatology are often obtained. A protocol, applied to five cases described herein, is suggested.
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Affiliation(s)
- L J Lowy
- Department of Pediatrics, New York College of Podiatric Medicine, NY 10035, USA
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49
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Moses RL, Cavalli GI, Schmidt RJ, Rao VM, Cotler J, Cohn J, Spiegel JR. Posttraumatic synostosis of the cervical spine to the thyroid cartilage presenting as dysphagia. Otolaryngol Head Neck Surg 1997; 117:S84-6. [PMID: 9419111 DOI: 10.1016/s0194-5998(97)70065-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- R L Moses
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107-5098, USA
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50
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Affiliation(s)
- R Valentin
- Department of Nephrology, Radiology and Neurology, Gilead Krankenanstalten, Bielefeld, Germany
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