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Madani H, El Hassnaoui Y, Ait Benali H, Shimi M. Aneurysmal bone cyst of the calcaneus: A rare case report and review of the literature. Int J Surg Case Rep 2024; 119:109802. [PMID: 38788635 PMCID: PMC11140776 DOI: 10.1016/j.ijscr.2024.109802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Aneurysmal bone cyst (ABC) is a benign lytic bone tumor of the skeletal system but locally destructive lesion of unknown origin. It often occurs in childhood and usually involves the metaphyseal region of long bones; thus, its localisation in the calcaneum remains rare; its atypical presentation in our case makes it remarkable. CASE PRESENTATION We describe a case of a young patient who suffered from chronic heel pain, in whom the clinical examination finds swelling and pain on palpation. A complete radiological assessment was carried out, which revealed a solitary and expansive osteolytic lesion within the calcaneus. Treatment included tumor curettage and reconstruction with allograft and cement. The biopsy report was consistent with an ABC. The postoperative follow-up at 18 months was marked by a good radio-clinical evolution and no recurrence. CLINICAL DISCUSSION ABCs are benign cystic expansive tumors that are reactive, locally destructive and blood-filled, their occurrence in the calcaneus has been reported in only 1.6 % of total reported cases. Talalgia is the most frequent sign associated with swelling. Liquid-liquid level images on MRI is a pathognomonic sign of these lesions but the gold standard diagnosis remains histology. Their treatment is based on curettage - filling by grafting. CONCLUSION Curettage combined graft makes results butter and improves the quality of life.
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Affiliation(s)
- Hamza Madani
- Traumatology and Orthopedics Department, University Hospital Center of Tangier, Abdelmalek Essaâdi University, Faculty of Medicine and Pharmacy, Tangier, Morocco.
| | - Youssef El Hassnaoui
- Traumatology and Orthopedics Department, University Hospital Center of Tangier, Abdelmalek Essaâdi University, Faculty of Medicine and Pharmacy, Tangier, Morocco
| | - Hicham Ait Benali
- Traumatology and Orthopedics Department, University Hospital Center of Tangier, Abdelmalek Essaâdi University, Faculty of Medicine and Pharmacy, Tangier, Morocco
| | - Mohammed Shimi
- Traumatology and Orthopedics Department, University Hospital Center of Tangier, Abdelmalek Essaâdi University, Faculty of Medicine and Pharmacy, Tangier, Morocco
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Sadek WMS, Salem MSE, Mohamed MSS, Ebeid WA. Functional and oncological outcome of patients with benign hindfoot tumors treated by curettage. Foot Ankle Surg 2023:S1268-7731(23)00101-7. [PMID: 37328403 DOI: 10.1016/j.fas.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/14/2023] [Accepted: 05/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Only 3 % of osseous tumors occur in the foot. The metatarsals are the -most common site whereas the calcaneus and talus are less common sites. Because these tumors are rare, the aim of our study is to assess the functional and the oncological outcome of patients with benign hindfoot tumors managed by curettage. METHODS The clinical and radiological data of 41 patients diagnosed with benign hindfoot tumors were retrospectively reviewed. The study included 31 males and 10 females. The average age was 23.68 (range, 5-49) years. The average follow-up period was 92.7 (range, 12-244) months. RESULTS At the last follow-up visit, the average Musculoskeletal Tumor Society scoring system (MSTS) score was 28.12 (range, 21-30). MSTS scores were higher in patients with latent tumors (P = .028) and patients managed by simple curettage (P = .018). The recurrence rate in calcaneal tumors was higher than those in the talus. The overall complication rate was 12.2 % (5 of 41 patients). Infection and subtalar arthritis were the most common complications. CONCLUSION Curettage of benign bone tumors of talus or calcaneus proved to be an effective method in the management of these patients. Their functional outcome is also excellent. All the complications are manageable without long term morbidity. LEVEL OF EVIDENCE Level IV Therapeutic study.
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Affiliation(s)
| | | | | | - Walid Atef Ebeid
- Department of Orthopedics and Traumatology, Cairo University, Cairo, Egypt.
