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Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_II | Pages 107 - 107
1 Apr 2005
Mtaomi M Mssedi M Dehmen J Hamida RB Frikha R Moula T
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Purpose: Echinococciasis or hydatid disease is a cosmopolite anthropozoonosis common to many mammalian species including humans. The disease is caused by development of the larval form of a canine tenia called Echinococcus granulosus. Muscle localisations are rare.

Material and methods: We report eleven cases of hydatic disease of muscle, generally with a unique primary hydatid. The proximal muscles of the lower limbs were predominantly involved. Diagnosis was suggested in patients with a soft tissue tumour in an endemic context. Ultrasonography was highly contributive to diagnosis. Surgical treatment was given in all cases, ideally by prudent enucleation of the cyst associated with pericystecomy in four patients.

Results: Early outcome was favourable with the exception of a suppuration of the resection zone in one patient. At mid term, there has been one secondary muscle localisation far from the initial site. At 2.5 years follow-up, there have been no cases of local or distant recurrence.

Discussion: It is important to establish the diagnosis of hydatid disease of muscle before surgery in order to limit the risk of anaphylactic shock and dissemination in the event of accidental puncture. Exclusively surgical treatment is indicated.

Conclusion: Hydatid disease of the muscle is a rare event. Diagnosis is basically provided by ultrasonography, avoiding the risk of puncture. Exclusive surgical treatment removes the cyst without puncture.


The Journal of Bone & Joint Surgery British Volume
Vol. 66-B, Issue 4 | Pages 562 - 565
1 Aug 1984
Fowles J Kassab M Moula T

Six children with entrapment of the medial epicondyle in the elbow after closed reduction of a posterior dislocation were seen an average of 14 weeks after injury. The elbows were painful and the average range of flexion was 22 degrees. Two children had ulnar nerve involvement which recovered after operation. The epicondyle was removed from the joint and either reattached to the humerus or excised, and the muscles reattached. Two children had anterior transposition of the ulnar nerve, one for pre-operative hyperaesthesia, and the other to relieve tension on the nerve. At follow-up, at an average of 15 months after operation, flexion had increased fivefold, none of the children had pain and all were leading normal lives.