A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Agrawal, Gaurav
- Modified Dynamic Suzuki Wire Frame for Proximal Interphalangeal Joint Fracture – A Case Report
Authors
1 Consulting Orthopaedic and Joint Reconstruction Surgeon, Lilavati Hospital & Research Centre, IN
2 Clinical Associate - Orthopaedic Surgery, PD Hinduja Hospital, Khar, IN
Source
The Indian Practitioner, Vol 74, No 6 (2021), Pagination: 42-47Abstract
Complex comminuted fractures of the base of the middle phalanx, proximal phalanx and proximal interphalangeal joint are a treatment challenge, as deformity, stiffness and loss of function are quite frequent and disabling, following surgical treatment. We present a case of a 31-year male who suffered from comminuted intra-articular fracture and dislocation of the middle phalangeal base of the little finger and middle finger of the same hand, a year apart. Both were closed injuries of the dominant hand. We used a modified dynamic Suzuki wire frame for treatment of both fractures in an acute setting and at late presentation for the middle finger and little finger respectively. Minimal soft tissue injury, capsulo-ligamentotaxis, early mobilisation with frame and early return to function were key aspects of this treatment. Modified dynamic Suzuki frame is a simple, minimally invasive, dynamic external fixation device, that allows early motion at PIPJ and eventually good remodelling and function at PIPJ and DIPJ, even in the long term. It can be used in modified forms for comminuted fractures of bases of distal and proximal phalanges as well.Keywords
Suzuki frame, phalanx fracture, middle phalanx, modified suzuki frame, hand fractures, ligamentotaxisReferences
- Shannon Carpenter, Rachel S, Rohde. Treatment of Phalangeal Fractures. Hand Clinics. 2013;29(4).
- Swanson AB. Fractures involving the digits of the hand. Orthop Clin North Am 1970;1(2): 261–74.
- Van Onselen EB, Karim RB, Hage JJ, et al. Prevalence and distribution of hand fractures. J Hand Surg Br 2003;28(5):491–5.
- Keramidas E, Solomos M, Page RE, et al. The Suzuki frame for complex intra-articular fractures of the proximal interphalangeal joint of the fingers. Ann Plast Surg 2007;58(5):484- 488.
- Salter RB, Simmonds DF, Malcolm BW, et al. The biological effect of continuous passive motion on the healing of fullthickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am 1980;62(8):1232- 1251.
- Ellis, SJ, Cheng, R, Prokopis, P. Treatment of proximal interphalangeal dorsal fracture-dislocation injuries with dynamic external fixation: a pins and rubber band system. J Hand Surg 2007; 32A: 1242–1250.
- Inanami, H, Ninomiya, S, Okutsu, I. Dynamic external finger fixator for fracture dislocation of the proximal interphalangeal joint. J Hand Surg Am 1993; 18: 160–164.
- Majumder, S, Peck, F, Watson, JS. Lessons learned from the management of complex intra-articular fractures at the base of the middle phalanges of fingers. J Hand Surg Br 2003; 28: 559–565.
- Schenck RR. Classification of fractures and dislo- cations of the proximal interphalangeal joint. Hand Clin 1994;10(2):179– 85.
- Stern, PJ, Roman, RJ, Kiefhaber, TR. Pilon fracture of the proximal interphalangeal joint. J Hand Surg Am 1991; 16: 844–850.
- Boussakri H, Elibrahimi A and Elmrini A. Dynamic Distraction External Fixation Derived from the SUZUKI Frame for Pip Joint Fractures. SM J Orthop. 2015;1(5):1025.
- Suzuki, Y, Matsunaga, T, Sato, S. Pins and rubbers traction system for treatment of comminuted intraarticular fractures and fracture-dislocations in the hand. J Hand Surg Br 1994; 19: 98–107.
- Deshmukh, SC, Kumar, D, Mathur, K. Complex fracturedislocation of the proximal interphalangeal joint of the hand. Results of a modified pins and rubbers traction system. J Bone Joint Surg Br 2004; 86: 406–412.
- Slade, JF, Baxamusa, TH, Wolfe, SW. External fixation of proximal interphalangeal joint fracture-dislocations. Atlas Hand Clin 2000; 5: 1–29.
