PMC10266415_01
Clinical and radiographical results before and after surgery of the right distal radius and the second metacarpal bone, and pathological result. The swollen right distal radius on the dorsum lateral aspect (A). The preoperative x-ray (B); hematoxylin-eosin staining of pathological tissue showing fibrous tissue with chronic inflammation and blood clot (C); x-ray 2 weeks postoperatively (D); 5 months postoperatively (E); and complete recovery of anatomic structure at 101 months postoperatively (F). Appearance (F) and range of motion (G-I) of the right wrist at the latest follow up. White arrow indicates the locations of intraosseous hemophilic pseudotumor.
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F1
Physical examination demonstrated that the right distal radius was swollen (50 mm x 30 mm x 20 mm) with well-defined margins and smooth surface on the dorsum lateral aspect (Figure 1A), with tenderness to palpation, and no significant abnormality was observed on the epidermal surface. The x-ray presented with soap like change in the thin cortical bone and low density of medullary cavity (Figure 1B). The pathology confirmed the diagnosis of intraosseous HPs with a predominance of blood clot, scattered fibrous tissue, and mild chronic inflammation (Figure 1C). Routine x-ray follow-up was scheduled at 2 weeks (Figure 1D), 5 months (Figure 1E), and 101 months (Figure 1F) postoperatively. Routine clinical follow-up indicated improved ROM and pain relief of the right wrist at 5 months, and the ROM and appearance of the right wrist were almost normal without discomfort at the 101-month follow-up (Figures 1G-I).
PMC10266415_02
Clinical and radiographical results before and after surgery on the proximal phalangeal bone of left thumb, middle finger, and little finger. The fusiform eminence could be seen at the proximal phalangeal bone preoperatively (A). The preoperative x-ray (B); 2 days postoperatively (C); 7 months postoperatively (D); and 18 months postoperatively (E); white arrow indicates the locations of intraosseous hemophilic pseudotumor. The appearance of proximal phalanges (F) and the range of motion of metacarpophalangeal joints (G).
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F2
Physical examination showed that fusiform eminence could be seen at the proximal phalangeal bone of left thumb, middle finger (30 mm x 20 mm x 20 mm), and little finger (Figure 2A). X-ray showed multiple bone destruction and thin cortical bones of the left proximal phalanges with local pathological fractures (Figure 2B). X-ray on POD 2 showed a satisfactory bone graft (Figure 2C). Radiographical follow-ups was scheduled at 7 months (Figure 2D) and 18 months (Figure 2E) postoperatively, the results of which demonstrated a complete recovery of the shape and structure of proximal phalanges. Additionally, the last clinical follow-up at 18 months after the operation displayed a satisfactory shape (Figure 2F) and functional outcomes (Figure 2G).