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3
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Gottlich C, Fisher JC, Campano D, Diab M. Management of Calcaneal Cysts in the Pediatric Population: A Review. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202303000-00007. [PMID: 36913318 PMCID: PMC10010847 DOI: 10.5435/jaaosglobal-d-22-00248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 03/14/2023]
Abstract
Cysts of the bone are a common pathology that, although benign, are frequently treated because of their tendency to compromise the integrity of affected bone. Two common entities are unicameral bone cysts and aneurysmal bone cysts. Although these are two distinct pathologies, they are treated similarly and thus will be discussed in tandem. The optimal treatment of calcaneal bone cysts in pediatric patients has long been debated among orthopaedic surgeons because of the relatively small number of cases and varied results within the literature. Currently, there are three lines of thought regarding treatment: observation, injection, and surgical intervention. When considering which course of treatment is best for an individual patient, the surgeon must consider the fracture risk without treatment, the risk of complications with treatment, and the recurrence rate with each treatment approach. There are limited data on pediatric calcaneal cysts specifically. Still, there are much data concerning simple bone cysts of long bones in the pediatric population and calcaneal cysts in the adult population. Because of the lack of literature on the subject, there is a need for a review of the available literature and a consensus on the approach to treating calcaneal cysts in the pediatric population.
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Jalan D, Gupta A, Elhence A, Nalwa A, Bharti JN, Elhence P. Primary aneurysmal bone cyst of the calcaneum: A report of three cases and review of literature. Foot (Edinb) 2021; 47:101795. [PMID: 33957532 DOI: 10.1016/j.foot.2021.101795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/23/2021] [Indexed: 02/04/2023]
Abstract
CASE DESCRIPTION Aneurysmal bone cysts (ABCs) are locally aggressive, cystic lesions of the skeletal system, most commonly seen in the metaphyseal region of long bones. On the other hand, an ABC of the foot (especially the calcaneum) is a rare entity, with very few cases reported in the literature. In this study, we present three such cases who presented to us with the chief complaint of chronic heel pain. All three patients were clinically reviewed following which a comprehensive radiological workup was performed. The latter revealed a solitary, expansile lesion within the calcaneum in all them. Treatment included extended curettage and reconstruction using autologous iliac crest bone grafts. Histopathological analysis of the curetted sample was consistent with features of primary ABC. There were no complications and all lesions had re-ossified at the latest follow up. CONCLUSION Calcaneal ABCs are rare, atypical lesions warranting a high index of suspicion and correlation of the patient's clinical, radiological and histopathological features to make a correct diagnosis.
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Affiliation(s)
- Divesh Jalan
- Central Institute of Orthoapedics, VMMC and Safdarjung Hospital, New Delhi 110029, India.
| | - Akshat Gupta
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.
| | - Abhay Elhence
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.
| | - Aasma Nalwa
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.
| | - Jyotsna Naresh Bharti
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.
| | - Poonam Elhence
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.
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5
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Abstract
Bone tumors of the foot are an uncommon finding. Most tumors are found incidentally on imaging and are benign. Care must be taken although due to the aggressive nature of malignant bone tumors that can occur in the calcaneus. Malignant lesions will more commonly present with symptoms of pain and swelling. Often misdiagnosed as soft tissue injuries, it is critical to be able to diagnose and treat these lesions early. Imaging plays an important role with plain films and advanced imaging. Surgical treatments can range from curettage with grafting to amputation for more aggressive lesions.
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Affiliation(s)
- Eric W Temple
- The Iowa Clinic, 5950 University Avenue West, Des Moines, IA 50266, USA; Unitypoint Health - Iowa Methodist Medical Center, 1415 Woodland Avenue, Des Moines, IA 50309, USA.
| | - Ryan D Prusa
- The Iowa Clinic, 5950 University Avenue West, Des Moines, IA 50266, USA; Unitypoint Health - Iowa Methodist Medical Center, 1415 Woodland Avenue, Des Moines, IA 50309, USA
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Balbouzis T, Alexopoulos T, Grigoris P. Os calcis lipoma: To graft or not to graft? - A case report and literature review. World J Orthop 2019; 10:292-298. [PMID: 31360644 PMCID: PMC6650635 DOI: 10.5312/wjo.v10.i7.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/25/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intraosseous lipoma is a rare benign lesion, commonly affecting the os calcis. Its pathogenesis and natural history are not fully understood, and its management remains controversial.
CASE SUMMARY A 56-year-old male complaining of heel pain was diagnosed with an os calcis lipoma. The lesion was treated with curettage and it was filled with impacted allograft and demineralized bone matrix. Histological examination confirmed the above diagnosis. Six months postoperatively, the patient returned to recreational long-distance running. Repeated computed tomography scanning, up to five years postoperatively, showed almost complete resorption of the graft over time.
CONCLUSION The treatment of an os calcis lipoma should be individualized, depending on the symptoms, the location and size of the lesion. Surgeons, electing to proceed with bone grafting, should consider the probability of bone graft resorption.