- Nanno M, Kodera N, Tomori Y, Takai S. Pins and rubbers traction system for fractures of the proximal interphalangeal joint. J Orthop Surg (Hong Kong). 2019 May-Aug;27(2)
- Richter M et al. Long-term follow-up of fracture dislocations and comminuted fractures of the PIP joint treated with Suzuki’s pin and rubber traction system. Handchir Mikrochir Plast Chir. 2008 Oct;40(5):330-5. German.
- Development and Optimization of Dorzolamide Hydrochloride and Timolol Maleate in Situ Gel for Glaucoma Treatment
Authors
1 College of Pharmacy, IPS Academy, Indore-452012 (M.P), IN
Source
Asian Journal of Pharmaceutical Analysis, Vol 1, No 4 (2011), Pagination: 93-97Abstract
In glaucoma disease when monotherapy treatment does not adequately lower the intraocular pressure (IOP) of the eye, one or more agents are added or substituted because 40 % of treated subjects required more than one medication to achieve the therapeutic goal of 20% IOP reduction from baseline and One of the two patients of glaucoma commenced on initial monotherapy will require additional ocular hypertensive agents within two years to control IOP. The present study describe the in-situ gel of dorzolamide hydrochloride and timolol maleate as an anti-glaucoma agent using various concentrations of Pluronic F-127 (15 and 20 % w/v) as a temperature induced gelling system in combination with varying concentrations of hydroxyl propyl methyl cellulose (0.5, 1.0, 1.5% w/v) (Methocel K15M) as a viscosity enhancing agent with an objective of increasing contact time, achieving controlled release, reduction in frequency of administration and greater therapeutic efficacy of drug. The prepared in situ gels were evaluated for their visual appearance, clarity, pH, viscosity, gelling strength, drug content, in vitro release studies. The formulation F3 shows satisfactory results and show the drugs release over an eight hour period. The developed system of combination of dorzolamide hydrochloride and timolol maleate is thus a viable alternative to conventional eye drops.Keywords
Glaucoma, Dorzolamide Hydrochloride, Timolol Maleate, Pluronic F127, HPMC and in Situ Gelling System.- A Thigh Swelling, Neoplasm or Surprise?
Authors
1 Orthopaedic Surgery, Arogyanidhi Hospital, Mumbai, IN
2 Arogyanidhi Hospital, Mumbai, IN
3 KLS Memorial Hospital, IN
Source
The Indian Practitioner, Vol 71, No 6 (2018), Pagination: 34-37Abstract
In the absence of sufficient history, a chronic swelling in the limb may be mistaken as a soft tissue neoplasm, bony tumor or infection. Our patient, who had a chronic and recurrent swelling in the thigh was investigated thoroughly using MRI and CT scans. A specific diagnosis wasn’t reached despite these investigations and soft tissue neoplasm was feared in a rather young patient. Ultrasound was used to guide aspiration and biopsy of the swelling and it incidentally led us to a diagnosis. MRI is an accurate tool in diagnosis of soft tissue conditions, but ultrasound is simple, cost effective, easily available and sometimes more sensitive in diagnosing various conditions in soft tissues of the limbs.References
- “Cancer – Signs and symptoms”. NHS Choices. Archived from the original on 8 June 2014. Retrieved 10 June 2014.
- Longo DL, Fauci AS, et al. : Harrison’s Principles of internal medicine. New York: McGraw-Hill Companies. 18th ed; 2011.
- Lew DP, Waldvogel FA. Osteomyelitis. Lancet. 2004; 364 (9431):369–79.
- Manaster BJ, Roberts CC, Andrews CL, et al. Diagnostic and surgical imaging anatomy: musculoskeletal. Salt Lake City (UT): Amirsys; 2006.
- Mousa A. Al-abbadi : Avicenna J Med. 2011 Jul-Sep; 1(1): 18-28.
- Todd J, Frank R, et al. Baker’s cyst Diagnostic and surgical considerations : Sports Health. 2015 Jul; 7(4): 359-365.
- Bongartz G, Vestring T, Peters PE. Magnetic resonance tomography of soft tissue tumors. Radiologe 1992;32:584-90.
- Ando, Hatori; UPS J Med Sci. 2009 Mar; 114(1): 46–51.
