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Abstract Objective The purpose of this study was to describe a surgical technique of bone resection with periosteal preservation and reconstruction in patients with high-grade bone malignant tumors and to determine its effect on local recurrences, and time and quality of bone union in bone autografting reconstruction. Patients and methods We retrospectively reviewed 11 cases of high-grade malignant bone tumors in children aged 4 to 16 years, who were treated with chemotherapy and tumor resection while preserving partially the adjacent periosteum. Tumors were located in the lower limb in eight cases; three tumors were in the humerus. The mean length of the bone defect after resection was 15.8 cm (range, 6–34.5 cm). Reconstruction was provided by non-vascularized autograft in eight cases (lower limb) and polymethyl methacrylate spacer in three cases (upper limb). Patients were followed up for a mean of 71 months. Results At the last follow-up, no patients had local recurrence. Three patients were dead because of metastasis. Bone union was good in time and quality in all children who had bone autografting. In cases of PMMA reconstruction, there was periosteal bone formation around the spacer. According to the MSTS functional score, patients with lower limb localizations had a mean score of 27.75 points and patients with upper limb localizations had a score of 24/30. Conclusion Preservation of the periosteum in bone resection for malignant tumors could be a good adjuvant alternative for bone reconstruction, without increasing the risk of local recurrence. However, patients must be carefully selected.

Claudication of the young patient is a very rare symptom for orthopaedic surgeons and it is often overlooked. We report a rare case of popliteal artery entrapment syndrome (PAES), discovered during a vascular claudication following post-traumatic anterior instability of the knee. The diagnosis was confirmed by CT angiography which showed a PAES, with a pathway in the inter-condylar notch. The patient had a releasing of the trapped vessel by myomectomy, with disappearance of vascular symptoms six months later. Through this case, we wanted to draw the attention of orthopaedic surgeons to the fact that the PAES can be asymptomatic. Its symptomatology can be triggered by a traumatic instability of the knee. Its presence represents a risk of lesion of the popliteal artery during arthroscopic ACL reconstruction. Therefore, it is important to think about this disease if a calf pain occurring after a ligament injury of the knee.

La maltraitance physique des enfants ou le syndrome des enfants battus est responsable de plus de 75.000 décès par an en France. Ce problème de santé publique reste sous diagnostiqué en Tunisie et dans le monde. Le chemin a été laborieux pour la reconnaissance du syndrome des enfants battus dans certaines sociétés même occidentales. Nous avons voulus exposer ce problème aux praticiens afin quéil soit mieux diagnostiqué et pris en charge. La maltraitance physique des enfants est appelé à tort syndrome de Silverman qui ne regroupe en fait que les lésions squelettiques chez ces enfants tels que les fractures.

In this study, we describe a 4-year-old boy with a head, cervical, and left shoulder injury following the reception of a heavy metallic door on his left side that resulted in SCIWORA. SCWORA is defined as spinal cord injury without x rays or CT scans lesions but can be detectable on RMI scans. SCIWORA follows trauma, sometimes trivial. The management consists of immobilization and nursing. The clinician should be aware of this entity. We are reporting the management of a four years old boy. [ABSTRACT FROM AUTHOR]

Primary pleomorphic liposarcoma of bone is an exceedingly rare sarcoma. We herein report the case of a primary pleomorphic liposarcoma of the distal femur in a 20-year-old female patient. Magnetic resonance imaging showed a 25.4-mm medullary necrotic tumor process in the lower third of the distal right femoral meta-diaphysis that was weakly enhanced after gadolinium injection. The patient first underwent an open biopsy. Microscopically, a pleomorphic liposarcoma were suspected. Immunohistochemically, tumor cells expressed the S-100 protein. Fluorescent in situ hybridization showed the absence of MDM2 gene amplification and the absence of EWING/PNET translocation. The diagnosis of primary pleomorphic liposarcoma of the bone was then retained. A wide resection and chemotherapy were performed. The patient died of liver metastasis after 8 months of follow-up. Primary pleomorphic liposarcoma has no specific clinical or radiological findings. Histological diagnosis and molecular study are crucial tools for making an accurate diagnosis. • Primary pleomorphic liposarcoma of the bone (PPLB) is exceedingly rare, representing <0.1% of primary bone tumors. • Radiological features are not specific. • Tumor cells strongly express S-100 protein with absence of MDM2 gene amplification and the absence of EWING/PNET translocation in FISH. [ABSTRACT FROM AUTHOR]

Reduction of developmental dislocation of the hip is difficult to achieve in children after walking age and particularly in older children. In fact, at this age the important retraction of the muscles around the hip associated with a marked acetabular dysplasia and elongation of the joint capsule explain the difficulty and instability of reduction and the frequency of complications. In this study we reviewed retrospectively the clinical and radiological results of 26 developmental dislocations of the hip treated by open reduction, pelvic osteotomy and femoral shortening in 21 children aged more than 5 years. Age at surgery ranged from 5 to 11 years (mean 7.5 years) with a follow-up of 1 to 8 years (mean 2 years 7 months). According to the clinical classification of MC Kay, 17 hips had a good result while 9 hips had a fair or poor result. According to the Severin classification system 18 hips had an excellent and good radiological result. Ten hips developed an avascular necrosis of the femoral head following the reduction.