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Affiliation(s)
- Theodoros Balbouzis
- Department of Orthopaedics, Metropolitan General Hospital, Holargos, Athens 15562, Greece
| | | | - Peter Grigoris
- Department of Orthopaedics, Metropolitan General Hospital, Holargos, Athens 15562, Greece
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Yan L, Zong J, Chu J, Wang W, Li M, Wang X, Song M, Wang S. Primary tumours of the calcaneus. Oncol Lett 2018; 15:8901-8914. [PMID: 29928329 PMCID: PMC6004727 DOI: 10.3892/ol.2018.8487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 03/02/2018] [Indexed: 12/14/2022] Open
Abstract
The calcaneus is a rare location for the occurrence and development of primary tumour types. Clinicians are unfamiliar with calcaneal tumour types, which may result in a delay in diagnosis or a missed diagnosis, resulting in unnecessary morbidity and amputation. Heel pain and localized swelling of the ankle are the most common symptoms. X-ray is the first choice for a tentative diagnosis of a calcaneal tumour. The final diagnosis depends on a histological examination. The treatment of calcaneal tumour types varies depending on the Enneking system. The majority of patients with benign tumours heal, except for a few with a palindromia. For malignant tumours, the prognosis is comparatively poor, resulting in disability and a high rate of metastasis. This review describes the spectrum of calcaneal tumour types and specifically illustrates the epidemiology, symptomatology, imagology, histopathology and treatment options that may facilitate diagnosis and improve prognosis.
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Affiliation(s)
- Litao Yan
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Junwei Zong
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Jin Chu
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Wendong Wang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Mingshu Li
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xianfeng Wang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Mingzhi Song
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
- Department of Orthopaedics, The Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116200, P.R. China
| | - Shouyu Wang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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Smith MO, Nicosia CE. A rare probable chondroblastoma of the calcaneus in a pre-Columbian subadult from Illinois. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2017; 16:14-21. [PMID: 28290305 DOI: 10.1016/j.ijpp.2017.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/11/2017] [Accepted: 01/14/2017] [Indexed: 06/06/2023]
Abstract
Discrete cystic or tumorous intraosseous lesions can arise from a variety of benign and malignant conditions as well as trauma and infection. They are clinically rarely observed in the calcaneus. A fourteen-to-seventeen-year-old subadult recovered from a Late Woodland (∼AD 800-1100) period mortuary context in the Mississippi River Valley of central Illinois presents with a single lytic intraosseous lesion on the posterior right calcaneus that bilaterally perforates the cortex. The lesion, although primarily anterior to the epiphyseal plate, does breach it. There is also a small perforation of the outer cortex of the epiphysis above the insertion of the Achilles' tendon. The lesion is well-defined with a primarily spongy cancellous interior margin. On the body of the calcaneus, there is periostosis and a slightly expansive endosteal reaction. Comparative radiographic assessments undertaken to differentially diagnose the lesion indicate that it was likely not malignant. Based on the posterior location, the radiographic signature, the bilateral cortical perforation and the breach of the epiphysis, the lesion is best interpreted as a chondroblastoma.
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Affiliation(s)
- Maria Ostendorf Smith
- Department of Sociology and Anthropology, Illinois State University, Normal, IL, United States.
| | - Christopher E Nicosia
- Department of Sociology and Anthropology, Illinois State University, Normal, IL, United States.
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Petersen U, Winter C, Petersen W. Endoskopisch gestützte Auffüllung symptomatischer Kalkaneuszysten. ARTHROSKOPIE 2015. [DOI: 10.1007/s00142-015-0030-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Keskinbora M, Köse O, Karslioglu Y, Demiralp B, Basbozkurt M. Another cystic lesion in the calcaneus: benign fibrous histiocytoma of bone. J Am Podiatr Med Assoc 2014; 103:141-4. [PMID: 23536505 DOI: 10.7547/1030141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Benign fibrous histiocytoma is a rare benign primary skeletal tumor that occurs frequently in the long bones and the pelvis. The calcaneus is an unusual location for benign fibrous histiocytoma. We did not identify any case of benign fibrous histiocytoma involving the calcaneus in the relevant literature. We describe a 22-year-old male patient with benign fibrous histiocytoma involving the calcaneus treated with curettage and bone grafting. At the final follow-up visit, 1 year after surgery, the patient was free of pain and walking unaided. We discuss the differential diagnosis of cystic lesions of the calcaneus.