- Osteoporosis in Orthopaedics:Review of Literature and Clinical Approach
Authors
1 Consulting Orthopaedic and Joint Reconstruction Surgeon, Lilavati Hospital and Research Centre, IN
2 Registrar, Dept of Orthopaedic Surgery, Lilavati Hospital and Research Centre, IN
Source
The Indian Practitioner, Vol 73, No 5 (2020), Pagination: 26-43Abstract
Osteoporosis affects 8 to 62 percent of women in India, with osteoporotic fractures leading to preventable morbidity and often mortality. Osteoporosis does not have any clinical symptoms and may often present with fracture as the first symptom. Our aim to review the literature and describe a clinical approach in osteoporosis was to help the practitioner and orthopaedic surgeon suspect, diagnose, treat, prevent, monitor, and lead a patient through uneventful surgery. Early diagnosis and effective treatment of osteoporosis can lead to decreased morbidity, mortality, and financial burden on the elderly and also improve their quality of life.Keywords
Osteoporosis, Osteopenia, Teriparatide, Bisphosphonates, Denosumab, Osteoporotic Fractures, T Score, Monitoring of Treatment, Bone Turnover Markers, Bone Density, DXA, BMD, FRAX Score.References
- Consensus Development Conference: Diagnosis, Prophylaxis and Treatment of Osteoporosis. Am J Med. 1991; 90[1]; 107-10.
- NIH Consensus Development Conference: Osteoporosis prevention, diagnosis and therapy. JAMA. 2001 Feb 14; 285[6]: 785-95.
- Kanis JA on behalf of the World Health Organization Scientific Group. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield; UK: 2007. Assessment of osteoporosis at the primary health-care level.
- Sozen T, Ozisic L et al. An overview and management of osteoporosis : Eur J Rheumatol. 2017; 4[1]: 46-56.
- Gullberg B, Johnell O et al. Worldwide projections for hip fracture. Osteoporos Int. 1997; 7[5]:407- 413.
- Malhotra N, Mithal A et al. Osteoporosis in Indians. Indian J Med Res. 2008 Mar; 127[3]:263-8.
- Khadilkar VA, Mandlik RM et al. Epidemiology and treatment of osteoporosis in women: an Indian perspective : Int J Women’s Health. 2015; 7: 841-850.
- Gandhi AB, Shukla AK et al. Evaluation of BMD of women above 40 years of age: J Obstet Gynaecol India. 2005 May; 55[3]: 265-267.
- Unni J, Garg R, Pawar R. Bone mineral density in women above 40 years. J Midlife Health. 2010:1:19-22.
- Chhibber G, Roy R et al. Prevalence of osteoporosis among elderly women living in Delhi and rural Haryana. Indian J Endocr Metab. 2007; 11:11-14.
- Shatrughna V, Kulkarni B et al. Bone status of Indian women from a low-income group and its relationship to nutritional status. Osteoporos Int. 2005; 16[12]:1827-1835.
- Klotzbuecher CM, Ross PD et al. Patients with prior fractures have an increased risk of future fractures: A summary of the literature and statistical synthesis. J Bone Miner Res. 2000; 15[4]: 721-739.
- Harrison RA, Siminoski K et al. Osteoporosis related kyphosis and impairments in pulmonary function: a systematic review. J Bone Miner Res. 2007; 22[3]: 447-457.
- Cooper C, Atkinson EJ et al. Population based study of survival after osteoporotic fractures. Am J Epidemiol. 1993; 137[9]:1001-1005.
- Ray NF, Chan JK et al. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: Report from the National Osteoporosis Foundation. J Bone Miner Res. 1997; 12[1]:24- 35.
- Adapted from Melton LJ and Regis BL. Osteoporosis: Etiology, Diagnosis and Management. Raven Press. 1988, 155-179.
- Lin YC, Lyle RM et al. Peak spine and femoral neck bone mass in young women. Bone. 2003; 32[5]:546-553.
- Rizzoli R, Bonjour JP et al. Osteoporosis, genetics and hormones. J Mol Endocrinol. 2001; 26[2]:79-94.
- Eismann JA. Genetics of osteoporosis. Endocr Rev. 1999; 20[6]:788-804.
- Riggs BL, Melton LJ. Involutional Osteoporosis. N Engl J Med. 1986; 314:1676-1686.
- Ribot C, Pouilles JM et al. Assessment of the risk of postmenopausal osteoporosis using clinical factors.
- Tannirandorn P, Epstein S. Drug-induced bone loss. Osteoporos Int. 2000; 11[8]:637-659.
- Marshall D, Johnell O et al. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996;312[7041]:1254-1259.
- Hui SL, Slemenda CW et al. Age and bone mass as predictors of fractures in a prospective study. J Clin Invest. 1998; 81[6]:1804-1809.
