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  • ISSN: 2373-9290
    Early Online
    Volume 5, Issue 2
    Review Article
    Thomas Knapper*, Karl Logan, and Daniel Gheorghiu
    Paget's disease of the bone remains the second commonest metabolic bone disease in adults. Early diagnosis and appropriate management is essential to reduce the risk of potentially debilitating consequences. Diagnosis can be challenging; with many patients initially asymptomatic. In the majority of cases it is a diagnosis made incidentally with either an unexplained alkaline phosphatase or radiographic abnormalities. In this review we focus on providing a clear understanding of the current concepts and theories regarding aetiology, pathophysiology, diagnosis and treatment of Paget's disease.
    Al-Mutair Angham* and Alsubhi Rajaa
    Rickets is a disorder that results from decreased mineralization of the growth plate in the growing infant, child and adolescent. Rickets can occur as heritable disorders with multiple genes mutations in different etiologies of types of rickets. There are different ways of classifying types of rickets, the most commonly used is to be classified as calciopenic and phosphopenic rickets. Calciopenic rickets is due to nutritional deficiency of vitamin D and or calcium and rarely due to vitamin D defect in its cellular action or its metabolism to active metabolite-calcitriol or due to excess loss of calcium in urine. Phosphopenic rickets is mainly due to renal phosphate wasting either due to primary renal tubular defect or excess generation of phosphatonin, compounds that inhibit phosphate reabsorption from renal tubules but unusually related to dietary phosphate deficiency that is wide available. Abnormalities in the alkaline phosphate synthesis impaired bone mineralization can be a rare cause of rickets. Serum 25-hydroxyvitamin D concentrations are low in vitamin D deficiency rickets and hereditary form of rickets due to inactivating mutations in CYP2R1 gene while may be normal in other hereditary forms of rickets in these latter disorders, the serum 1,25-dihydroxy vitamin D concentrations are often low or inappropriately in the normal range and can be high in vitamin D-resistant rickets. Treatment of each type of rickets depends on the underlying etiologies.
    Case Series
    Acker A, Portnoy L, Ohana N, and Korngreen A
    The use of intramedullary devices to fix intertrochanteric Neck of Femur fractures is an internationally well-established fixation method which demonstrated mechanical and biological advantages, especially in the treatment of unstable fractures patterns. Despite the biomechanically proved advantages of the proximal femoral nails, some complications had occurred over the years. A very rare type of complication was sporadically reported over the last few years, and was termed "Cut-in" or "medial migration" of the blade. We will present our experience of 2 cases with the "cut-in" complication and review the latest literature.
    Opinion
    Stasinopoulos Dimitrios*
    One of the most common tendinopathies of the upper limb is Lateral Elbow Tendinopathy (LET). LET is defined as pain in the lateral epicondyle1 and is characterized by disorganized collagen, an increased presence of fibroblasts, the absence of prostaglandins and inflammatory cells [1].
    Case Report
    Bruno Pavei*
    Objectives: To describe a rare case of significant vascular injury that occurred following the harvest of hamstring tendon graft for anterior cruciate ligament reconstruction, with the need of repair.
    Case report: A 30-year-old male soccer player presented with significant swelling and acute pain two hours after anterior cruciate ligament (ACL) reconstruction. Clinical examination and MRI scan showed bleeding, and a large hematoma in the middle of the left thigh. Hemorrhagic contention was only possible after a secondary repair, where a vessel of the sartorius muscle was bleeding profusely 12 hours after the primary surgery.
    Discussion: The presence of a large number of vessels on the medial side of the knee associated with blind flexor tendons graft hamstring is cause of vascular injury during removal of the hamstring graft.
    Conclusion: Although uncommon, graft hamstring of flexor tendons can have devastating consequences if some hemostasis procedures are not correctly applied.
    Case Report
    Maximilian Maechler, Joerg Friesenbichler, Werner Maurer-Ertl, Lukas A Holzer, KoppanyBodo and Andreas Leithner
    Abstract: Giant cell tumours (GCT) of bone are classified as benign or intermediate neoplasm and affect long bones in most of the cases. However, giant cell tumour of bone represents about 5% of primary bone tumours, but occurrence of multifocal GCT is rare. Multifocal GCTs occur in less than 1% and metastatic spread of these lesions is very uncommon. Further, reports of multifocal, metachronous GCTs are very rare in literature.
    Herein, we present a case of a 59-year old male patient, who suffered from multifocal, metachronous GCT, which involved the skull, the sacrum, lung and abdomen.
    Due to the fact that this case is rather rare, right diagnosis is getting complicated because metastatic lesions of the masked primary giant cell tumour of bone could be misunderstood and may lead to other ways of therapy. In conclusion the present case report emphasizes the possibility of a multifocal GCT of bone as a possible differential diagnosis for multiple osteolytic lesions with metastatic spread to lungs, abdomen or other regions.
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