[Melorheostosis of the hand. A case report]

Debridement arthroplasty of a rare case of elbow stiffness. A case report and literature review

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Melorheostosis of the elbow associated with elbow stiffness is extremely rare.

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In the standard radiology or orthopedics literature Melorheostosis (from the Greek: melos = limb, rheos = flow) is described monotonously as a “flowing hyperostosis” resembling dripping candle wax.

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Patients with this condition may have joint pain, stiffness, deformity, and restricted range of motion due to bony and soft-tissue contracture. Involvement usually follows a sclerotomal distribution and usually affects only one extremity.

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There is no standard treatment for melorheostosis, and management plans must be made on an individual patient basis. The aims of treatment are pain relief and maintaining function.

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Some Surgical treatment for this condition includes tendon lengthening, excision of fibrous and osseous tissue, fasciotomy, capsulotomy, sympathectomy, corrective osteotomy, Ilizarov lengthening, arthrodesis, implant arthroplasty, and even amputation of severely affected limbs with vascular ischemia.

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In this study we found that debridement arthroplasty is safe and effective in treating elbow stiffness associated with Melorheostosis.

Introduction

Elbow stiffness is a common condition that affects the quality of life of patients. Melorheostosis of the elbow associated with elbow stiffness is extremely rare.

Presentation of case

We report the case of a 28 yr old male who presented with elbow stiffness which occurred within one year without prior history of trauma or infection. The patient had decrease in range of motion together with progressive worsening pain that forced him to seek medical attention.

Discussion

There is no standard treatment for melorheostosis, and management plans must be made on an individual patient basis. The aims of treatment are pain relief and maintaining function.

Conclusion

Debridement arthroplasty is safe and effective in treating elbow stiffness associated with Melorheostosis.

Melorheostosis of the thumb and trapezium bone

Melorheostosis of the hand is rare. We report a 28-year-old woman with persistent pain associated with a slowly growing mass on the dorsum of the right thumb. The radiographs, computed tomography, and magnetic resonance imaging were used to examine characteristic of melorheostosis involving the trapezium bone, first metacarpal, and proximal phalange. The lesions underwent a surgical debulking of the hyperostotic cortex and a cortical fenestration.

Melorheostosis of the hand in a 7-year-old girl

Melorheostosis of the hand is rare. We report a 7-year-old girl who presented with a contracture of the left hand. Diagnosis was made by conventional radiography and bone scintigraphy. MRI proved to be a very useful tool to visualize the soft-tissue changes. This is especially important when surgical repair is considered.