- World Health Organization. Technical report series 843, WHO, Geneva. 1994.
- Baim S, Binkley N et al. Official positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD position development conference. J Clin Densitom. 2008; 11[1]:75-91.
- Rauch F, Plotkin H et al. Fracture prediction and the definition of osteoporosis in children and adolescents: The ICSD 2007 Paediatric Official Positions. J Clin Densitom. 2008; 11[1]:22-28.
- Gordon CM, Bachrach LK et al. Dual energy x-ray absorptiometry interpretation and reporting in children and adolescents: the 2007 paediatric official positions. J Clin Densitom. 2008; 11:43-58.
- Unnanuntana A, Gladnick BP et al. The assessment of fracture risk. J Bone Joint Surg Am. 2010; 92[3]:743-753.
- Dufresne TE, Chmielewski PA et al. Risedronate preserves bone architecture in early postmenopausal women in 1 year as measured by three-dimensional microcomputed tomography. Calcif Tissue Int. 2003;73: 423-32.
- Cummings SR, Karpf DB et al. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs. Am J Med. 2002;112: 281-9.
- Lochmuller EM, Zeller JB, et al. Correlation of femoral and lumbar DXA and calcaneal ultrasound, measured in situ with intact soft tissues, with the in vitro failure loads of the proximal femur. Osteoporos Int. 1998; 8:591-8.
- Melton LJ, Chrischilles EA et al. How many women have osteoporosis? J Bone Miner Res. 1992; 7:1005-10.
- Siris ES, Chen YT, et al. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004; 164:1108-12.
- Schuit SC, Vanderklift M et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam study. Bone. 2004; 34:195-202. Erratum in: Bone. 2006; 38:603.
- Sornay-Rendu E, Munoz F, et al. Identification of osteopenic women at high risk of fracture : the OFELY study. J Bone Miner Res. 2005; 20:1813-9.
- Greenspan SL, Myers ER et al. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA. 1994; 271:128-33.
- Garnero P, Hausherr E et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS prospective study. J Bone Miner Res. 1996;11: 1531-8.National Osteoporosis Foundation. Physician’s guide to prevention and treatment of osteoporosis. Belle Mead, NJ: Excerpta Medica; 2003.
- Kanis JA, McCloskey EV et al; National Osteoporosis Guideline Group. Case finding for the management of osteoporosis with FRAX—assessment and intervention thresholds for the UK. Osteoporos Int. 2008; 19:1395-408.
- Kanis JA, Oden A et al. FRAX and its applications to clinical practice. Bone. 2009; 44:734-43.
- Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002; 359:1929-36.
- Kanis JA, Johnell O et al. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19:385-97.
- Kanis JA, Johnell O et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004; 35:375-82.
- Kanis JA, Oden A, et al. The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int. 2007; 18:1033-46.
- Zethraeus N, Borgstrom F et al. Cost-effectiveness of the treatment and prevention of osteoporosis — a review of the literature and a reference model. Osteoporos Int. 2007; 18:923.
- Tang BM, Eslick GD et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: A meta-analysis. Lancet. 2007; 370[9588]:657-666.
- Bonaiuti D, Shea B et al. Exercise for preventing and treating osteoporosis in postmenopausal women. The Cochrane database of systematic reviews. 2002; [2]:CD000333.
- Feskanich D, Willett W et al. Walking and leisure time activity and risk of hip fracture in post- menopausal women. JAMA. 2002; 288[18]:2300-2306.
- Masud T, Binkley N et al. Position development conference members. Official positions for FRAX clinical regarding falls and frailty : can falls and frailty be used in FRAX?
- From joint official positions development conference of the ISCD and international osteoporosis foundation on FRAX. J Clin Densitom. 2011; 14[3]:194-204.
- National Osteoporosis Foundation. Clinician’s guide to prevention and treatment of osteoporosis. 2008. http://www.nof.org/professionals/cliniciansguide_ form.asp. Accessed 2009 Oct 22.
- Dawson-Hughes B, Tosteson AN et al. National Osteoporosis Foundation Guide Committee. Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int. 2008; 19:449-58.
- Riggs BL, Parfit AM. Drugs used to treat osteoporosis : the critical need for a uniform nomenclature based on their action on bone remodelling. J Bone Miner Res. 2005;20[2]:17784.
- Hewitt RE, Lissina A, et al. The bisphosphonate acute phase response : rapid and copious production of pro inflammatory cytokines by peripheral blood and T cells in response to amino bisphosphonates is inhibited by statins. Clin Exp Immunol. 2005; 139[1]:101-111.
