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A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis

January 10, 2019/0 Comments/in Vol 3 | Issue 1| Jan-June 2019 /by ASESADMIN2016

Acta of Shoulder and Elbow Surgery | Volume 3 | Issue 1 | Jan- June 2019 | Page 3-6 | Michał Górecki, Piotr Czarnecki Authors: Michał Górecki [1], Piotr Czarnecki [2]. [1] Student Research Group of Hand Surgery, University of Medical Sciences Poznań, Poland [2] Department of Traumatology, Orthopaedics and Hand Surgery of Viktor Dega […]

Training by Publishing

January 10, 2019/0 Comments/in Vol 3 | Issue 1| Jan-June 2019 /by ASESADMIN2016

Acta of Shoulder and Elbow Surgery | Volume 3 | Issue 1 | Jan-June 2019 | Page 1-2 | Ashok Shyam Author: Ashok Shyam [1,2]. [1] Indian Orthopaedic Research Group, Thane, India [2] Sancheti Institute for Orthopaedics &Rehabilitation, Pune, India Address of Correspondence Dr. Ashok Shyam. IORG House, A-203, Manthan Apts, Shreesh CHS, Hajuri Road, Thane, India. 400604 Email: […]

A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis

January 10, 2019/0 Comments/in Vol 3 | Issue 1| Jan-June 2019 /by ASESADMIN2016

Training by Publishing

January 10, 2019/0 Comments/in Vol 3 | Issue 1| Jan-June 2019 /by ASESADMIN2016

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A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis

January 10, 2019/0 Comments/in Vol 3 | Issue 1| Jan-June 2019 /by ASESADMIN2016

Authors: Michał Górecki [1], Piotr Czarnecki [2].

[1] Student Research Group of Hand Surgery, University of Medical Sciences Poznań, Poland
[2] Department of Traumatology, Orthopaedics and Hand Surgery of Viktor Dega Orthopedic and Rehabilitation Clinical Hospital

Address of Correspondence
Dr. Michał Górecki,
Mścibora 74, 61-062 Poznań, Poland
E-mail: michalmgorecki@gmail.com

Abstract

Background: Osteochondromas are the most common form of benign bone tumour. They are mostly asymptomatic, but sometimes they can irritate surrounding structures, like vessels or nerves, and cause complications. More often they apply to the lower extremities, especially around the knee joint. Osteochondromas which cause complications in the upper extremities are much less common. This paper presents a rare case of a brachial artery pseudoaneurysm as a complication of a proximal humerus exostosis, which was initially described and treated as malignant tumour of the arm. A comprehensive review of the literature has also been carried out.
Methods: A 19-year-old male patient was admitted with acute pain of the left arm. Eight years earlier he had been diagnosed with hereditary multiple osteochondromas. Examination revealed a palpable, non-painful tumour of the axilla’s area and the posterior part of the left arm. An magnetic resonance imaging (MRI) with contrast demonstrated three osteochondromas in the area of the proximal humerus. From the free end of one of these, a big, nodular structure was spreading. From the MRI, a chondrosarcoma was suspected. Samples were taken for histopathological examination. After the surgery, increased pulsations were observed around the operative area. A ultrasonography (USG) revealed a fibrotic pseudoaneurysm of the left brachial artery. Histopathological examination showed deposits of heamosiderin without any cancer cells. With the change in diagnosis, the next stage of treatment was planned – artery reconstruction using a saphenous vein graft and an osteochondroma excision.
Results: A few weeks after surgery, the patient recovered full function of the upper extremity and did not report any discomfort. A control USG showed proper flow through the brachial artery and venous graft.
Conclusion: In the case of a tumour in the area of an osteochondroma, caused by trauma, a pseudoaneurysm should be suspected. Diagnostic and therapeutic treatment must be properly planned, as unrecognised it could cause a severe, life-threatening haemorrhage during the operation.
Keywords: pseudoaneurysm, osteochondroma, malignant transformation, brachial artery, chondrosarcoma.

References

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How to Cite this article: Górecki M, Czarnecki P. A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis. Acta of Shoulder and Elbow Surgery Jan- June 2019;3(1):3-6.

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Training by Publishing

January 10, 2019/0 Comments/in Vol 3 | Issue 1| Jan-June 2019 /by ASESADMIN2016

Author: Ashok Shyam [1,2].

[1] Indian Orthopaedic Research Group, Thane, India
[2] Sancheti Institute for Orthopaedics &Rehabilitation, Pune, India

Address of Correspondence
Dr. Ashok Shyam.
IORG House, A-203, Manthan Apts, Shreesh CHS, Hajuri Road, Thane, India. 400604
Email: drashokshyam@yahoo.co.uk

This is a digital world we live in. In last 20 years technology has changed the face of this world specially the way in which the data is shared and interaction is improved. This has accelerated things especially scientific inquiry and distribution of scientific concepts. In field of orthopaedics this has lead to better implants and more literature. Increased numbers of journals and articles have led to increased awareness about the results of particular surgery and implant. Also it has improved the propagation of awareness about a new technique / implant and its results. In last century, a new technique would simply remain with a single surgeon or country for a long time [Ilizarov ring fixator for example], but now with advent of the online tools and websites, distribution of knowledge is simply amazing.
One of the areas where technology can be successfully used is area of Training in surgical skills. We are currently having video websites like Vu-medi and many more videos on you tube etc, however I believe journals can play a very active part in this area. Surgical training of highest quality can reach each and every corner of the world simply by combining a format which will include text, pictures as well as videos. We all have basic surgical skill sets and to step up our training we would simply need to conceptualise and visualise different methods. This can easily be gained from the above format. Of course the learning curve for such training would be much longer and at times there will be unforeseen complications and difficulties. For this reason such articles should have a continued thread of comment and discussions which can be compiled over a period of time and better a list of frequently asked questions. This can provide answers to queries for a new trainee or even for an experienced surgeon. I believe the techniques should be open peer reviewed and not undergo a blinded peer review. The reviewers should be openly allowed to ask the surgeons questions and doubts that the reader will have. A post publication review of the technique is one of the most important part of this initiative where readers and peers can comment on the published technique. The goal of this entire exercise should be improvement of technique and to impart correct surgical principles to the trainees.
Acta of Shoulder and Elbow Surgery wants to pioneer in this area of surgical training by publishing and will be inviting several surgeons on our special editorial board where techniques can be invited and published. I believe this will help surgeons from all across the world to learn new techniques and also improve older techniques. Innovations and tricks and tops in older techniques can easily be demonstrated by using the online tools. Open access will allow much better outreach and more audience for the author too. I sincerely hope that this idea will take firm root and will grow over a period of time

If you have any further opinions about this idea, please write to me. With this I leave you to enjoy this issue.

Dr. Ashok Shyam
Co-Editor in chief- Acta of Shoulder and Elbow Surgery

How to Cite this article:. Shyam A. Training by Publishing. Acta of Shoulder and Elbow Surgery Jan- June 2019;3(1):1-2.

Half Sized Blog Element (Single Author Style)

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A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis

Training by Publishing

A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis

Training by Publishing

Full Sized Blog Element (Big Preview Pic)

A brachial artery pseudoaneurysm in the form of a “malignant tumour” as a complication of a proximal humerus exostosis

Authors: Michał Górecki [1], Piotr Czarnecki [2].

Abstract

References

(Abstract Full Text HTML) (Download PDF)

Training by Publishing

Author: Ashok Shyam [1,2].

(Abstract Full Text HTML) (Download PDF)

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