High-flow priapism after pelvic fracture

Romain Carlat (1), Renaud Destraix (4), Nicolas Jacquemart (2), François Melebeck (3), Michaël Twahirwa (4), Michaël De Foy (3) Published in the journal : October 2023 Category : Chirurgie orthopédique

Priapism is an erectile dysfunction characterized by partial or complete penile erection lasting more than four hours without any sexual stimulation. Its incidence is estimated at 0.5-0.9 cases per 100,000 people per year. Ischemic priapism, which is more frequent and painful, is induced by the paralysis of the cavernous smooth muscle, which can no longer contract, allowing hypoxic blood to stagnate within the sinusoidal spaces. Arterial priapism, rare (5% of priapism) and typically painless, generally results from direct perineal trauma responsible for an arterio-cavernous fistula. In this case report, we discuss the multidisciplinary management of a 31-year-old patient, polytraumatized after a high-velocity motorcycle accident. He presented with a pelvic fracture osteosynthesized with a plate and screws. Following surgery, the patient developed post-traumatic high-flow priapism, which was managed by interventional radiology.

Read more

Myositis ossificans circumscripta: from diagnosis to treatment

Pauline Despontin, Nanni Allington (1) Published in the journal : May 2023 Category : Chirurgie orthopédique

Non-tumoral heterotopic bone proliferation within soft tissues, and more specifically in striated skeletal muscles, is known as myositis ossificans.

The most frequently encountered form is the acquired form which is benign and often trauma-related, but can also appear without any trigger. It develops through three stages (acute, subacute, and mature). Diagnosis can be difficult, especially during the acute phase where the clinical presentation can mimic other pathologies, such as muscle abscess or sarcoma. It is important to identify the disease at this stage, as it avoids unnecessary recourse to biopsy. When mature, myositis ossificans has a well-defined appearance, hence the name myositis ossificans circumscripta. In all cases, the diagnosis will require imaging exams. The pathophysiological mechanism of myositis ossificans has not yet been fully elucidated, but there are several theories.

This article illustrates the diagnosis and management of acquired and circumscribed myositis ossificans on the basis of a clinical case.

Read more