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Affiliation(s)
- Mert Keskinbora
- Orthopaedics and Traumatology Department, Gulhane Military Medical Academy, Ankara, Turkey
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Jamshidi K, Mazhar FN, Yahyazadeh H. Chondromyxoid fibroma of calcaneus. Foot Ankle Surg 2013; 19:48-52. [PMID: 23337277 DOI: 10.1016/j.fas.2012.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 09/14/2012] [Accepted: 10/10/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chondromyxoid fibroma is a rare benign primary bone tumor composed of immature myxoid mesenchymal and cartilaginous tissue. Its occurrence in calcaneus is very rare and few cases of calcaneal involvement have been reported in literature. We report five cases of CMF in calcaneus. METHODS Five cases, with the final diagnosis of chondromyxoid fibroma of the calcaneal bone are included in this report. Preoperative tumor workup was performed for our patients. We reviewed and recorded demographic data and the sign and symptoms of patients at presentation to our center. Mode of treatments, postoperative complications and recurrence were also studied. Curettage, high speed burring and bone grafting was performed in 4 of our patients and in the remaining case we only carried out curettage and burring. RESULTS Of the five patients, 3 were male and 2 were female. The mean age at presentation was 21. Two of our cases had previous surgery in other centers and had been referred to our clinic because of recurrence. The chief complaint in all of our patients was heel pain. The mean follow up period was 25.2 months. All of our patients had a delay in the diagnosis of tumor. We did not have any recurrence in our patients during follow up period. CONCLUSIONS This case series shows that chondromyxoid fibroma is not necessarily as exceedingly rare as generally reported in the current literature. This tumor should be considered in the differential diagnosis in patients with ankle and heel pain.
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Affiliation(s)
- Khodamorad Jamshidi
- ShafaYahyaian Rehabilitation Center, Tehran University of Medical Sciences, Tehran, Iran
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MR imaging of the paediatric foot and ankle. Pediatr Radiol 2013; 43 Suppl 1:S107-19. [PMID: 23478926 DOI: 10.1007/s00247-012-2449-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 02/09/2012] [Accepted: 06/06/2012] [Indexed: 02/07/2023]
Abstract
Radiography is the mainstay for initial evaluation of paediatric foot and ankle pathology. MRI is the preferred exam for further characterisation of the majority of these conditions. The modality features high sensitivity and specificity for this purpose with few exceptions. Findings on MRI will often dictate patient referral and further management, and are frequently required for surgical planning. This article will provide an overview of a variety of pathologies that afflict the foot and ankle in children. These include tarsal coalition, osteochondral lesions, osteonecrosis, osteochondroses, stress fractures, osteomyelitis, inflammatory arthritis, neoplasms of bone and soft tissue, and foreign bodies. Their respective imaging manifestations on MRI are the focus of the paper. Technical parameters and marrow signal variation are also discussed.
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Madhuri V, Balakumar B, Walter NM, Prakash H, Dutt V, Chowdhurie L. Function after total calcanectomy for malignant tumor in a child: is complex reconstruction necessary? J Foot Ankle Surg 2011; 51:71-5. [PMID: 22083067 DOI: 10.1053/j.jfas.2011.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Indexed: 02/03/2023]
Abstract
Complex reconstruction after calcaneal excision for aggressive or malignant tumors has been advocated. In this report we describe a 7-year-old child who underwent chemotherapy followed by total calcanectomy for a primitive neuroectodermal tumor of the calcaneum. The near-normal function achieved after the operation leads us to believe that complex reconstruction after calcaneal excision is not warranted in every pediatric case. This report also highlights the benefits of the Cincinnati incision for calcanectomy, and describes the gait abnormalities after the operation. To the best of our knowledge, a description of the gait abnormality observed after calcanectomy for tumor resection in a pediatric patient has not been reported up to now.
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Affiliation(s)
- V Madhuri
- Paediatric Orthopaedic Unit, Christian Medical College, Vellore, India.
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Babazadeh S, Broadhead ML, Schlicht SM, Powell GJ, Tymms GM. Pathologic fracture of a calcaneal aneurysmal bone cyst. J Foot Ankle Surg 2011; 50:727-32. [PMID: 21652227 DOI: 10.1053/j.jfas.2011.04.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Indexed: 02/03/2023]
Abstract
A 21-year-old man presented with a pathologic fracture through the posterior aspect of the calcaneus into an aneurysmal bone cyst. The patient was treated using curettage, phenol, alcohol, and burr with open reduction and internal fixation. This is the first reported case of a pathologic fracture of an aneurysmal bone cyst of the calcaneus, highlighting the fracture potential of these lesions and the need for early management.
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Affiliation(s)
- Sina Babazadeh
- Department of Orthopaedics, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
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Roth S, Sestan B, Madarevic T, Gulan G, Gruber B, Miletic D. Endoscopic assistance in the treatment of calcaneal and humeral juvenile bone cysts. J Orthop Sci 2010; 15:837-42. [PMID: 21116905 DOI: 10.1007/s00776-010-1522-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 03/03/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Sandor Roth
- Institute of Children Orthopaedics, University Hospital Center Rijeka, 42 Kresimirova, Rijeka 51000, Croatia
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