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Another Cystic Lesion in the Calcaneus
Benign Fibrous Histiocytoma of Bone
Benign fibrous histiocytoma is a rare benign primary skeletal tumor that occurs frequently in the long bones and the pelvis. The calcaneus is an unusual location for benign fibrous histiocytoma. We did not identify any case of benign fibrous histiocytoma involving the calcaneus in the relevant literature. We describe a 22-year-old male patient with benign fibrous histiocytoma involving the calcaneus treated with curettage and bone grafting. At the final follow-up visit, 1 year after surgery, the patient was free of pain and walking unaided. We discuss the differential diagnosis of cystic lesions of the calcaneus. (J Am Podiatr Med Assoc 103(2): 141–144, 2013)
Pure open dislocation of the ankle, or dislocation not accompanied by rupture of the tibiofibular syndesmosis ligaments or fractures of the malleoli or of the posterior border of the tibia, is an extremely rare injury. A 62-year-old man injured his right ankle in a motor vehicle accident. Besides posterolateral ankle dislocation, there was a 7-cm transverse skin cut on the medial malleolus, and the distal end of the tibia was exposed. After reduction, we made a 2- to 2.5-cm longitudinal incision on the lateral malleolus; the distal fibular fracture was exposed. Two Kirschner wires were placed intramedullary in a retrograde manner, and the fracture was stabilized. The deltoid ligament and the medial capsule were repaired. The tibiofibular syndesmosis ligaments were intact. At the end of postoperative year 1, right ankle joint range of motion had a limit of approximately 5° in dorsiflexion, 10° in plantarflexion, 5° in inversion, and 0° in eversion. The joint appeared normal on radiographs, with no signs of osteoarthritis or calcification. The best result can be obtained with early reduction, debridement, medial capsule and deltoid ligament restoration, and early rehabilitation. Clinical and radiographic features at long-term follow-up also confirm good mobility of the ankle without degenerative change or mechanical instability. (J Am Podiatr Med Assoc 98(6): 469–472, 2008)
Malignant fibrous histiocytoma of bone is the osseous counterpart of the tumor in soft tissue. It is a rare primary bone tumor, and there have been conflicting reports on its grades of malignancy. The appendicular skeleton, especially the femur, is the most common site of involvement, whereas the calcaneus is rarely involved. We describe a primary malignant fibrous histiocytoma of the calcaneal bone in a 21-year-old man. The patient underwent neoadjuvant and adjuvant chemotherapy and below-the-knee amputation, and no local recurrence or metastasis was noted after 2 years of follow-up. (J Am Podiatr Med Assoc 97(3): 218–222, 2007)