- Perazella MA, Markowitz GS. Bisphosphonate nephrotoxicity. Kidney Int. 2008; 74[11]: 1385-1393.
- Rizzoli R, Burlet et al. Osteonecrosis of the jaw and bisphosphonate treatment for osteoporosis. Bone. 2008; 42[5]:841-847
- Allison MB, Markman L et al. Atypical incomplete femoral fractures in asymptomatic patients on long term bisphosphonate therapy. Bone. 2013; 55[1]:113-118.
- McKenna MJ, van der Kamp S et al. Incomplete atypical femoral fractures: assessing the diagnostic utility of DXA by extending femur length. J Clin Densitom. 2013; 16[4]: 579583.
- Diab DL, Watts NB, et al. Bisphosphonate drug holiday : Who when and how long. Ther Adv Musculoskelet Dis. 2013; 5[3]:107-111.
- Boyle WJ, Simonet WS et al. Osteoclast differentiation and activation. Nature. 2003; 423[6937]: 337-342.
- Black DM, Schwartz AV, et al. Effects of continuing or stopping alendronate after 5 years of treatment: The Fracture Intervention Trial Long - Term Extension [FLEX] : A randomised trial. JAMA. 2006; 296[24]:2927-2938.
- Black DM, Greenspan SL, et al. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med. 2003; 349: 1207-1215.
- Deal C, Omizo M, et al. Combination teriparatide and raloxifene therapy for postmenopausal osteoporosis : results from 6 - month —blind placebo - controlled trial. J Bone Miner Res. 2005; 20:1905-1911.
- Cosman F, Eriksen EF et al. Effects of intravenous Zoledronic acid plus subcutaneous teriparatide [rhPTH[1-34]] in postmenopausal osteoporosis. J Bone Miner Res. 2011;26[3]:503511
- Leder BZ, Tsai JN, et al. Two years of denosumab and teriparatide administration in postmenopausal women with osteoporosis [the DATA extension study]: A randomised control trial. J CLin Endocrine Metab; 2014; 99[5]:1694-1700.
- van Staa TP, Leufkens HG et al. Does a fracture at one site predict later fractures at other sites? A British cohort study. Osteoporos Int. 2002; 13:624-629.
- Johnell O, Oden A et al. Acute and long term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int. 2001:12:207-214
- Johnell O, Kanis JA et al. Fracture risk following an osteoporotic fracture. Osteoporos Int. 2004; 15:175-179
- Kanis JA. Treatment of osteoporotic fracture. Lancet. 1984; 17[1]:27-33.
- Seeley DG, Browner WS et al. Which fractures are associated with low appendicular bone mass in elderly women? The Study of Osteoporotic Fractures Research Group. Ann Intern Med. 1981; 115:837-842.
- Kanis JA, Oden A et al. The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001; 12:417-427.
- Mackey DC, Black DM et al. Effects of anti- resorptive treatment on nonvertebral fracture outcomes. J Bone Miner Res. 2011; 26:2411-2418.
- Cummings SR, Karpf DB et al. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs. Am J Med. 2002; 112:281-289.
- Sarkar S, Mitlak BH et al. Relationships between bone mineral density and incident vertebral fracture risk with raloxifene therapy. J Bone Miner Res. 2002; 17:1-10.
- Delmas PD, Li Z et al. Relationship between changes in bone mineral density and fracture risk reduction with antiresorptive drugs: some issues with meta-analyses. J Bone Miner Res. 2004; 19:33-37.
- Delmas PD, Seeman E. Changes in bone mineral density explain little of the reduction in vertebral or non-vertebral fracture risk with anti-resorptive therapy. Bone. 2004; 34:599-604.
- Eastell R, Barton I et al. Relationship of early changes in bone resorption to the reduction in fracture risk with risedronate. J Bone Miner Res. 2003; 18:1051-1056.
- Eastell R, Hannon RA et al. Relationship of early changes in bone resorption to the reduction in fracture risk with risedronate: review of statistical analysis. J Bone Miner Res. 2007; 22:1656-1660.
- Reginster J-Y, Sarkar S, Zegels B et al. Reduction in PINP, a marker of bone metabolism, with raloxifene treatment and its relationship with vertebral fracture risk. Bone. 2004; 34:344-351.
