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It is well known that clinical assessment of the metastatic status of the cervical lymph nodes in patients with squamous cell carcinoma of the upper aerodigestive tract is frequently inaccurate, and several causes for false-positive assessments are well described. We report a novel cause, namely, a case of myositis ossificans traumatica of the sternocleidomastoid muscle, which presented as a neck mass after a direct laryngoscopy for biopsy of a laryngeal squamous cell carcinoma. The importance of this lesion is that it should be considered in the clinical differential diagnosis of swellings in the neck.
The aim of this study was to analyse the management of Gartland type III supracondylar humerus fractures in children older than 10 years at our paediatric orthopaedics and to determine the clinical and radiographic long-term effects following open reduction by the small medial approach and cross-fixation with three kirschner wires. Eighty-three cases of Gartland type III supracondylar humerus fractures in children older than 10 years were treated by open reduction by the small medial approach and cross-fixation with three kirschner wires from January 2010 to December 2015. All patients were followed up from 12 to 15 months (mean: 13 months). Assessments after 1 year included neurovascular examination, Flynn's criteria (elbow function and carrying angle), pain and complications (infections, growth disturbances or iatrogenic nerve injuries). All fractures healed within 2 months. According to Flynn's criteria, 80 (96.4%) patients achieved satisfactory outcomes, whereas three (3.6%) were graded as unsatisfactory because of limited elbow motion. The mean carrying angle measured 9.4° (1°-16°) compared with 10.8° on the contralateral side (5°-16°). No case of cubitus varus was noted. No wound infection and displacement of bone fracture occurred. No case of iatrogenic ulnar nerve injury and vascular deficits was noted. There were no cases of myositis ossificans or Volkmann's ischaemic contracture. It is safe and effective to treat Gartland type III paediatric supracondylar humerus fractures in older children with open reduction by the medial approach and crossed K-wires fixation.
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