- Sarkar S, Reginster J-Y et al. Relationship between changes in biochemical markers of bone turnover and BMD to predict vertebral fracture risk. J Bone Miner Res. 2004; 19:394-401.
- Bauer DC, Black DM, Garnero P et al. Change in bone turnover and hip, non-spine, and vertebral fracture in alendronatetreated women: the fracture intervention trial. J Bone Miner Res. 2004; 19:1250-1258.
- Delmas PD, Munoz F et al. Effects of yearly zoledronic acid 5 mg on bone turnover markers and relation of PINP with fracture reduction in postmenopausal women with osteoporosis. J Bone Miner Res. 2009; 24:1544-1551.
- Glover SJ, Gall M et al. Establishing a reference interval for bone turnover markers in 637 healthy, young, premenopausal women from the United Kingdom, France, Belgium, and the United States. J Bone Miner Res. 2009;24:389-397.
- Vasikaran S, Eastell R, Bruyere O, for the IOF-IFCC Bone Marker Standards Working Group et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011; 22:391-420.
- Jobke B, Muche B et al. Teriparatide in bisphosphonate-resistant osteoporosis: microarchitectural changes and clinical results after 6 and 18 months. Calcif Tissue Int. 2011; 89:130-139.
- Keaveny TM, McClung MR et al. Femoral strength in osteoporotic women treated with teriparatide or alendronate. Bone. 2012; 50:165-170.
- Hadji P, Gamerdinger D et al. Rapid Onset and Sustained Efficacy [ROSE] study: results of a randomised, multi- centre trial comparing the effect of zoledronic acid or alendronate on bone metabolism in postmenopausal women with low bone mass. Osteoporos Int. 2012; 23:625-633.
- Saag K, Lindsay R et al. A single zoledronic acid infusion reduces bone resorption markers more rapidly than weekly oral alendronate in postmenopausal women with low bone mineral density. Bone. 2007; 40:1238-1243.
- Freemantle N, Satram-Hoang S et al. Final results of the DAPS [Denosumab Adherence Preference Satisfaction] study: a 24-month, randomized, crossover comparison with alendr- onate in postmenopausal women. Osteoporos Int. 2012; 23:317-326.
- Nguyen TV, Eisman JA et al. Femoral neck bone loss predicts fracture risk independent of baseline BMD. J Bone Miner Res. 2009; 20[7]:1195-1201.
- Lewiecki EM. Non-responders to osteoporosis therapy. J Clin Densitom. 2003; 6[4]:307-314.
- Adami S, Isaia G et al. Fracture incidence and characterization in patients on osteoporosis treatment: the ICARO study. J Bone Miner Res. 2006; 21:1565-1570.
- Diez-Perez A, Olmos JM et al. Risk factors for prediction of inadequate response to antiresorptives. J Bone Miner Res. 2012; 27:817-824.
- Ip TP, Leung J et al. Management of osteoporosis in patients hospitalised for hip fractures, Osteoporos Int. 2010; 21[4]:605-614.
- Joong BS, Yun JSn et al. Influence of Early Bisphosphonate Administration for Fracture Healing in Patients with Osteoporotic Proximal Humerus Fractures. Clin Orthop Surg. 2016; 8[4]:437-443.
- Kim TY, Ha YC et al. Does early administration of bisphosphonate affect fracture healing in patients with intertrochanteric fractures? J Bone Joint Surg Br. 2012; 94[7]:956-960.
- Gong HS, Song CH et al. Early initiation of bisphosphonate does not affect healing and outcomes of volar plate fixation of osteoporotic distal radial fractures. J Bone Joint Surg Am. 2012; 94[19]:1729- 1736.
- Eriksen EF, Lyles KW et al. Antifracture efficacy and reduction of mortality in relation to timing of first dose of zoledronic acid after hip fracture. J Bone Miner Res. 2009; 24[7]:1308-1313.
- Dirschl DR, Henderson RC et al. Accelerated bone mineral loss following a hip fracture: a longitudinal study. Bone. 1997; 21[1]:79-82.
- Li YT, Cai HF et al. Timing of the initiation of bisphosphonates after surgery for fracture healing : a systematic review and meta-analysis of randomised controlled trials. Osteoporos Int. 2015; 26[2]:431-441.
- Giannoudis P1, Tzioupis C et al. Fracture healing in osteoporotic fractures: is it really different? A basic science perspective. Injury. 2007; 38[1]:590-599.
- Cortet B. Bone repair in osteoporotic bone: postmenopausal and cortisone induced osteoporosis. Osteoporosis Int. 2011; 22:2007-2010.
- Cornell CN. Internal fracture fixation in patients with osteoporosis. J Am Acad Orthop Surg. 2003; 11:109-119.
- Bogunovic L, Cherney SM et al. Biomechanical considerations for surgical stabilization of osteoporotic fractures. Orthop Clin North Am. 2013; 44:183-200.
- Johanson NA, Litrenta J et al. Surgical treatment options in patients with impaired bone quality. Clin Orthop Relat Res. 2011; 469:2237-2240.
- Glomus Tumor - A Delayed Diagnosis, Yet Simple Cure: Case Reports
Authors
1 Orthopaedic surgery, Lilavati Hospital & Research Center, Mumbai, India, IN
2 Orthopaedic Surgery, PD Hinduja Hospital, Khar, Mumbai, India, IN
3 Orthopaedic surgery, PD Hinduja Hospital, Mumbai, India, IN
Source
The Indian Practitioner, Vol 75, No 1 (2022), Pagination: 33-40Abstract
Glomus tumors are rare soft-tissue neoplasms that constitute 2% of all soft-tissue tumors in the extremities. They are painful lesions that can impair quality of life. Diagnosis is often delayed as they can easily be confused with more common pathologies. They are best diagnosed through MRI scan or ultrasonography of the concerned digit. We present two cases in this article, one of a subungual glomus tumor of the great toe (Hallux) and one of the index finger. Both tumors had a delay in diagnosis as this tumor cannot easily be diagnosed through simple radiographs. They showed classical clinical symptoms.Both were eventually diagnosed on MRI scan. Surgical excision is the gold standard in treatment of subungual glomus tumors and is also curative. We used a transungual approach for the hallux and a lateral subperiosteal approach for the index finger. In conclusion, glomus tumors are rare, benign tumors that commonly occur in the sub-ungual region. High clinical suspicion is important for clinical diagnosis. MRI scan and ultrasound can diagnose the tumor and yield information about local spread. Surgical excision is usually curative with approximately 10% chance of recurrence and rare chance of malignant transformation
Keywords
Glomus Tumor, Sub-ungual, Love test, Transungual, Benign tumor, Hallux tumor, Glomus bodyReferences
- Mravic M, LaChaud G, Nguyen A, Scott MA, Dry SM, James AW. Clinical and histopathological diagnosis of glomus tumor: an institutional experience of 138 cases. Int J Surg Pathol.2015 May;23(3):181-8.
- Fletcher CDM, Unni K, and Meretens F, editors. Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC Press; 2002.p.136–137, The World Health Organization of Tumours; vol 5.
- Drape JL, Idy-Peretti I, Goettmann S, Guerin-Surville H, Bittoun J. Standard and high resolution magnetic resonance imaging of glomus tumors of toes and fingertips. J Am Acad Dermatol. 1996 Oct;35(4):550-5.
- Chiang YP, Hsu CY, Lien WC, Chang YJ. Ultrasonographic appearance of subungual glomus tumors. J Clin Ultrasound.2014 Jul-Aug;42(6):336-40.
- Theumann NH, Goettmann S, Le Viet D, Resnick D, Chung CB, Bittoun J, et al. Recurrent glomus tumors of fingertips: MR imaging evaluation. Radiology. 2002 Apr;223(1):143-51.
- Matloub HS, Muoneke VN, Prevel CD, Sanger JR, Yousif NJ.Glomus tumor imaging: use of MRI for localization of occult lesions. J Hand Surg Am. 1992 May;17(3):472-5.
- Weiss SW, Goldblum JR, editors. Perivascular tumors. In: Enzinger and Weiss’s Soft Tissue Tumors. 4th ed. St Louis, Mo: Mosby; 2001.p.985–1001.
- Netscher DT, Aburto J, Koepplinger M. Subungual Glomus Tumor. J Hand Surg Am. 2011 Dec;37(4):821-3.
- Gandhi J, Yang SS, Hurd J. The anatomic location of digital glomus tumor recurrences. J Hand Surg Am. 2010 Jun; 35(6):986-9.
- Roddy E. Revisiting the pathogenesis of podagra: why does gout target the foot?. J Foot Ankle Res. 2011;4(1):13.doi:10.1186/1757-1146-4-13
- Love JG. Glomus tumors: diagnosis and treatment. Mayo Clin Staff Proc. 1944;19:113–6.
- Roan TL, Chen CK, Horng SY, Hsieh JH, Tai HC, Hsieh MH, et al. Surgical technique innovation for the excision of subungual glomus tumors. Dermatol Surg. 2011;37:259–62
- Vasisht B, Watson HK, Joseph E, Lionelli GT. Digital glomus tumors: A 29-year experience with a lateral subperiosteal approach. Plast Reconstr Surg. 2004;114:1486–9.
- McDermott EM, Weiss AP. Glomus Tumors. J Hand Surg Am.2006;31:1397-1400
- Caroll RE, Berman AT. Glomus tumors of the hand: Review of literature and report on 28 cases. J Bone Joint Surg Am.1972;54:691-703
- Schiefer TK, Parker WL, Anakwenze OA, Amadio PC, et al.Extra digital glomus tumors: a 20-year experience. Mayo Clin Proc. 2006;81:1337–1344
- Strahan J, Bailie HW. Glomus Tumor. A review of 15 cases.Br J Surg. 1972;59:91–93
- Trehan SK, Soukup DS, Mintz DN, Perino G, Ellis SJ.Glomus Tumors in the Foot: Case Series. Foot Ankle Spec.2015 Dec;8(6):460–5.
- Van Geertruyden J, Lorea P, Goldschmidt D, de Fontaine S, Schuind F, Kinnen L, Ledoux P, Moermans JP. Glomus tumours of the hand. A retrospective study of 51 cases. J Hand Surg Br. 1996 Apr;21(2):257–60.
- Hildreth DH. The ischaemia for glomus tumors: a new diagnostic test. Rev. Surg. 1970;27:147–148.
- Bao-guo S, Wu Yun-tao W, Jia-Zhen L. Glomus tumours of the hand and foot. International Orthopaedics. 1997 Jan; 20(6):339–341.
- Mohler DG, Lim CK, Martin B. Glomus tumor of the plantar arch: a case report with magnetic resonance imaging findings. Foot Ankle Int. 1997 Oct;18(10):672–4.
- Matsunaga A, Ochiai T, Abe I, et al. Subungual glomus tumour: evaluation of ultrasound imaging in preoperative assessment. Eur J Dermatol. 2007 Jan-Feb;17(1):67–9.
- Chen SH, Chen YL, Cheng MH, Yeow KM, Chen HC, Wei FC. The use of ultrasonography in preoperative localization of digital glomus tumors. Plast Reconstr Surg. 2003 Jul;112(1):115-9.
- Fornage BD. Glomus tumors in the fingers: diagnosis with US. Radiology. 1988 Apr;167(1):183-5.
- Cha SM, Shin HD, Park YC. Surgical Resection of Occult Subungual Glomus Tumors: Cold Sensitivity and Sonographic Findings. Ann Plast Surg. 2018 Oct;81(4):411-415.
- Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Subhi F, El-Shayeb AF. Magnetic resonance imaging in the diagnosis of glomus tumours of the hand. J Hand Surg Br. 2005 Oct; 30(5):535-40.
- Mundada P, Becker M, Lenoir V, Stefanelli S, Rougemont AL, Beaulieu JY, et al. High resolution MRI of nail tumors and tumor-like conditions. Eur J Radiol. 2019 Mar;112:93-105.
- Lee SH, Roh MR, Chung KY. Subungual glomus tumors: surgical approach and outcome based on tumor location. Dermatol Surg. 2013 Jul;39(7):1017-22.
- Tada H, Hirayma T, Takemitsu Y. Prevention of postoperative nail deformity after subungual glomus resection. J Hand Surg Am. 1994;19:500–3.
- Grover C, Khurana A, Jain R, Rathi V. Transungual surgical excision of subungual glomus tumour. J Cutan Aesthet Surg.2013;6(4):196-203. doi:10.4103/0974-2077.123401
- Li TS, Choong MY, Wu CI, Chen HC, Chung KC. Autologous fat graft to restore nail bed contour following resection of a subungual glomus. J Hand Surg Am. 2011;36:726–8.
- Kim YJ, Kim DH, Park JS, Baek JH, Kim KJ, Lee JH. Factors affecting surgical outcomes of digital glomus tumour: a multicentre study. J Hand Surg Eur Vol. 2018 Jul;43(6):652-658.
- Gandhi J, Yang SS, Hurd J. The anatomic location of digital glomus tumor recurrences. J Hand Surg Am. 2010;35:986–9.